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Endotype-driven precision medicine in chronic rhinosinusitis.
Hongfei Lou1, Chengshuo Wang1, Luo Zhang1,2,3
1Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
Expert Review of Clinical Immunology
|October 11, 2019
Summary
Precision medicine advances chronic rhinosinusitis (CRS) care by identifying endotypes. Type 2 inflammation biomarkers predict treatment response in CRS with nasal polyps (CRSwNP), guiding personalized therapies.
Area of Science:
- Immunology
- Otolaryngology
- Precision Medicine
Background:
- Chronic rhinosinusitis (CRS) presents diverse phenotypes and endotypes, complicating treatment.
- Current therapies are often insufficient, necessitating personalized approaches based on disease mechanisms.
Purpose of the Study:
- To provide a comprehensive overview of CRS phenotypes and endotypes.
- To explore the role of biomarkers in guiding personalized treatment strategies for CRS.
- To review the efficacy of targeted biologics for specific CRS endotypes, particularly CRSwNP.
Main Methods:
- Literature review of CRS phenotypes, endotypes, and biomarkers.
- Analysis of clinical trial data for type 2-targeting biologics in CRSwNP.
- Discussion of geographic and ethnic variations in CRS endotype distribution.
Main Results:
- Biomarkers can predict prognosis and guide personalized pharmacotherapy, surgery, and innovative treatments for CRS.
- Type 2-targeting biologics show efficacy in clinical trials for CRS with nasal polyps (CRSwNP).
- Understanding of type 2 inflammation in CRS is advanced, with good predictive biomarkers for corticosteroid responsiveness.
Conclusions:
- Endotype-driven integrated care offers a promising approach for managing CRS.
- Identifying patient subsets and biomarkers is crucial for optimizing biotherapeutic strategies.
- Further research is needed for non-type 2 inflammation treatments and biologic safety in routine use.
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