Lane Andrew P
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine Outpatient Center, Sixth Floor, 601 North Caroline Street, Baltimore, MD 21287-0910, USA.
Curr Allergy Asthma Rep. 2009 May;9(3):205-12. doi: 10.1007/s11882-009-0030-5.
Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory condition with a multifactorial basis. Infectious triggers of CRS have been proposed, but demonstration remains elusive. Evolving research suggests that abnormal host mucosal immune responses, rather than specific pathogens themselves, may underlie the chronic inflammatory state. Despite constant contact with airborne particulates and microorganisms, the sinonasal epithelium maintains mucosal homeostasis through innate and adaptive immune mechanisms that eliminate potential threats. Innate immunity encompasses a broad collection of constitutive and inducible processes that can be nonspecific or pathogen directed. Some innate immune pathways are closely intertwined with tissue growth and repair. The persistent inflammation observed in CRS may result from a pathologic imbalance in innate immune interactions between the host and the environment. Impairment of critical innate immune protection renders the sinonasal mucosal surface susceptible to colonization and potential injury, stimulating the prominent adaptive immune response that characterizes CRS.
慢性鼻-鼻窦炎(CRS)是一种具有多因素基础的异质性炎症性疾病。虽然有人提出CRS存在感染性触发因素,但仍难以证实。不断发展的研究表明,慢性炎症状态的基础可能是宿主黏膜免疫反应异常,而非特定病原体本身。尽管鼻窦上皮持续接触空气传播的颗粒物和微生物,但它通过先天性和适应性免疫机制维持黏膜内环境稳定,从而消除潜在威胁。先天性免疫包括一系列广泛的组成性和诱导性过程,这些过程可以是非特异性的,也可以是针对病原体的。一些先天性免疫途径与组织生长和修复密切相关。CRS中观察到的持续性炎症可能源于宿主与环境之间先天性免疫相互作用的病理失衡。关键先天性免疫保护功能的受损使鼻窦黏膜表面易于定植和受到潜在损伤,从而激发了CRS特有的显著适应性免疫反应。