Pheno-Endotyping Antrochoanal Nasal Polyposis

Area of Science:

• Otolaryngology
• Pathology
• Immunology

Background:

• Antrochoanal polyps (ACPs) are benign lesions originating in the maxillary sinus and extending into the choana.
• Despite advancements in diagnosis and treatment, the pathogenesis of ACPs remains poorly understood.

Purpose of the Study:

• To review current knowledge on the etiology, inflammatory parameters, and microscopic findings of ACPs.
• To define an ACP phenotype based on inflammatory and microscopic characteristics and propose potential endotypes.

Main Methods:

• Literature review of existing studies on antrochoanal polyps.
• Analysis of inflammatory patterns and microscopic features described in the literature.

Main Results:

• ACPs are characterized by a T1-dominant neutrophilic inflammation.
• Microscopic examination reveals tissue remodeling (fibrin deposition, edema) and epithelial/lamina propria cysts.
• A potential link between the T1-dominant immune response and lymphatic obstruction is hypothesized.

Conclusions:

• ACPs present a distinct inflammatory and microscopic phenotype.
• Further research is needed to elucidate the precise pathogenic mechanisms and confirm potential endotypes.