Rethinking neutrophils and eosinophils in chronic rhinosinusitis

Tim Delemarre, Bruce S. Bochner, Hans Uwe Simon, Claus Bachert*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Chronic rhinosinusitis (CRS) often is characterized by an eosinophilic inflammatory pattern, nowadays referred to as type 2 inflammation, although the mucosal inflammation is dominated by neutrophils in about a third of the patients. Neutrophils are typically predominant in 50% of patients with CRS without nasal polyps, but also are found to play a role in patients with severe type 2 CRS with nasal polyp disease. This review aims at summarizing the current understanding of the eosinophilic and neutrophilic inflammation in CRS pathophysiology, and provides a discussion of their reciprocal interactions and the clinical impact of the mixed presentation in patients with severe type 2 CRS with nasal polyps. A solid understanding of these interactions is of utmost importance when treating uncontrolled severe CRS with nasal polyps with biologicals that are preferentially directed toward type 2 inflammation. We here focus on recent findings on both eosinophilic and neutrophilic granulocytes, their subgroups and the activation status, and their interactions in CRS.

Original languageEnglish (US)
Pages (from-to)327-335
Number of pages9
JournalJournal of Allergy and Clinical Immunology
Volume148
Issue number2
DOIs
StatePublished - Aug 2021

Keywords

  • Charcot-Leyden crystals
  • Chronic rhinosinusitis
  • IL-17
  • activation
  • biologicals
  • eosinophils
  • extracellular traps
  • neutrophils
  • type 2 inflammation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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