L Klimek1, M Koennecke2, J Hagemann3, B Wollenberg2, S Becker3. 1. Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183, Wiesbaden, Deutschland. Ludger.Klimek@Allergiezentrum.org. 2. Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. 3. Hals‑, Nasen‑, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55101, Mainz, Deutschland.
Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial inflammation of the nasal and paranasal mucosa. Until now, no internationally standardized classification could be developed. In most cases, CRS is phenotypically classified according to chronic rhinosinusitis with (CRScNP) and without nasal polyps (CRSsNP). However, recent studies could show that there are numerous endotypes within these phenotypes based on different inflammatory mechanisms. This review describes the important immunological mechanisms of CRScNP and highlights modern treatment options with biologicals directly addressing particular immunological processes. METHODS: Current knowledge on immunological and molecular processes of CRS, particularly CRScNP, was extracted from Medline, PubMed, national and international study- and guideline-registers, and the Cochrane library by a systematic review of the literature. RESULTS: Based on current literature, various immunological mechanisms for CRS and CRScNP could be identified. Relevant studies for the treatment of eosinophilic conditions such as asthma or CRScNP are presented and, if available, results of these studies are discussed. CONCLUSION: The growing insight into the underlying immunological mechanisms of CRScNP could pave the way for new personalized treatment options such as biologicals in the future.
BACKGROUND:Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial inflammation of the nasal and paranasal mucosa. Until now, no internationally standardized classification could be developed. In most cases, CRS is phenotypically classified according to chronic rhinosinusitis with (CRScNP) and without nasal polyps (CRSsNP). However, recent studies could show that there are numerous endotypes within these phenotypes based on different inflammatory mechanisms. This review describes the important immunological mechanisms of CRScNP and highlights modern treatment options with biologicals directly addressing particular immunological processes. METHODS: Current knowledge on immunological and molecular processes of CRS, particularly CRScNP, was extracted from Medline, PubMed, national and international study- and guideline-registers, and the Cochrane library by a systematic review of the literature. RESULTS: Based on current literature, various immunological mechanisms for CRS and CRScNP could be identified. Relevant studies for the treatment of eosinophilic conditions such as asthma or CRScNP are presented and, if available, results of these studies are discussed. CONCLUSION: The growing insight into the underlying immunological mechanisms of CRScNP could pave the way for new personalized treatment options such as biologicals in the future.
Authors: L Klimek; S Becker; R Buhl; A M Chaker; T Huppertz; T K Hoffmann; S Dazert; T Deitmer; U Förster-Ruhrmann; H Olze; J Hagemann; S K Plontke; H Wrede; W Schlenter; H J Welkoborsky; B Wollenberg; A G Beule; C Rudack; S Strieth; R Mösges; C Bachert; T Stöver; C Matthias; A Dietz Journal: Laryngorhinootologie Date: 2020-05-08 Impact factor: 1.057
Authors: Ludger Klimek; Ulrike Förster-Ruhrmann; Achim G Beule; Adam M Chaker; Jan Hagemann; Felix Klimek; Ingrid Casper; Tilman Huppertz; Thomas K Hoffmann; Stefan Dazert; Thomas Deitmer; Heidi Olze; Sebastian Strieth; Holger Wrede; Wolfgang W Schlenter; Hans-Jürgen Welkoborsky; Barbara Wollenberg; Christoph Bergmann; Mandy Cuevas; Caroline Beutner; Moritz Gröger; Sven Becker Journal: Allergo J Date: 2022-09-05