基于表型的慢性鼻-鼻窦炎气道重塑机制的研究进展:综述。
Advances in the Knowledge of the Underlying Airway Remodeling Mechanisms in Chronic Rhinosinusitis Based on the Endotypes: A Review.
机构信息
Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea.
出版信息
Int J Mol Sci. 2021 Jan 18;22(2):910. doi: 10.3390/ijms22020910.
Chronic rhinosinusitis (CRS) is a chronic inflammatory condition of the nasal and paranasal sinus mucosa that affects up to 10% of the population worldwide. CRS is the most representative disease of the upper respiratory tract where airway remodeling occurs, including epithelial damage, thickening of the basement membrane, fibrosis, goblet cell hyperplasia, subepithelial edema, and osteitis. CRS is divided into two phenotypes according to the presence or absence of nasal polyps: CRS with nasal polyp (CRSwNP) and CRS without nasal polyps (CRSsNP). Based on the underlying pathophysiologic mechanism, CRS is also classified as eosinophilic CRS and non-eosinophilic CRS, owing to Type 2 T helper (Th2)-based inflammation and Type 1 T helper (Th1)/Type 17 T helper (Th17) skewed immune response, respectively. Differences in tissue remodeling in CRS are suggested to be based on the clinical phenotype and endotypes; this is because fibrosis is prominent in CRSsNP, whereas edematous changes occur in CRSwNP, especially in the eosinophilic type. This review aims to summarize the latest information on the different mechanisms of airway remodeling in CRS according to distinct endotypes.
慢性鼻-鼻窦炎(CRS)是一种影响全球多达 10%人群的鼻腔和鼻旁窦黏膜的慢性炎症性疾病。CRS 是发生气道重塑的上呼吸道最具代表性的疾病,包括上皮损伤、基底膜增厚、纤维化、杯状细胞增生、黏膜下水肿和骨炎。根据是否存在鼻息肉,CRS 分为两种表型:伴有鼻息肉的 CRS(CRSwNP)和不伴有鼻息肉的 CRS(CRSsNP)。基于潜在的病理生理机制,CRS 还分为嗜酸性 CRS 和非嗜酸性 CRS,分别归因于基于 2 型 T 辅助(Th2)的炎症和 1 型 T 辅助(Th1)/17 型 T 辅助(Th17)偏向的免疫反应。CRS 中组织重塑的差异可能基于临床表型和内型;这是因为 CRSsNP 中纤维化明显,而 CRSwNP 中出现水肿变化,特别是在嗜酸性类型中。本综述旨在根据不同的内型总结 CRS 中气道重塑不同机制的最新信息。
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