Pawankar Ruby, Nonaka Manabu
Department of Otolaryngology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo 113-8603, Japan. pawankar_ruby/
Curr Allergy Asthma Rep. 2007 Jun;7(3):202-8. doi: 10.1007/s11882-007-0073-4.
Chronic rhinosinusitis (CRS) is presently classified into two subgroups: CRS without and CRS with nasal polyps. A variety of inflammatory mediators, including cytokines and chemokines, as well as adhesion molecules and matrix metalloproteinases, are upregulated in both subgroups of CRS; remodeling is also observed in both. However, there are also characteristic differences. Whereas CRS without nasal polyps has more neutrophilic infiltration, in CRS with nasal polyps (especially when associated with allergy/asthma) eosinophil infiltration is strikingly increased. Although several features of remodeling (eg, squamous metaplasia, basement membrane thickening, collagen deposition, hyperplasia of mucous glands, and goblet cells) are features seen in both subgroups of CRS, epithelial shedding as observed in asthma is not seen in either subgroup. Furthermore, pseudocyst formation seen in CRS with nasal polyps is not seen in CRS without nasal polyps.
慢性鼻-鼻窦炎（CRS）目前分为两个亚组：不伴有鼻息肉的CRS和伴有鼻息肉的CRS。在CRS的两个亚组中，多种炎症介质，包括细胞因子和趋化因子，以及黏附分子和基质金属蛋白酶均上调；在两者中均观察到重塑。然而，也存在特征性差异。不伴有鼻息肉的CRS有更多的中性粒细胞浸润，而在伴有鼻息肉的CRS中（尤其是与变应性/哮喘相关时），嗜酸性粒细胞浸润显著增加。尽管重塑的一些特征（如鳞状化生、基底膜增厚、胶原沉积、黏液腺增生和杯状细胞增生）在CRS的两个亚组中均可见，但在两个亚组中均未观察到哮喘中所见的上皮脱落。此外，伴有鼻息肉的CRS中所见的假性囊肿形成在不伴有鼻息肉的CRS中未见到。
