Nguyen Lily H P, Fakhri Samer, Frenkiel Saul, Hamid Qutayba A
Meakins-Christie Laboratories, McGill University, 3626 St. Urbain Street, Montreal, Quebec, Canada H2X 2P2.
Curr Allergy Asthma Rep. 2003 Nov;3(6):505-12. doi: 10.1007/s11882-003-0062-1.
The development of chronic sinusitis is a complex multifactorial process characterized by inflammation of nasal and sinus mucosa. Many studies have shown that the composition of the inflammatory substrate in chronic sinusitis is similar to that seen in allergic rhinitis and in the late-phase response to antigen challenge. Mononuclear cells, consisting of T and B lymphocytes and activated eosinophils, are prominent in the sinus mucosa of patients with chronic sinusitis, especially in atopic patients. Cellular recruitment and activation of the inflammatory infiltrate have been largely attributed to the effects of T(H)2 cytokines (namely interleukin -4, IL-5, IL-13, and granulocyte-macrophage colony-stimulating factor). Current treatment of allergic chronic sinusitis consists of nasal corticosteroids and immunotherapy. A subgroup of steroid-insensitive patients demonstrates an overexpression of a variant of the glucocorticoid receptor (GR). Despite these advances, the management and treatment of chronic sinusitis is often fraught with failures and remains a frustrating task for both physician and patient.
慢性鼻窦炎的发展是一个复杂的多因素过程，其特征为鼻腔和鼻窦黏膜的炎症。许多研究表明，慢性鼻窦炎中炎症底物的组成与变应性鼻炎及抗原激发后迟发反应中所见的相似。由T和B淋巴细胞以及活化嗜酸性粒细胞组成的单核细胞在慢性鼻窦炎患者的鼻窦黏膜中很突出，尤其是在特应性患者中。炎症浸润的细胞募集和活化很大程度上归因于辅助性T细胞2（TH2）细胞因子（即白细胞介素-4、IL-5、IL-13和粒细胞-巨噬细胞集落刺激因子）的作用。变应性慢性鼻窦炎的当前治疗包括鼻用皮质类固醇和免疫疗法。一部分对类固醇不敏感的患者表现出糖皮质激素受体（GR）变体的过表达。尽管有这些进展，慢性鼻窦炎的管理和治疗常常充满失败，对医生和患者来说仍然是一项令人沮丧的任务。
