Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 148, Issue 2, Pages 327-335Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2021.03.024
Keywords
Chronic rhinosinusitis; type 2 inflammation; eosino-phils; neutrophils; activation; extracellular traps; Charcot-Leyden crystals; IL-17; biologicals
Categories
Funding
- Flams wetenschappelijk Onderzeok (FWO) Flanders [1515516N]
- Flams wetenschappelijk Onderzeok (FWO) Flanders (Excellence of Science [EOS]) [GOG2318N]
- Inter-university Attraction Poles [P7/30]
- Sanofi [A17/TT/1942, A19/TT/0828]
- National Institute of Allergy and Infectious Diseases [U19AI136443]
- Swiss National Science Foundation [310030_184816]
- Russian Government
Ask authors/readers for more resources
Chronic rhinosinusitis is often characterized by eosinophilic inflammation, but a third of patients have mucosal inflammation dominated by neutrophils. Understanding the interactions between eosinophilic and neutrophilic inflammation in pathophysiology, as well as the mixed presentation in patients with severe type 2 CRS with nasal polyps, is crucial for treatment.
Chronic rhinosinusitis (CRS) often is characterized by an eosinophilic inflammatory pattern, nowadays referred to as type 2 inflammation, although the mucosal inflammation is dominated by neutrophils in about a third of the patients. Neutrophils are typically predominant in 50% of patients with CRS without nasal polyps, but also are found to play a role in patients with severe type 2 CRS with nasal polyp disease. This review aims at summarizing the current understanding of the eosinophilic and neutrophilic inflammation in CRS pathophysiology, and provides a discussion of their reciprocal interactions and the clinical impact of the mixed presentation in patients with severe type 2 CRS with nasal polyps. A solid understanding of these interactions is of utmost importance when treating uncontrolled severe CRS with nasal polyps with biologicals that are preferentially directed toward type 2 inflammation. We here focus on recent findings on both eosinophilic and neutrophilic granulocytes, their subgroups and the activation status, and their interactions in CRS. (J Allergy Clin Immunol 2021;148:327-35.)
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available