Pathogenesis of eosinophilic chronic rhinosinusitis.
Pathogenesis of eosinophilic chronic rhinosinusitis.
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DOI：
10.1186/s12950-016-0121-8
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Takeuchi K
中科院分区：
文献类型：
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作者：
Shah SA;Ishinaga H;Takeuchi K
嗜酸性粒细胞性慢性鼻窦炎（ECRS）是一种难治性疾病。患有ECRS的患者表现为粘稠粘液产生、长期鼻塞、嗅觉丧失和继发于细菌感染的间歇性急性加重。尽管进行了内科和外科干预，但复发率很高，对生活质量有显著影响。应考虑到最近南亚国家ECRS患病率的增加以及手术后ECRS复发的强烈趋势。大多数病例需要再次手术，这些病例的组织学检查显示嗜酸性粒细胞占主导地位的炎症。嗜酸性粒细胞的降解和积聚、细胞因子的释放以及粘液分泌在ECRS的发病机制中起重要作用。ECRS与非ECRS不同，其中嗜酸性粒细胞不参与疾病的发病机制，并且在许多临床特征、血液检查和鼻息肉组织学发现、手术后疾病的临床特征、药物疗效和计算机断层扫描发现方面也不同。本文综述了ECRS的临床过程、诊断和治疗，以及其病理生理学和嗜酸性粒细胞、粘液、细胞因子和其他介质在ECRS发病机制中的作用。
Eosinophilic chronic rhinosinusitis (ECRS) is considered a refractory and intractable disease. Patients with ECRS present with thick mucus production, long-term nasal congestion, loss of sense of smell, and intermittent acute exacerbations secondary to bacterial infections. Despite medical and surgical interventions, there is a high rate of recurrence with significant impairment to quality of life. The recent increasing prevalence of ECRS in south Asian countries and the strong tendency of ECRS to reoccur after surgery should be considered. The majority of cases need repeat surgery, and histological examinations of these cases show eosinophilic-dominant inflammation. The degradation and accumulation of eosinophils, release of cytokines, and mucus secretion have important roles in the pathogenesis of ECRS. ECRS differs from non-ECRS, in which eosinophils are not involved in the pathogenesis of the disease, and also in terms of many clinical characteristics, blood examination and nasal polyp histological findings, clinical features of the disease after surgery, efficacy of medications, and computed tomography findings. This review describes the clinical course, diagnosis, and treatment of ECRS as well as its pathophysiology and the role of eosinophils, mucus, cytokines, and other mediators in the pathogenesis of ECRS.