Chronic Rhinosinusitis without Nasal Polyps

• Published in: The journal of allergy and clinical immunology in practice (Cambridge, MA) Vol. 4; no. 4; pp. 575 - 582
• Main Authors: Cho, Seong Ho, MD, Kim, Dae Woo, MD, PhD, Gevaert, Philippe, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2016; Elsevier Limited
• Subjects: Accreditation; Age; Allergies; Allergy and Immunology; Animals; Antibiotics; Asthma; Chronic Disease; Chronic rhinosinusitis without nasal polyps; Clinical trials; Copyright; Ear diseases; Endoscopy; Endotype; Epidemiology; Health education; Humans; Inflammation; Internal Medicine; Nose; Phenotype; Physicians; Prognosis; Rhinitis - epidemiology; Rhinitis - genetics; Rhinitis - physiopathology; Rhinitis - therapy; Sinuses; Sinusitis - epidemiology; Sinusitis - genetics; Sinusitis - physiopathology; Sinusitis - therapy; Studies; Surgery; NO; NP; eosinophilic cationic protein; CRS; CRSwNP; ICAM-1; AOAH; intercellular adhesion molecule 1; acyloxyacyl hydroxylase; nasal polyp; CRSsNP; GATA-3; intranasal corticosteroid; cystic fibrosis; chronic rhinosinusitis with nasal polyps; Endotype; TLR; interleukin; Toll-like receptor; functional endoscopic sinus surgery; nitric oxide; CF; IL; N-acetyl Pro-Gly-Pro; VEGF; GATA binding protein 3; Phenotype; Chronic rhinosinusitis without nasal polyps; ECP; vascular endothelial growth factor; INCS; chronic rhinosinusitis; PGP; FESS
• ISSN: 2213-2198; 2213-2201
• DOI: 10.1016/j.jaip.2016.04.015

Chronic rhinosinusitis without nasal polyps (CRSsNP) is more prevalent than chronic rhinosinusitis with nasal polyps (CRSwNP). Certain diseases predispose to whereas others are associated with CRSsNP. Predisposing diseases include allergic and nonallergic upper and lower airway diseases, epithelial cell disorders, immunodeficiencies, autoimmune diseases, and some infectious diseases. In addition, environmental and host factors, examples of which include smoking, a higher incidence of abnormal biofilms, and innate immune defects, play a role in the pathogenesis of this disease. CRSsNP is characterized by histologic abnormalities, including basement membrane thickening (fibrosis) and goblet cell hyperplasia. Neutrophils and several chemokines, TGF-β and C-X-C motif chemokine ligand (CXCL)-8, play a role in CRSsNP remodeling. However, there are conflicting data about CRSsNP endotypes, for example, whether it is characterized by neutrophilia or eosinophilia or both. In spite of advancements and the understanding of the pathogenesis of this disease, additional study is necessary to better comprehend its underlying mechanisms, endotypes, and evidence-based treatment strategies.