Inflammatory cytokines in allergy and rhinosinusitis

Abstract

Cytokines are involved in initiating and perpetuating the host immune response to allergens and also modulating the mucosal cellular milieu characteristic of chronic rhinosinusitis. This paper reviews the current state of knowledge regarding the most relevant cytokines in allergy and rhinosinusitis and highlights recent findings in the literature. Chronic rhinosinusitis with nasal polyps is characterized by a type 2 T helper cell cytokine polarization, whereas chronic rhinosinusitis without nasal polyps has a type 1 T helper cell cytokine expression pattern. Targeted therapies against specific cytokines such as interleukin-5 have shown promise in treating allergic diseases. Genetic polymorphisms in cytokines and their receptors have been shown to confer susceptibility to asthma and allergy. Transforming growth factor-beta has been found to have proinflammatory and anti-inflammatory effects in the nose and paranasal sinuses and appears to have a role in airway remodeling. Cytokines drive the immune system's response to allergen exposure and participate in sinonasal mucosal inflammatory conditions. Although the roles of individual cytokines in atopic disease and rhinosinusitis are becoming clearer, future studies will need to build on our knowledge of cytokine functions by focusing on therapeutic approaches to quieting the immune system and dampening the inflammatory cascade.