Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otorhinolaryngology, Beijing, China.
Expert Rev Clin Immunol. 2023 Jul-Dec;19(8):949-958. doi: 10.1080/1744666X.2023.2232115. Epub 2023 Jul 4.
Chronic rhinosinusitis (CRS) is a heterogeneous disease, and its complex pathophysiological characteristics pose a challenge to its clinical treatment. CRS is distinguished not only by clinical phenotype but also by endotype characteristics, which are divided into type 2 CRS and non-type 2 CRS.
In this review, we summarize and discuss current studies that depict the mechanisms and endotypes of CRS. In particular, inflammatory cells and the microbiome play a role in the pathophysiology of CRS. We also listed some of the biomarkers described in recent studies that may serve as a theoretical foundation for additional investigations. We have summarized the advantages and disadvantages of existing treatments and listed the available biological treatments for CRS in detail.
Endotype-driven therapeutic options face many challenges because of the complexity of the disease. Glucocorticoids, nasal endoscopic surgery, and biological therapy are the main treatments used in clinical practice, but they have limitations. This review provides advice on the clinical management and treatment options for patients with different endotypes, which will be more conducive to improving the quality of life and reducing the financial burden on patients.
慢性鼻-鼻窦炎（CRS）是一种异质性疾病，其复杂的病理生理特征对其临床治疗构成挑战。CRS 不仅以临床表型为特征，还以表型特征为特征，分为 2 型 CRS 和非 2 型 CRS。
在这篇综述中，我们总结和讨论了目前描述 CRS 机制和表型的研究。炎症细胞和微生物组在 CRS 的病理生理学中起作用。我们还列出了一些最近研究中描述的生物标志物，这些标志物可能为进一步的研究提供理论基础。我们总结了现有治疗方法的优缺点，并详细列出了 CRS 的现有生物治疗方法。
由于疾病的复杂性，表型驱动的治疗选择面临许多挑战。糖皮质激素、鼻内镜手术和生物治疗是临床实践中主要的治疗方法，但它们存在局限性。本综述就不同表型患者的临床管理和治疗选择提供了建议，这将更有利于提高患者的生活质量并减轻其经济负担。
