New Discoveries Regarding Endotypes of Chronic Rhinosinusitis with Nasal Polyp

Abstract

Chronic rhinosinusitis (CRS) is a common chronic inflammatory disease of the nasal and paranasal mucosa and it usually affects substantial impaired quality of life. CRS is a highly heterogeneous disease and currently defined as subgroups of patients based on nasal endoscopic findings, accompanied either by CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). However, clinical phenotypes does not adequately reflect the pathophysiologic diversity within patients with CRS. Thus, CRS was also classified according to the inflammatory endotypes, which defined as subtypes of disease with an immunologically different from others by the involvement of a specific molecule or cell. To date, it has been well known that CRSsNP patients characterized by a predominant T helper cell type 1 inflammatory response, whereas CRSwNP patients from Western driven by a T helper cell type 2 inflammation and increased eosinophil infiltration. Meanwhile, CRSwNP patients from Asian displayed a mixed T cell profile with a non-eosinophilic inflammation pattern. However, recent some studies have reported the new discoveries regarding immunologic different endotypes of CRSwNP, such as innate lymphoid cells and activated B-cell mediated immune response. Therefore, herein we describe concepts and new discoveries of immunologic endotype in patients with CRSwNP. Key words: B-cell ㆍ Chronic rhinosinusitis ㆍ Innate immunity ㆍ Nasal polyp