Upper Airway Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
J Allergy Clin Immunol. 2011 Oct;128(4):728-32. doi: 10.1016/j.jaci.2011.07.049. Epub 2011 Aug 24.
Chronic rhinosinusitis (CRS) is a heterogeneous group of inflammatory diseases of the nasal and paranasal cavities either accompanied by polyp formation (CRSwNP) or without polyps (CRSsNP). CRSsNP and CRSwNP are prevalent medical conditions associated with substantial impaired quality of life, reduced workplace productivity, and serious medical treatment costs. Despite recent research evidence that contributes to further unveiling the pathophysiology of these chronic airway conditions, the cause remains poorly understood and appears to be multifactorial. A diverse spectrum of alterations involving histopathology, inflammatory cell and T-cell patterns, remodeling parameters (eg, TGF-β), eicosanoid and IgE production, microorganisms, and epithelial barrier malfunctions is reported in the search to describe the pathogenesis of this heterogeneous group of upper airway diseases. Furthermore, novel evidence indicates considerable heterogeneity within the CRSwNP subgroup determining the risk of comorbid asthma. The characterization of specific disease subgroups is a challenging scientific and clinical task of utmost importance in the development of diagnostic tools and application of individualized treatments. This review focuses on recent evidence that sheds new light on our current knowledge regarding the inflammatory process of CRS to further unravel its pathogenesis.
慢性鼻-鼻窦炎（CRS）是一组鼻腔和鼻旁腔炎症性疾病，伴有或不伴有息肉形成（CRSwNP）。CRSsNP 和 CRSwNP 是常见的医疗病症，与生活质量严重受损、工作场所生产力降低以及医疗费用高昂有关。尽管最近的研究证据有助于进一步揭示这些慢性气道疾病的病理生理学，但病因仍不清楚，似乎是多因素的。在探索描述这组异质性上呼吸道疾病的发病机制时，报告了涉及组织病理学、炎症细胞和 T 细胞模式、重塑参数（例如 TGF-β）、类二十烷酸和 IgE 产生、微生物和上皮屏障功能障碍的广泛改变。此外，新的证据表明，CRSwNP 亚组内存在相当大的异质性，决定了伴发哮喘的风险。特定疾病亚组的特征描述是一项具有挑战性的科学和临床任务，对于开发诊断工具和应用个体化治疗至关重要。本综述重点介绍了最近的证据，这些证据为我们目前对 CRS 炎症过程的认识提供了新的见解，以进一步阐明其发病机制。
