Fakhri Samer, Frenkiel Saul, Hamid Qutayba A
Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec.
J Otolaryngol. 2002 Aug;31 Suppl 1:S2-9. doi: 10.2310/7070.2002.21307.
The development of chronic sinusitis is a multifactorial process primarily related to allergen exposure, genetic predisposition, and persistent infections. Like allergic rhinitis, the inflammatory substrate in chronic sinusitis is highlighted by the abundance of mononuclear inflammatory cells, eosinophils, and T helper type 2 (Th2) cytokines. Corticosteroids are the most potent agents available for relieving the symptoms of chronic sinusitis, and they act by inhibiting the synthesis of Th2 cytokines and other inflammatory mediators. The mechanisms of corticosteroid insensitivity in chronic sinusitis and other inflammatory conditions are poorly understood. Microbial products and abnormalities in cytokine expression and corticosteroid receptors have been suggested as potential mechanisms of corticosteroid resistance. The purpose of this article is to review our current knowledge of the pathogenesis of chronic sinusitis and highlight recent advances in the molecular biology of the inflammatory process underlying this condition. The issue of corticosteroid insensitivity in chronic sinusitis will also be addressed.
慢性鼻窦炎的发展是一个多因素过程，主要与过敏原暴露、遗传易感性和持续性感染有关。与变应性鼻炎一样，慢性鼻窦炎中的炎症基质以大量单核炎性细胞、嗜酸性粒细胞和2型辅助性T（Th2）细胞因子为特征。皮质类固醇是可用于缓解慢性鼻窦炎症状的最有效药物，它们通过抑制Th2细胞因子和其他炎症介质的合成发挥作用。慢性鼻窦炎和其他炎症性疾病中皮质类固醇不敏感的机制尚不清楚。微生物产物以及细胞因子表达和皮质类固醇受体的异常已被认为是皮质类固醇抵抗的潜在机制。本文的目的是回顾我们目前对慢性鼻窦炎发病机制的认识，并强调该疾病潜在炎症过程分子生物学的最新进展。慢性鼻窦炎中皮质类固醇不敏感的问题也将得到探讨。
