Perspectives in Therapy of Chronic Rhinosinusitis.

Abstract

The recent classification of chronic rhinosinusitis (CRS) focusses on investigating underlying immunopathophysiological mechanisms. Primary CRS is subdivided based on endotype dominance into type 2 (that relates mostly to the Th2 immune response with high levels of IL-5, IL-13, and IgE), or non-type 2 (that corresponds to the mix of type 1 and type 3). The treatment selection of CRS is dependent on endotype dominance. Currently, the majority of patients receive standardized care-traditional pharmacological methods including local or systemic corticosteroids, nasal irrigations or antibiotics (for a selected group of patients). If well-conducted drug therapy fails, endoscopic sinus surgery is conducted. Aspirin treatment after aspirin desensitization (ATAD) with oral aspirin is an option for the treatment in nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) patients. However, in this review the focus is on the role of biological treatment-monoclonal antibodies directed through the specific type 2 immune response targets. In addition, potential targets to immunotherapy in CRS are presented. Hopefully, effective diagnostic and therapeutic solutions, tailored to the individual patient, will be widely available very soon.

• Authors: Jacek Brzost, Katarzyna Czerwaty, Karolina Dżaman, Nils Ludwig, Katarzyna Piszczatowska, Mirosław J Szczepański
• Journal: Diagnostics (Basel, Switzerland) (Diagnostics (Basel)) Vol. 12 Issue 10 (Sep 23 2022) ISSN: 2075-4418 [Print] Switzerland
• PMID: 36291990 (Publication Type: Journal Article, Review)