Upper Airways Research Laboratory, Faculty of Medicine, Ghent University, Ghent, Belgium.
Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
J Allergy Clin Immunol. 2021 Aug;148(2):327-335. doi: 10.1016/j.jaci.2021.03.024. Epub 2021 Apr 21.
Chronic rhinosinusitis (CRS) often is characterized by an eosinophilic inflammatory pattern, nowadays referred to as type 2 inflammation, although the mucosal inflammation is dominated by neutrophils in about a third of the patients. Neutrophils are typically predominant in 50% of patients with CRS without nasal polyps, but also are found to play a role in patients with severe type 2 CRS with nasal polyp disease. This review aims at summarizing the current understanding of the eosinophilic and neutrophilic inflammation in CRS pathophysiology, and provides a discussion of their reciprocal interactions and the clinical impact of the mixed presentation in patients with severe type 2 CRS with nasal polyps. A solid understanding of these interactions is of utmost importance when treating uncontrolled severe CRS with nasal polyps with biologicals that are preferentially directed toward type 2 inflammation. We here focus on recent findings on both eosinophilic and neutrophilic granulocytes, their subgroups and the activation status, and their interactions in CRS.
慢性鼻-鼻窦炎（CRS）常表现为嗜酸性炎症模式，如今被称为 2 型炎症，尽管大约三分之一的患者的黏膜炎症以中性粒细胞为主。中性粒细胞通常在无鼻息肉的 CRS 患者中占 50%，但也在严重 2 型 CRS 伴鼻息肉病患者中发挥作用。本综述旨在总结 CRS 病理生理学中嗜酸性和中性粒细胞炎症的当前认识，并讨论它们的相互作用以及严重 2 型 CRS 伴鼻息肉患者中混合表现的临床影响。当使用主要针对 2 型炎症的生物制剂治疗伴有鼻息肉的未控制的严重 CRS 时，对这些相互作用有深入的了解至关重要。我们在此重点关注最近关于嗜酸性粒细胞和中性粒细胞、它们的亚群和激活状态及其在 CRS 中的相互作用的发现。
