Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\25838086
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Allergol+Int
2015 ; 64
(2
): 121-30
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Immunopathology of chronic rhinosinusitis
#MMPMID25838086
Kato A
Allergol Int
2015[Apr]; 64
(2
): 121-30
PMID25838086
show ga
Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by local
inflammation of the upper airways and sinuses which persists for at least 12
weeks. CRS can be divided into two phenotypes dependent on the presence of nasal
polyps (NPs); CRS with NPs (CRSwNP) and CRS without NPs (CRSsNP). Immunological
patterns in the two diseases are known to be different. Inflammation in CRSsNP is
rarely investigated and limited studies show that CRSsNP is characterized by type
1 inflammation. Inflammation in CRSwNP is well investigated and CRSwNP in Western
countries shows type 2 inflammation and eosinophilia in NPs. In contrast, mixed
inflammatory patterns are found in CRSwNP in Asia and the ratio of eosinophilic
NPs and non-eosinophilic NPs is almost 50:50 in these countries. Inflammation in
eosinophilic NPs is mainly controlled by type 2 cytokines, IL-5 and IL-13, which
can be produced from several immune cells including Th2 cells, mast cells and
group 2 innate lymphoid cells (ILC2s) that are all elevated in eosinophilic NPs.
IL-5 strongly induces eosinophilia. IL-13 activates macrophages, B cells and
epithelial cells to induce recruitment of eosinophils and Th2 cells, IgE mediated
reactions and remodeling. Epithelial derived cytokines, TSLP, IL-33 and IL-1 can
directly and indirectly control type 2 cytokine production from these cells in
eosinophilic NPs. Recent clinical trials showed the beneficial effect on
eosinophilic NPs and/or asthma by monoclonal antibodies against IL-5, IL-4R?, IgE
and TSLP suggesting that they can be therapeutic targets for eosinophilic CRSwNP.