Endotypic heterogeneity of chronic rhinosinusitis

Krasilnikova S.V., Gorbunova K.V., Eliseeva T.I., Bulgakova V.A.

1) Privolzhsky Research Medical University, Nizhny Novgorod, Russia; 2) Russian Scientific Center of Surgery named after Academician B.V. Petrovsky, Moscow, Russia; 3) Pirogov Russian National Research Medical University, Moscow, Russia

Chronic rhinosinusitis (CRS) is one of the most common chronic respiratory diseases worldwide. CRS with polyps (CRS with polyps) is characterized by a high relapse rate, refractoriness to therapy, and is an unsolved problem in clinical rhinology. CRS is a heterogeneous disease with multiple clinical and immunological variants. The basis of the pathogenesis of CRS is chronic inflammation of the mucous membranes associated with pathological remodeling. This inflammation can occur with both high and low levels of type 2 immune response. Focusing on one type of inflammation (mainly T2) does not reflect the whole picture of pathogenesis. The emergence of new biological drugs targeting alarmins and specific cytokines requires a deep understanding of the involved immune pathways for adequate selection of therapy and prediction of response. There is a rapid increase in literature data on the role of individual cell populations and mediators, but there is no holistic understanding of their interactions and significance for different endotypes of CRS. Systematization of this knowledge will help to identify gaps in research, outline promising areas for the development of diagnostic biomarkers potentially suitable for targeted biological therapy, and improve the effectiveness of a personalized approach to the treatment of patients with CRS. This review is aimed to a comprehensive analysis and systematization of modern data on the immunological mechanisms of the pathogenesis of chronic rhinosinusitis. The article presents an overview of the scientific literature. A scientific search on the topic of immunogenesis of chronic rhinosinusitis was performed. The corresponding key terms and filters in the PubMed and Google Scholar search engines were used.

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About the Authors

S.V. Krasilnikova, Cand. Sci. (Med.), Associate Professor, Department of Ear, Nose and Throat Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia; mashkovasv@mail.ru, ORCID: https://orcid.org/0000-0001-6153-6691
K.V. Gorbunova, Postgraduate Student, Department of Hospital Pediatrics, Privolzhsky Research Medical University, Nizhny Novgorod, Russia; ksenya.gorbunova@mail.ru, ORCID: https://orcid.org/0000-0003-4985-1546
T.I. Eliseeva, Dr. Sci. (Med.), Associate Professor, Professor at the Department of Hospital Pediatrics, Privolzhsky Research Medical University, Nizhny Novgorod, Russia; eliseevati@yandex.ru, ORCID: https://orcid.org/0000-0002-1769-3670
Vilya A. Bulgakova, Dr. Sci. (Med.), Head of the Department of Scientific and Information Development, Research Institute of Pediatrics and Children’s Health, Research Clinical Center No. 2, Russian Scientific Center of Surgery named after Academician B.V. Petrovsky; Professor at the Department of Faculty Pediatrics, Faculty of Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia; irvilbulgak@mail.ru, ORCID:
https://orcid.org/0000-0003-4861-0919 (corresponding author)

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