慢性鼻窦炎(CRS)是鼻和鼻旁窦粘膜的慢性炎性疾病,其影响全世界高达10%的人口。CRS是发生气道重塑的上呼吸道最具代表性的疾病,包括上皮损伤,基底膜增厚,纤维化,杯状细胞增生,上皮下水肿,和骨炎。CRS根据鼻息肉的存在或不存在分为两种表型:具有鼻息肉的CRS(CRSwNP)和不具有鼻息肉的CRS(CRSsNP)。基于潜在的病理生理机制,CRS也分为嗜酸性粒细胞CRS和非嗜酸性粒细胞CRS。由于2型T辅助(Th2)为基础的炎症和1型T辅助(Th1)/17型T辅助(Th17)扭曲的免疫反应,分别。CRS中组织重塑的差异被认为是基于临床表型和基因型;这是因为纤维化在CRSsNP中是突出的,而水肿变化发生在CRSwNP中,尤其是嗜酸性粒细胞型。本综述旨在总结CRS中不同基因型气道重塑机制的最新信息。
Chronic rhinosinusitis (CRS) is a chronic inflammatory condition of the nasal and paranasal sinus mucosa that affects up to 10% of the population worldwide. CRS is the most representative disease of the upper respiratory tract where airway remodeling occurs, including epithelial damage, thickening of the basement membrane, fibrosis, goblet cell hyperplasia, subepithelial edema, and osteitis. CRS is divided into two phenotypes according to the presence or absence of nasal polyps: CRS with nasal polyp (CRSwNP) and CRS without nasal polyps (CRSsNP). Based on the underlying pathophysiologic mechanism, CRS is also classified as eosinophilic CRS and non-eosinophilic CRS, owing to Type 2 T helper (Th2)-based inflammation and Type 1 T helper (Th1)/Type 17 T helper (Th17) skewed immune response, respectively. Differences in tissue remodeling in CRS are suggested to be based on the clinical phenotype and endotypes; this is because fibrosis is prominent in CRSsNP, whereas edematous changes occur in CRSwNP, especially in the eosinophilic type. This
review aims to summarize the latest information on the different mechanisms of airway remodeling in CRS according to distinct endotypes.