Epithelial-Mesenchymal Transition in Chronic Rhinosinusitis.

Area of Science:

• Immunology
• Cell Biology
• Otorhinolaryngology

Background:

• Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the nasal and sinus mucosa exceeding 12 weeks.
• CRS is classified by polyp presence (with or without) and inflammatory endotypes (Type 1, 2, 3), impacting disease severity and treatment.
• Epithelial-mesenchymal transition (EMT) is increasingly recognized as a critical factor in CRS pathogenesis.

Purpose of the Study:

• To review the complex mechanisms of EMT in CRS.
• To highlight the role of epithelial barrier dysfunction in driving CRS development and progression.
• To identify potential therapeutic targets for restoring epithelial integrity and reversing EMT in CRS.

Main Methods:

• Review of recent studies on EMT mechanisms in CRS.
• Analysis of signaling pathways involved in EMT induction and progression.
• Focus on epithelial barrier integrity and its role in disease pathogenesis.

Main Results:

• CRS involves epithelial barrier disruption, triggering repair processes that activate EMT.
• EMT induction in CRS is mediated by factors like infections, allergens, hypoxia, and pollutants.
• Key signaling pathways (TGF-β, Wnt, HMGB1, AGE/ERK, TNF-α) and downstream effectors (Smad2/3, GSK-3β/β-catenin, RAGE, NF-κB) regulate EMT in CRS.

Conclusions:

• Epithelial barrier dysfunction and subsequent EMT are central to CRS development and progression.
• Understanding EMT mechanisms is crucial for developing targeted therapies.
• Restoring epithelial integrity and reversing EMT represent promising therapeutic strategies for CRS.