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Chronic rhinosinusitis: pathogenesis, therapy options, and more.

Umut Can Kucuksezer1, Cevdet Ozdemir2,3, Mubeccel Akdis4,5

  • 1a Department of Immunology, Aziz Sancar Institute of Experimental Medicine , Istanbul University , Istanbul , Turkey.

Expert Opinion on Pharmacotherapy
|October 23, 2018
PubMed
Summary

Chronic rhinosinusitis (CRS) involves nasal cavity and sinus inflammation. Understanding immune pathogenesis and subtypes is key for developing personalized treatments for this condition.

Keywords:
Allergen specific immunotherapyallergybiomarkerchronic rhinosinusitisendotypingnasal polypspathogenesis

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Area of Science:

  • Immunology
  • Otolaryngology

Background:

  • Chronic rhinosinusitis (CRS) is defined as inflammation of the nasal cavity and paranasal sinuses lasting over 12 weeks.
  • CRS pathogenesis is complex, involving innate and adaptive immunity, genetic predispositions, environmental influences, and the microbiome.
  • CRS is clinically classified based on the presence or absence of nasal polyps, with CRS with nasal polyps sharing molecular similarities with atopic diseases.

Purpose of the Study:

  • To review the immune pathogenesis of CRS.
  • To delineate the differences between CRS subtypes.
  • To discuss recent therapeutic advancements for personalized medicine in CRS.

Main Methods:

  • Review of recent scientific literature on CRS.
  • Analysis of immunological mechanisms underlying CRS.
  • Evaluation of current and emerging treatment strategies.

Main Results:

  • Recent research has significantly advanced the understanding of CRS pathophysiology, natural history, and treatment.
  • Disease endotyping and the introduction of novel therapeutic agents represent key advancements.
  • Prior studies lacking endotyping demonstrated inefficiencies with certain treatments.

Conclusions:

  • Successful CRS treatment necessitates a clear understanding of underlying pathogenesis and contributing factors.
  • Identifying biomarkers, developing personalized approaches, and utilizing disease algorithms are crucial for effective CRS therapy.
  • Personalized medicine holds promise for improving treatment outcomes in chronic rhinosinusitis.