The epithelium-derived inflammatory mediators of chronic rhinosinusitis with nasal polyps

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory airway disease characterized as tight junction loosening, inflammation, and mucosal remodeling. Epithelial cells form a barrier against allergens, bacteria, and proteases, and can also trigger or enhance the immune response by releasing various inflammatory mediators including cytokines, chemokines, and secreted proteins to promote the pathogenesis of CRSwNP. Areas covered: We review the epithelium-derived cytokine and secreted protein networks driving CRSwNP, and discuss these mediators in a cellular context. We illustrate their roles as potential mediators-biomarkers in clinical practice, which may help to understand the mechanisms underlying the pathologies of different endotypes of CRSwNP and to improve treatment outcomes in patients with CRSwNP based on the development of novel predictors for CRSwNP management. Expert opinion: The understanding of the role of epithelium-derived inflammatory mediators helps to investigate the pathophysiological mechanisms of CRSwNP endotypes. An increasing number of studies show that these mediators target immune cells and promote the recruitment, activation or regulation of the proliferation or apoptosis of these cells. Based on this achievement, further investigations are necessary to explore the multi-dimensional role of epithelium-derived inflammatory mediators in CRSwNP.