Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands.
Curr Allergy Asthma Rep. 2018 Mar 24;18(4):25. doi: 10.1007/s11882-018-0776-8.
Chronic rhinosinusitis is a disease with high prevalence, significant impact on health-related quality of life (HRQoL) and it is associated with substantial healthcare and productivity costs. We face an urgent need to improve the level of disease control and achieve higher patient satisfaction and disease prevention. Precision medicine is increasingly recognized as the way forward in optimal patient care. The combination of personalized care, prevention of disease, prediction of success of treatment, and participation of the patient in the elaboration of the treatment plan is expected to guarantee the best possible therapeutic approach for individuals suffering from a chronic disabling condition.
This is a narrative review on the current state of endotypes, biomarkers, and targeted treatments in chronic inflammatory conditions of the nose and paranasal sinuses. Different phenotypes of rhinitis and chronic rhinosinusitis (CRS) have been described based on symptom severity and duration, atopy status, level of control, comorbidities, and presence or absence of nasal polyps in CRS. The underlying pathophysiological mechanisms are diverse, with different endotypes being recognized. Novel emerging therapies are targeting specific pathophysiological pathways or endotypes. This endotype-driven treatment approach requires careful selection of the patient population who might benefit from a specific treatment. This review provides a comprehensive overview of the current state of endotypes, biomarkers and targeted treatments in chronic inflammatory conditions of the nose and paranasal sinuses.
慢性鼻-鼻窦炎是一种发病率高、对健康相关生活质量（HRQoL）有显著影响的疾病，它与大量的医疗保健和生产力成本有关。我们迫切需要提高疾病控制水平，提高患者满意度和疾病预防水平。精准医学越来越被认为是优化患者护理的未来方向。个性化护理、疾病预防、治疗效果预测以及患者参与治疗方案的制定的结合有望保证患有慢性致残性疾病的个体获得最佳的治疗方法。
这是一篇关于鼻腔和鼻窦慢性炎症的内型、生物标志物和靶向治疗的现状的叙述性综述。基于症状严重程度和持续时间、特应性状态、控制水平、合并症以及慢性鼻-鼻窦炎（CRS）中是否存在鼻息肉，已经描述了不同的鼻炎和慢性鼻-鼻窦炎（CRS）表型。潜在的病理生理机制是多种多样的，已经认识到不同的内型。新型新兴疗法针对特定的病理生理途径或内型。这种基于内型的治疗方法需要仔细选择可能受益于特定治疗的患者人群。本综述全面概述了鼻腔和鼻窦慢性炎症的内型、生物标志物和靶向治疗的现状。
