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Endotypes of chronic rhinosinusitis.
Jonathan Yip1, Eric Monteiro2, Yvonne Chan3
1Department of Otolaryngology - Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Current Opinion in Otolaryngology & Head and Neck Surgery
|December 4, 2018
Summary
Chronic rhinosinusitis (CRS) endotyping classifies disease variants by pathophysiology. This approach may guide personalized biologic therapies for recalcitrant CRS, though endotypes require further characterization.
Area of Science:
- Immunology
- Otolaryngology
- Pharmacology
Background:
- Chronic rhinosinusitis (CRS) classification is shifting from phenotypic to endotypic approaches.
- Endotyping CRS based on pathophysiologic mechanisms aids in predicting disease progression and identifying therapeutic targets.
- Understanding CRS endotypes is crucial for developing personalized pharmacotherapies, especially with the advent of biologic agents.
Purpose of the Study:
- To review the pathophysiology and endotypes of CRS.
- To highlight biologic therapies targeting CRS mediators.
- To explore the potential of endotyping for personalized treatment of recalcitrant CRS.
Main Methods:
- Review of current literature on CRS pathophysiology and endotyping.
- Analysis of immune response pathways (Type 1, 2, 3) implicated in CRS.
- Examination of cluster analysis approaches for CRS endotype definition.
Main Results:
- CRS involves dysregulated immune responses with contributions from innate lymphoid cells, CD4 T helper cells, and CD8+ cytotoxic T cells.
- Proposed CRS endotypes are based on immune response deviations into Type 1, 2, and 3.
- Biologics targeting cytokines, immunoglobulin E, and inflammatory mediators are under investigation for CRS treatment.
Conclusions:
- Significant progress has been made in understanding CRS pathomechanisms.
- Further research is needed for the complete characterization of CRS endotypes.
- Endotyping CRS holds promise for targeted biologic therapies.
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