ENT Private Practice, 29 Voreiou Ipeirou str, Athens, Greece.
Embiodiagnostics Biology Research Company, Melissinon and Damvergidon str, Heraklion, Crete, Greece.
Curr Allergy Asthma Rep. 2019 Feb 22;19(2):12. doi: 10.1007/s11882-019-0850-x.
Our scope is the presentation of research and clinical progresses in relation to precision medicine that are expected to alter our clinical practice in relation to chronic rhinosinusitis (CRS). Current knowledge on phenotypes and endotypes, biomarkers, and clinical markers for diagnosis, medical and surgical therapy, and prognosis is presented as well as the role of precision medicine in United Airway Disease and SCUAD (severe-uncontrolled chronic upper airway inflammation).
Current technological progresses, mostly in relation to molecular biology and information technology, have permitted more detailed pathophysiological assessments and multidimensional approaches in airways diseases. Based on the concept of united airways diseases, new classification schemes, called endotypes, have been proposed for CRS. In addition, novel biological treatments that have been introduced for the treatment of asthma show great promise as well for severe uncontrolled cases of CRS with nasal polyps. Central to this approach are new biomarkers that are being examined in relation to complex bio-clinical traits of CRS. As this narrative review of the aforementioned precision medicine initiatives in relation to CRS advances, a modification of current practice is expected not only for severe chronic upper airways diseases in tertiary centers but also for milder and more common cases that are being encountered in the community.
本文旨在介绍精准医学领域的研究和临床进展，这些进展有望改变我们在慢性鼻-鼻窦炎（CRS）方面的临床实践。本文还介绍了表型和内型、生物标志物和临床标志物在诊断、药物和手术治疗以及预后方面的应用，以及精准医学在联合气道疾病和 SCUAD（严重、控制不佳的慢性上气道炎症）中的作用。
当前的技术进步，主要涉及分子生物学和信息技术，使得我们能够对气道疾病进行更详细的病理生理学评估和多维研究。基于联合气道疾病的概念，为 CRS 提出了新的分类方案，称为内型。此外，新型生物疗法已被引入哮喘治疗，对于伴有鼻息肉的严重、控制不佳的 CRS 也显示出巨大的应用前景。该方法的核心是正在研究与 CRS 复杂临床特征相关的新型生物标志物。随着对上述与 CRS 相关的精准医学计划的叙述性综述的推进，预计不仅在三级中心的严重慢性上气道疾病中，而且在社区中遇到的更常见的轻度疾病中，当前的治疗方法都将得到改变。
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