Chronic rhinosinusitis in Asia.

Area of Science:

• Immunology
• Otolaryngology
• Epidemiology

Background:

• Chronic rhinosinusitis (CRS) presents a significant global health burden, often proving challenging to treat.
• Distinct inflammatory signatures characterize CRS worldwide, with notable differences between Asian and Western populations.

Purpose of the Study:

• To investigate the varying inflammatory profiles of chronic rhinosinusitis (CRS) globally.
• To examine the prevalence and implications of the
• eosinophilic shift
• in Asian patients with CRS.

Main Methods:

• Comparative analysis of inflammatory signatures in CRS patients across different continents.
• Review of existing research on CRS epidemiology and treatment outcomes in Asia versus Western countries.

Main Results:

• Asian CRS patients exhibit a more neutrophilic inflammatory profile compared to European and North American counterparts.
• The prevalence of type 2 inflammation in nasal polyps is lower in parts of Asia (20-60%) versus the West (~80%).
• A significant "eosinophilic shift" towards type 2 inflammation is observed in several Asian countries over the past two decades.

Conclusions:

• Understanding regional inflammatory differences in CRS is crucial for effective treatment selection, including pharmacotherapy, surgery, and biotherapy.
• The observed "eosinophilic shift" in Asia necessitates further research into its causes and pathophysiological mechanisms to optimize patient care.