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Pathological mechanisms and clinical features of eosinophilic chronic rhinosinusitis in the Japanese population.
- Source :
-
Allergology international : official journal of the Japanese Society of Allergology [Allergol Int] 2010 Sep; Vol. 59 (3), pp. 247-256. Date of Electronic Publication: 2010 Jun 25. - Publication Year :
- 2010
-
Abstract
- The overall pathological view of paranasal sinus inflammation in the Japanese population has profoundly changed in recent years. Eosinophilic chronic rhinosinusitis (ECRS) is a clinical entity of intractable chronic sinus inflammation accompanied by numerous infiltrations of activated eosinophils in the paranasal sinus mucosa and/or nasal polyps. Several pathologic processes are considered to act in concert to promote the accumulation of eosinophils in ECRS. They include infiltration of progenitor cells, increase in local IL-3, IL-5, IL-13, GM-CSF and eotaxin production, and upregulation of adhesion molecules. The role of nasal allergen sensitization and innate immunity responses in the sinus mucosa has also been proposed in the development of ECRS. Various pathogens including TLRs ligands may trigger an abnormal immune response at the mucosal surface. The objectives of ECRS management should focus directly on inhibition of local eosinophil infiltration. Surgical procedures include widely opening the bony wall septum of every affected sinus and mechanical removal of diseased mucosal lesion. The use of local and/or systemic steroids, leukotriene receptor antagonists, and Th2 cytokine antagonists is recommended. Local administration of steroids is a potent treatment strategy for preventing relapse of nasal polyposis and is considered to be the first-line treatment for ECRS patients.
- Subjects :
- Animals
Anti-Inflammatory Agents therapeutic use
Chronic Disease
Eosinophils drug effects
Eosinophils pathology
Humans
Japan
Nasal Mucosa immunology
Nasal Polyps pathology
Paranasal Sinuses pathology
Paranasal Sinuses surgery
Rhinitis drug therapy
Rhinitis physiopathology
Sinusitis drug therapy
Sinusitis physiopathology
Steroids therapeutic use
Eosinophils immunology
Nasal Polyps immunology
Paranasal Sinuses immunology
Rhinitis immunology
Sinusitis immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1592
- Volume :
- 59
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Allergology international : official journal of the Japanese Society of Allergology
- Publication Type :
- Academic Journal
- Accession number :
- 20567131
- Full Text :
- https://doi.org/10.2332/allergolint.10-RAI-0202