Kato Atsushi, Kita Hirohito
Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Nat Rev Immunol. 2025 Apr 16. doi: 10.1038/s41577-025-01159-0.
Asthma and chronic rhinosinusitis (CRS) are common chronic inflammatory diseases of the respiratory tract that have increased in prevalence over the past five decades. The clinical relationship between asthma and CRS has been well recognized, suggesting a common pathogenesis between these diseases. Both diseases are driven by complex airway epithelial cell and immune cell interactions that occur in response to environmental triggers such as allergens, microorganisms and irritants. Advances, including a growing understanding of the biology of the cells involved in the disease, the application of multiomics technologies and the performance of large-scale clinical studies, have led to a better understanding of the pathophysiology and heterogeneity of asthma and CRS. This research has promoted the concept that these diseases consist of several endotypes, in which airway epithelial cells, innate lymphoid cells, T cells, B cells, granulocytes and their mediators are distinctly involved in the immunopathology. Identification of the disease heterogeneity and immunological markers has also greatly improved the protocols for biologic therapies and the clinical outcomes in certain subsets of patients. However, many clinical and research questions remain. In this Review, we discuss recent advances in characterizing the immunological mechanisms of asthma and CRS, with a focus on the main cell types and molecules involved in these diseases.
哮喘和慢性鼻-鼻窦炎（CRS）是常见的慢性呼吸道炎症性疾病，在过去五十年中患病率有所上升。哮喘与CRS之间的临床关系已得到充分认识，提示这两种疾病存在共同的发病机制。这两种疾病均由复杂的气道上皮细胞和免疫细胞相互作用驱动，这些相互作用是对环境触发因素（如过敏原、微生物和刺激物）作出的反应。包括对参与疾病的细胞生物学的深入了解、多组学技术的应用以及大规模临床研究的开展等进展，使人们对哮喘和CRS的病理生理学及异质性有了更好的认识。这项研究推动了这样一种概念，即这些疾病由几种内型组成，其中气道上皮细胞、固有淋巴细胞、T细胞、B细胞、粒细胞及其介质明显参与免疫病理学过程。疾病异质性和免疫标志物的识别也极大地改进了生物治疗方案以及某些患者亚组的临床结局。然而，许多临床和研究问题仍然存在。在本综述中，我们讨论了在表征哮喘和CRS免疫机制方面的最新进展，重点关注参与这些疾病的主要细胞类型和分子。
