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Polyps, asthma, and allergy: what's new.
Dimitrios Terzakis1, Christos Georgalas
1aDepartment of Otorhinolaryngology, Henry Dunant Hospital, Athens bEndoscopic Skull Base Center, Hygeia Hospital, Marousi, Greece cCenter for Skull Base Patients, Leiden University Medical Center, Leiden, The Netherlands.
Current Opinion in Otolaryngology & Head and Neck Surgery
|November 17, 2016
Summary
New research explores the immunology linking chronic rhinosinusitis with nasal polyps, asthma, and allergy. Targeted therapies and early surgical intervention show promise for managing these complex airway diseases.
Area of Science:
- Immunology
- Otolaryngology
- Allergy
Background:
- Chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and allergy share common inflammatory pathways.
- The exact cause-and-effect relationship between these conditions remains unclear.
- Understanding the complex immunology is crucial for effective management.
Purpose of the Study:
- To review new studies on the immunology linking CRSwNP, asthma, and allergy.
- To highlight advances in new therapies for these conditions.
- To discuss surgical indications and timing, particularly for complex cases.
Main Methods:
- Review of recent scientific literature.
- Endotyping patients to identify specific inflammatory profiles.
- Analysis of cytokine roles and novel monoclonal antibody (mAb) therapies.
Main Results:
- T2 inflammation is amplified by specific cytokines, potentially involving innate lymphoid cells.
- New mAbs targeting these cytokines show potential for reducing asthma severity and improving sinonasal outcomes.
- Early surgical intervention improves SNOT-22 outcomes and may reduce postoperative asthma incidence in refractory cases.
Conclusions:
- Current data can improve the management of refractory cases of asthma and polyps.
- A patient-centered, multidisciplinary approach is essential for managing these interconnected airway diseases.
- Integrating medical and surgical strategies is key for optimal patient outcomes.
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