Nasal polyposis pathophysiology: Endotype and phenotype open issues.
Am J Otolaryngol
; 39(4): 441-444, 2018.
Article
em En
| MEDLINE
| ID: mdl-29550078
ABSTRACT
PURPOSE:
Endotyping chronic rhinosinusitis with nasal polyps (CRSwNP) poses a challenge for rhinologists nowadays. Phenotyping CRSwNP proved inappropriate as an approach to their classification because of their common clinical features. Endotyping, being based on the pathogenic mechanism, provides a precise picture more appropriate for use in clinical practice. Patients' treatment and follow-up can thus be tailored to cope with the degree of aggressiveness of a specific CRSwNP endotype. The aim of this study was to analyze the available information about the main currently accepted endotypes of CRSwNP; furthermore, we reported and commented evidence regarding some clinical conditions associated with nasal polyposis which could be related with new endotypes. MATERIALS ANDMETHODS:
Pubmed and Scopus electronic database were searched. The main available studies about CRSwNP endotyping published predominantly in the last 5â¯years were critically analyzed.RESULTS:
The pathophysiological features of some asthma-related CRSwNP (allergic fungal rhinosinusitis, aspirin-exacerbated respiratory disease) are quite well understood, including them among known endotypes of CRSwNP. On the other hand, because of their known pathophysiological mechanisms, some well-known diseases associated with aggressive forms of CRSwNP, such as eosinophilic granulomatosis with polyangiitis, primary ciliary dyskinesia and cystic fibrosis, should be investigated as potentially related with CRSwNP endotypes.CONCLUSIONS:
CRSwNP comprises several inflammatory endotypes defined by different pathogenic mechanisms. These endotypes correlate with the disease's clinical manifestations and behavior. A thorough understanding of CRSwNP endotypes will enable targeted medical therapies and tailored follow-up protocols.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sinusite
/
Rinite
/
Pólipos Nasais
Tipo de estudo:
Diagnostic_studies
/
Guideline
Limite:
Humans
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article