Current Review of Comorbidities in Chronic Rhinosinusitis.

IF 5.4 2区医学 Q1 ALLERGY

Current Allergy and Asthma Reports Pub Date : 2024-11-19 DOI:10.1007/s11882-024-01184-4

Alexander Choi, Shuhui Xu, Amber U Luong, Sarah K Wise

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Abstract

Purpose of review: Chronic rhinosinusitis (CRS) is a heterogenous disease with a significant impact on patient quality of life and a substantial economic burden. CRS is associated with several systemic inflammatory conditions. We provide an updated review of CRS comorbidities as a springboard for future comorbidity mapping and potential therapeutics.

Recent findings: The link between environmental allergies and CRS is most evident for central compartment atopic disease (CCAD) and allergic fungal rhinosinusitis (AFRS) subtypes but remains inconclusive for CRS overall. The association between asthma and CRS, reinforced by the unified airway theory, is evidenced by their response to similar biologic therapies. Another lower respiratory tract disease, COPD, has up to a 50% co-occurrence with CRS and warrants careful screening and treatment. Eosinophilic esophagitis and CRS share eosinophilic inflammation in different sites, meriting further research. Obesity not only presents physiological challenges but also correlates with a more severe subset of CRS. Diabetes mellitus is associated with CRSwNP, possibly secondary to therapeutics with steroids. Autoimmunity may contribute to nasal polyp formation through cytokines such as B-cell activating factor (BAFF), offering potential for future therapeutics. This review illustrates the need to employ a macroscopic approach in clinical decision making and treatment of CRS. Comorbidities may contribute to an overall proinflammatory state, magnify severity of symptoms, be a source of treatment resistance, and even an opportunity for future therapeutics.

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慢性鼻炎并发症现状综述。

审查目的：慢性鼻炎（CRS）是一种异质性疾病，对患者的生活质量有很大影响，并造成巨大的经济负担。CRS 与多种全身性炎症有关。我们对 CRS 的并发症进行了最新综述，作为未来绘制并发症图和潜在疗法的跳板：最近的研究结果：环境过敏与 CRS 之间的联系在中央隔室特应性疾病（CCAD）和过敏性真菌鼻炎（AFRS）亚型中最为明显，但在 CRS 整体中仍无定论。哮喘和 CRS 之间的联系在统一气道理论的支持下，从它们对类似生物疗法的反应中得到了证实。另一种下呼吸道疾病慢性阻塞性肺病（COPD）与 CRS 的并发率高达 50%，需要仔细筛查和治疗。嗜酸性粒细胞食管炎和 CRS 在不同部位有相同的嗜酸性粒细胞炎症，值得进一步研究。肥胖不仅带来生理上的挑战，还与更严重的 CRS 亚群相关。糖尿病与 CRSwNP 相关，可能是继发于类固醇治疗。自身免疫可能会通过 B 细胞活化因子 (BAFF) 等细胞因子促进鼻息肉的形成，为未来的治疗提供了可能性。本综述说明，在 CRS 的临床决策和治疗中需要采用宏观方法。合并症可能会导致整体的促炎状态，加重症状的严重程度，成为治疗阻力的来源，甚至成为未来治疗的契机。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Allergy and Asthma Reports 医学-过敏

CiteScore

11.20

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of Current Allergy and Asthma Reports is to systematically provide the views of highly selected experts on current advances in the fields of allergy and asthma and highlight the most important papers recently published. All reviews are intended to facilitate the understanding of new advances in science for better diagnosis, treatment, and prevention of allergy and asthma. We accomplish this aim by appointing international experts in major subject areas across the discipline to review select topics emphasizing recent developments and highlighting important new papers and emerging concepts. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. Over a one- to two-year period, readers are updated on all the major advances in allergy and asthma.