Direct measurement of upper airway inflammation in children with chronic rhinosinusitis: implications for asthma

Curr Opin Allergy Clin Immunol. 2016 Feb;16(1):18-23. doi: 10.1097/ACI.0000000000000237.

Abstract

Purpose of review: Chronic rhinosinusitis (CRS) is a common heterogenous multifactorial disorder affecting children and adults. The exact mechanism is not completely understood. In this review, we aim to summarize our recent findings regarding etiologies and pathogenesis of CRS in children and review recent studies investigating inflammatory patterns in the upper airways in children and adults with CRS.

Recent findings: There are only a few small studies measuring upper airway inflammation in children with CRS. These studies demonstrated more toward eosinophilic and T-cell driven inflammatory pattern. Cytokine patterns in upper airways seem to correlate with asthma symptoms in children with CRS. Adult studies demonstrate eosinophilic and Th-2 (T helper-1) driven inflammation in CRS with nasal polyps and Th-1 (T helper-2) driven inflammation in CRS without nasal polyps.

Summary: Current knowledge about the characteristics of tissue inflammation in upper airways in children with CRS is limited. More studies are needed to better understand the pathogenesis and better define the subgroups of CRS. The findings of such studies will lead to identifying the biological targets to treat this condition.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Asthma / etiology
  • Asthma / immunology*
  • Asthma / pathology
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Humans
  • Infant
  • Inflammation / immunology
  • Inflammation / pathology
  • Male
  • Nasal Polyps / complications
  • Nasal Polyps / immunology
  • Nasal Polyps / pathology
  • Rhinitis / complications
  • Rhinitis / immunology*
  • Rhinitis / pathology
  • Sinusitis / complications
  • Sinusitis / immunology*
  • Sinusitis / pathology
  • Th1 Cells / immunology*
  • Th1 Cells / pathology
  • Th2 Cells / immunology*
  • Th2 Cells / pathology