Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes

Ping Ping Cao; Zhi Chao Wang; Robert P. Schleimer; Zheng Liu

doi:10.1016/j.anai.2018.10.014

Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes

Ping Ping Cao, Zhi Chao Wang, Robert P. Schleimer, Zheng Liu

Medicine, Allergy Division

Research output: Contribution to journal › Review article › peer-review

102 Scopus citations

Abstract

Objective: Chronic rhinosinusitis (CRS) is a heterogeneous disorder with distinct pathophysiologic mechanisms. Based on transcription factor expression and cytokine production patterns in different innate lymphoid cell (ILC) types, in parallel with those of adaptive CD4⁺ T-helper (T_H) cells and CD8⁺ cytotoxic T (Tc) cells, new perspectives on endotypes of patients are emerging for the immune response deviation into type 1 (orchestrated by ILC1s and Tc1, and T_H1 cells), type 2 (characterized by ILC2s and Tc2 and T_H2 cells), and type 3 (mediated by ILC3s and Tc17 and T_H17 cells). In addition, cluster analysis has been applied to endotyping of CRS in recent years, which has provided additional novel insights into CRS pathogenesis. This review assessed pathologic mechanisms of CRS based on type 1, 2, and 3 immune responses and how they inform us to begin to understand CRS endotypes. This review also assessed recent cluster analysis studies of CRS endotypes. The impact of endotype on therapeutic management of CRS also is summarized. Data Sources: Review of published literature. Study Selections: Relevant literature concerning CRS endotypes and possible underlying mechanisms was obtained from a PubMed search and summarized. Results and Conclusion: CRS with and without nasal polyps are composed of distinct endotypes with distinct deviated immune responses, pathogenic mechanisms, and different responses to medical and surgical treatment. An endotype of CRS with prominent type 2 immune responses is the best-studied endotype and generally can benefit from treatment with steroids and specific type 2 disrupting biologics.

Original language	English (US)
Pages (from-to)	33-40
Number of pages	8
Journal	Annals of Allergy, Asthma and Immunology
Volume	122
Issue number	1
DOIs	https://doi.org/10.1016/j.anai.2018.10.014
State	Published - Jan 2019

Funding

Funding Sources: This work was supported by the National Natural Science Foundation of China (grant 81400449 to P.-P.C. and grants 81630024 , 81570899 , and 81325006 to Z.L.), the Natural Science Foundation of Hubei Province (grant 2017CFA016 to Z.L.), and the “Ten Thousand Plan” of the National High Level Talents Special Support Plan (to Z.L.). R.P.S was supported in part by grants R37HL068546, AI137174, and U19AI106683 (Chronic Rhinosinusitis Integrative Studies Program [CRISP]) from the National Institutes of Health and The Ernest S. Bazley Charitable Foundation.

ASJC Scopus subject areas

Immunology and Allergy
Immunology
Pulmonary and Respiratory Medicine

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10.1016/j.anai.2018.10.014

Cite this

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title = "Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes",

abstract = "Objective: Chronic rhinosinusitis (CRS) is a heterogeneous disorder with distinct pathophysiologic mechanisms. Based on transcription factor expression and cytokine production patterns in different innate lymphoid cell (ILC) types, in parallel with those of adaptive CD4+ T-helper (TH) cells and CD8+ cytotoxic T (Tc) cells, new perspectives on endotypes of patients are emerging for the immune response deviation into type 1 (orchestrated by ILC1s and Tc1, and TH1 cells), type 2 (characterized by ILC2s and Tc2 and TH2 cells), and type 3 (mediated by ILC3s and Tc17 and TH17 cells). In addition, cluster analysis has been applied to endotyping of CRS in recent years, which has provided additional novel insights into CRS pathogenesis. This review assessed pathologic mechanisms of CRS based on type 1, 2, and 3 immune responses and how they inform us to begin to understand CRS endotypes. This review also assessed recent cluster analysis studies of CRS endotypes. The impact of endotype on therapeutic management of CRS also is summarized. Data Sources: Review of published literature. Study Selections: Relevant literature concerning CRS endotypes and possible underlying mechanisms was obtained from a PubMed search and summarized. Results and Conclusion: CRS with and without nasal polyps are composed of distinct endotypes with distinct deviated immune responses, pathogenic mechanisms, and different responses to medical and surgical treatment. An endotype of CRS with prominent type 2 immune responses is the best-studied endotype and generally can benefit from treatment with steroids and specific type 2 disrupting biologics.",

author = "Cao, {Ping Ping} and Wang, {Zhi Chao} and Schleimer, {Robert P.} and Zheng Liu",

note = "Publisher Copyright: {\textcopyright} 2018 Elsevier Ltd",

year = "2019",

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doi = "10.1016/j.anai.2018.10.014",

language = "English (US)",

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N2 - Objective: Chronic rhinosinusitis (CRS) is a heterogeneous disorder with distinct pathophysiologic mechanisms. Based on transcription factor expression and cytokine production patterns in different innate lymphoid cell (ILC) types, in parallel with those of adaptive CD4+ T-helper (TH) cells and CD8+ cytotoxic T (Tc) cells, new perspectives on endotypes of patients are emerging for the immune response deviation into type 1 (orchestrated by ILC1s and Tc1, and TH1 cells), type 2 (characterized by ILC2s and Tc2 and TH2 cells), and type 3 (mediated by ILC3s and Tc17 and TH17 cells). In addition, cluster analysis has been applied to endotyping of CRS in recent years, which has provided additional novel insights into CRS pathogenesis. This review assessed pathologic mechanisms of CRS based on type 1, 2, and 3 immune responses and how they inform us to begin to understand CRS endotypes. This review also assessed recent cluster analysis studies of CRS endotypes. The impact of endotype on therapeutic management of CRS also is summarized. Data Sources: Review of published literature. Study Selections: Relevant literature concerning CRS endotypes and possible underlying mechanisms was obtained from a PubMed search and summarized. Results and Conclusion: CRS with and without nasal polyps are composed of distinct endotypes with distinct deviated immune responses, pathogenic mechanisms, and different responses to medical and surgical treatment. An endotype of CRS with prominent type 2 immune responses is the best-studied endotype and generally can benefit from treatment with steroids and specific type 2 disrupting biologics.

AB - Objective: Chronic rhinosinusitis (CRS) is a heterogeneous disorder with distinct pathophysiologic mechanisms. Based on transcription factor expression and cytokine production patterns in different innate lymphoid cell (ILC) types, in parallel with those of adaptive CD4+ T-helper (TH) cells and CD8+ cytotoxic T (Tc) cells, new perspectives on endotypes of patients are emerging for the immune response deviation into type 1 (orchestrated by ILC1s and Tc1, and TH1 cells), type 2 (characterized by ILC2s and Tc2 and TH2 cells), and type 3 (mediated by ILC3s and Tc17 and TH17 cells). In addition, cluster analysis has been applied to endotyping of CRS in recent years, which has provided additional novel insights into CRS pathogenesis. This review assessed pathologic mechanisms of CRS based on type 1, 2, and 3 immune responses and how they inform us to begin to understand CRS endotypes. This review also assessed recent cluster analysis studies of CRS endotypes. The impact of endotype on therapeutic management of CRS also is summarized. Data Sources: Review of published literature. Study Selections: Relevant literature concerning CRS endotypes and possible underlying mechanisms was obtained from a PubMed search and summarized. Results and Conclusion: CRS with and without nasal polyps are composed of distinct endotypes with distinct deviated immune responses, pathogenic mechanisms, and different responses to medical and surgical treatment. An endotype of CRS with prominent type 2 immune responses is the best-studied endotype and generally can benefit from treatment with steroids and specific type 2 disrupting biologics.

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Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes

Abstract

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