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Endotype-driven care pathways in patients with chronic rhinosinusitis
Claus Bachert1, Nan Zhang2, Peter W Hellings3
1Upper Airways Research Laboratory and Department of Oto-Rhino-Laryngology, Ghent University and Ghent University Hospital, Ghent, Belgium; Division of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, Sweden.
The Journal of Allergy and Clinical Immunology
|May 8, 2018
Summary
Chronic rhinosinusitis (CRS) management is advancing with endotype-based approaches. Personalized treatments, including biologics targeting type 2 cytokines, are showing promise for improved patient outcomes.
Area of Science:
- Otolaryngology
- Immunology
- Pharmacology
Background:
- Chronic rhinosinusitis (CRS) is clinically classified into forms with and without nasal polyps.
- Current treatments include glucocorticosteroids, antibiotics, and surgery based on imaging.
- Limitations in predicting prognosis and guiding personalized therapy exist.
Purpose of the Study:
- To explore the potential of endotype-based classification for CRS management.
- To highlight advancements in personalized pharmacotherapy and surgical strategies.
- To introduce novel biologic treatments targeting specific immune pathways.
Main Methods:
- Clinical differentiation of CRS into phenotypes.
- Endotyping based on underlying pathomechanisms and immune responses.
- Review of current and emerging treatment modalities, including biologics.
Main Results:
- Endotype identification offers improved prognosis prediction and risk assessment.
- Biologics targeting type 2 cytokines (IL-4, IL-5, IL-13) and IgE show promising early-phase study results.
- Surgical approaches are evolving towards mucosal replacement strategies.
Conclusions:
- Endotype-driven approaches are crucial for personalized CRS management.
- Innovative treatments like biologics represent a significant advancement.
- Integrated care pathways are needed to incorporate these innovations effectively.
Keywords:
Chronic rhinosinusitisbiologicsendotypesintegrated care pathwaysnasal polypspharmacotherapysurgerytype 2 inflammationMore Related Videos
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