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一项全面综述:探索伴鼻息肉的变应性鼻炎——机制、管理及新兴疗法

A Comprehensive Review Exploring Allergic Rhinitis With Nasal Polyps: Mechanisms, Management, and Emerging Therapies.

作者信息

Narasimhan Gowtham, Deshmukh Prasad T, Gaurkar Sagar S, Khan Farhat Q

机构信息

Otolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Apr 28;16(4):e59191. doi: 10.7759/cureus.59191. eCollection 2024 Apr.

Abstract

Allergic rhinitis (AR) and nasal polyps (NP) are common inflammatory disorders of the upper airways that often coexist and significantly impact patients' quality of life. This comprehensive review explores the intricate relationship between AR and NP, elucidating the underlying mechanisms, clinical manifestations, and management strategies. Immunological mechanisms, genetic predispositions, and environmental factors contribute to the development and progression of both conditions. Pharmacological therapies, including intranasal corticosteroids and biologic agents, are cornerstone treatments for managing AR with NP. At the same time, surgical interventions such as functional endoscopic sinus surgery (FESS) may be necessary in refractory cases. Emerging therapies, including immunomodulatory agents and precision medicine approaches, hold promise in improving treatment outcomes. A multidisciplinary approach, personalized treatment plans, and patient education are essential for optimizing clinical practice. Future research should focus on identifying novel therapeutic targets, conducting large-scale clinical trials, exploring precision medicine approaches, and investigating the role of the microbiome. Addressing these research priorities and implementing evidence-based treatment strategies can improve outcomes for patients with AR and NP.

摘要

变应性鼻炎(AR)和鼻息肉(NP)是上呼吸道常见的炎症性疾病,常同时存在,对患者的生活质量有显著影响。这篇综述探讨了AR和NP之间的复杂关系,阐明了潜在机制、临床表现和管理策略。免疫机制、遗传易感性和环境因素促成了这两种疾病的发生和发展。药物治疗,包括鼻内用糖皮质激素和生物制剂,是治疗AR合并NP的基础治疗方法。同时,在难治性病例中可能需要进行功能性鼻内镜鼻窦手术(FESS)等手术干预。包括免疫调节剂和精准医学方法在内的新兴疗法有望改善治疗效果。多学科方法、个性化治疗方案和患者教育对于优化临床实践至关重要。未来的研究应专注于确定新的治疗靶点、开展大规模临床试验、探索精准医学方法以及研究微生物群的作用。解决这些研究重点并实施循证治疗策略可改善AR和NP患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e689/11130740/52512823f94b/cureus-0016-00000059191-i01.jpg

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