BACKGROUND: Our objective is to present recent research findings on recalcitrant chronic rhinosinusitis (CRS) in relation to "Severe Chronic Upper Airway Disease" (SCUAD). METHODOLOGY: Literature review using Medline and Em base databases (search terms 'chronic rhinosinusitis'; "chronic sinusitis" or"Severe Chronic Upper Airway Disease") limited to articles published in the English language. RESULTS: Complex pathophysiological mechanisms characterize various forms of chronic rhinitis and rhinosinusitis (CRS), where inflammation persists in spite of adequate medical treatment. In these cases, a multifactorial etiology often underlies the development of sino-nasal inflammation. The interaction between chronic upper and lower airway inflammation via neurogenic and systemic pathways may complicate the therapy of these patients, and lead to insufficient symptom control. CONCLUSION: The recently introduced definition of"Severe Chronic Upper Airway Disease" (SCUAD) increases awareness of those patients with persistent inflammation and symptoms despite guideline-driven pharmacologic treatment. The concept of SCUAD may prove helpful in directing research towards clarifying the definition, diagnosis and pathophysiology of rhinitis and rhinosinusitis,their limits and overlap. In this review, a hypothesis on SCUAD immunopathology is also presented.
BACKGROUND: Our objective is to present recent research findings on recalcitrant chronic rhinosinusitis (CRS) in relation to "Severe Chronic Upper Airway Disease" (SCUAD). METHODOLOGY: Literature review using Medline and Em base databases (search terms 'chronic rhinosinusitis'; "chronic sinusitis" or"Severe Chronic Upper Airway Disease") limited to articles published in the English language. RESULTS: Complex pathophysiological mechanisms characterize various forms of chronic rhinitis and rhinosinusitis (CRS), where inflammation persists in spite of adequate medical treatment. In these cases, a multifactorial etiology often underlies the development of sino-nasal inflammation. The interaction between chronic upper and lower airway inflammation via neurogenic and systemic pathways may complicate the therapy of these patients, and lead to insufficient symptom control. CONCLUSION: The recently introduced definition of"Severe Chronic Upper Airway Disease" (SCUAD) increases awareness of those patients with persistent inflammation and symptoms despite guideline-driven pharmacologic treatment. The concept of SCUAD may prove helpful in directing research towards clarifying the definition, diagnosis and pathophysiology of rhinitis and rhinosinusitis,their limits and overlap. In this review, a hypothesis on SCUAD immunopathology is also presented.
Authors: J van der Veen; S F Seys; M Timmermans; P Levie; M Jorissen; W J Fokkens; P W Hellings Journal: Allergy Date: 2016-09-15 Impact factor: 13.146
Authors: Sven F Seys; Shana De Bont; Wytske J Fokkens; Claus Bachert; Isam Alobid; Manuel Bernal-Sprekelsen; Leif Bjermer; Ina Callebaut; Lars-Olaf Cardell; Sean Carrie; Paolo Castelnuovo; Russell Cathcart; Jannis Constantinidis; Leen Cools; Marjolein Cornet; Gregory Clement; Tony Cox; Lieve Delsupehe; Jaime Correia-de-Sousa; Lauren Deneyer; Geert De Vos; Zuzana Diamant; Maria Doulaptsi; Simon Gane; Philippe Gevaert; Claire Hopkins; Valérie Hox; Thomas Hummel; Werner Hosemann; Raf Jacobs; Mark Jorissen; Anette Kjeldsen; Basile N Landis; Winde Lemmens; Andreas Leunig; Valerie Lund; Gert Mariën; Joaquim Mullol; Metin Onerci; Susanna Palkonen; Isabel Proano; Emmanuel Prokopakis; Dermot Ryan; Herbert Riechelmann; Pernilla Sahlstrand-Johnson; Sanna Salmi-Toppila; Christine Segboer; Kato Speleman; Andreas Steinsvik; Pavol Surda; Peter-Valentin Tomazic; Olivier Vanderveken; Laura Van Gerven; Thibaut Van Zele; Jan Verfaillie; Benedicte Verhaeghe; Kathie Vierstraete; Stephan Vlaminck; Martin Wagenmann; Benoit Pugin; Peter W Hellings Journal: Allergy Date: 2020-06-19 Impact factor: 13.146