Demirdag Yesim Y, Ramadan Hassan H
aDivision of Allergy, Immunology and Rheumatology, Department of Pediatrics, Columbia University Medical Center, New York City, New York bDepartment of Otolaryngology Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA.
Curr Opin Allergy Clin Immunol. 2016 Feb;16(1):18-23. doi: 10.1097/ACI.0000000000000237.
Chronic rhinosinusitis (CRS) is a common heterogenous multifactorial disorder affecting children and adults. The exact mechanism is not completely understood. In this review, we aim to summarize our recent findings regarding etiologies and pathogenesis of CRS in children and review recent studies investigating inflammatory patterns in the upper airways in children and adults with CRS.
There are only a few small studies measuring upper airway inflammation in children with CRS. These studies demonstrated more toward eosinophilic and T-cell driven inflammatory pattern. Cytokine patterns in upper airways seem to correlate with asthma symptoms in children with CRS. Adult studies demonstrate eosinophilic and Th-2 (T helper-1) driven inflammation in CRS with nasal polyps and Th-1 (T helper-2) driven inflammation in CRS without nasal polyps.
Current knowledge about the characteristics of tissue inflammation in upper airways in children with CRS is limited. More studies are needed to better understand the pathogenesis and better define the subgroups of CRS. The findings of such studies will lead to identifying the biological targets to treat this condition.
慢性鼻-鼻窦炎（CRS）是一种影响儿童和成人的常见异质性多因素疾病。确切机制尚未完全明确。在本综述中，我们旨在总结关于儿童CRS病因和发病机制的最新研究结果，并回顾近期关于CRS儿童和成人上呼吸道炎症模式的研究。
仅有少数小型研究测量了CRS儿童的上呼吸道炎症。这些研究显示出更多嗜酸性粒细胞和T细胞驱动的炎症模式。CRS儿童上呼吸道中的细胞因子模式似乎与哮喘症状相关。成人研究表明，有鼻息肉的CRS患者存在嗜酸性粒细胞和Th-2（辅助性T细胞1）驱动的炎症，无鼻息肉的CRS患者存在Th-1（辅助性T细胞2）驱动的炎症。
目前关于CRS儿童上呼吸道组织炎症特征的认识有限。需要更多研究以更好地理解发病机制并更准确地定义CRS的亚组。此类研究结果将有助于确定治疗该病的生物学靶点。
