期刊
AMERICAN JOURNAL OF RHINOLOGY
卷 22, 期 6, 页码 549-559出版社
OCEAN SIDE PUBLICATIONS INC
DOI: 10.2500/ajr.2008.22.3228
关键词
Adaptive immune system; chronic rhinosinusitis; fungal hypothesis; immune barrier hypothesis; innate immune system; nasal polyps; superantigen hypothesis
资金
- NHLBI NIH HHS [R01 HL078860-03, R01 HL078860] Funding Source: Medline
- NIAID NIH HHS [R01 AI072570-03, R01 AI072570] Funding Source: Medline
Background: Chronic rhinosinusitis (CRS) has been defined as persistent symptomatic inflammation of the nasal and sinus mucosa resulting from the interaction of multiple host and environmental factors. Recent studies have implicated Alternaria fungi or toxigenic Staphylococcus aureus as Critical agents in CRS pathogenesis. The emphasis oil environmental agents in CRS etiology has focused interest toward elimination of those agents as the prime mechanism of therapy. This viewpoint is in marked contrast to the current perspective on some other chronic inflammatory epithelial disorders that afflict the skin, lungs, and gilt, Wherein host factors are believed to predispose to disease expression in the presence of ubiquitous environmental agents. Methods: The current review evaluates CRS etiology from this perspective and considers that CRS develops, in part, as an outcome Of a dysfunctional host response. Specifically, evidence from our laboratory and others Will be reviewed indicating that CRS is associated with a failure of the mechanical and immunologic barriers across the nasal mucosa. The hypothesis would further propose that genetic and epigenetic variation predisposes susceptible individuals to barrier failure in the presence of environmental stress leading to CRS. Results: From this unifying perspective, bacteria and fungi are seen as disease modifiers rather than primary etiologic agents. Conclusion: The goal is to place concepts of CRS pathophysiology in a framework consistent With a current understanding of chronic inflammation in general and epithelial disease in particular.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据