Allergy Asthma Immunol Res.  2017 Jul;9(4):299-306. 10.4168/aair.2017.9.4.299.

Emerging Endotypes of Chronic Rhinosinusitis and Its Application to Precision Medicine

• Kim DW
• Cho SH

• KMID: 2378192
• DOI: http://doi.org/10.4168/aair.2017.9.4.299

Abstract

Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disease with various underlying pathophysiologic mechanisms which translate to endotypes, in contrast to clinical phenotypes or histological subtypes. Defining endotypes can help clinicians predict disease prognosis, select subjects suitable for a specific therapy, and assess risks for comorbid conditions, including asthma. Therefore, with recent advancement of biologicals in CRS clinical trials, endotyping can be a breakthrough in treating recalcitrant CRS. CRS is caused by dysregulated immunologic responses to external stimuli, which induce various inflammatory mediators from inflammatory cells, including innate lymphoid cells (ILCs) and T lymphocytes as well as epithelial cells. Thymic stromal lymphopoietin (TSLP), interleukin (IL)-25, and IL-33, which are mainly secreted by epithelial cells in response to external stimuli, act on type 2 ILCs and T helper 2 (Th2) cells, inducing IL-4, IL-5, and IL-13. Local immunoglobulin E (IgE) production is also a signature event in nasal polyps (NP). These inflammatory mediators are novel potential therapeutic targets for recalcitrant CRS. This article reviews recent publications regarding endotypes and endotype-based therapeutic strategies in CRS and NP.

Keyword

Nasal polyps; chronic rhinosinusitis; endotypes; phenotypes; biologicals; cytokines

MeSH Terms

Asthma
Cytokines
Epithelial Cells
Immunoglobulin E
Immunoglobulins
Interleukin-13
Interleukin-33
Interleukin-4
Interleukin-5
Interleukins
Lymphocytes
Nasal Polyps
Phenotype
Precision Medicine*
Prognosis
T-Lymphocytes
Cytokines
Immunoglobulin E
Immunoglobulins
Interleukin-13
Interleukin-33
Interleukin-4
Interleukin-5
Interleukins

Figure

• 

  Figure Endotypes and biologicals of CRS with NP. CRS, chronic rhinosinusitis; NP, nasal polyps.

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