身体状况:持续性鼻窦炎伴鼻息肉和哮喘

Dr. Seejo George, Dr. Unnikrishnan Thamarassery
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摘要

诊断为持续性鼻窦炎伴鼻腔息肉的个体,其特征是存在2型免疫特征,经常经历严重和反复出现的症状。下呼吸道疾病,如哮喘,经常与其他医学疾病共存,并具有类似的潜在生理机制。慢性鼻窦炎伴鼻息肉(CRSwNP)伴哮喘的特点是受影响组织中存在嗜酸性粒细胞浸润和周围环境中免疫球蛋白E (IgE)水平升高。从临床角度来看,慢性鼻窦炎伴鼻息肉(CRSwNP)患者并发哮喘与鼻窦症状加重和生活质量下降有关。此外,通过药物和手术干预来控制这种情况带来了更大的挑战。鼻息肉病与哮喘的共存在疾病管理方面提出了挑战。这种合并症与加重易感性、气道阻塞加重和更大程度的嗜酸性粒细胞炎症有关。诊断为慢性鼻窦炎伴鼻息肉(CRSwNP)并并发阿司匹林加重呼吸系统疾病(AERD)的个体是一个亚组,其特征是存在非常严重且难以控制的症状。此外,这些患者通常表现出高度的鼻息肉严重程度。呼吸道合并症的诊断和治疗可以通过识别和理解下呼吸道和上呼吸道共同的病理生理途径而得到极大的帮助。开发针对流行的2型炎症机制的全身性药物的令人信服的理由是,慢性鼻窦炎伴鼻道息肉(CRSwNP)和哮喘之间存在全身性炎症联系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medical condition: Persistent rhinosinusitis accompanied by nasal polyps and asthma
Individuals diagnosed with persistent rhinosinusitis accompanied with polyps in the nasal cavity, which is distinguished by the presence of a type 2 immunological signature, frequently experience severe and recurring symptoms. Lower respiratory tract disorders, such as asthma, frequently coexist with other medical illnesses and have comparable underlying physiological mechanisms. Chronic rhinosinusitis with nasal polyps (CRSwNP) accompanied with asthma is distinguished by the presence of eosinophilic infiltration in the affected tissues and elevated levels of immunoglobulin E (IgE) in the immediate environment. From a clinical perspective, the presence of concomitant asthma in individuals with chronic rhinosinusitis with nasal polyps (CRSwNP) is linked to heightened sinonasal symptoms and a worse quality of life. Furthermore, managing this condition by medicinal and surgical interventions poses greater challenges. The coexistence of nasal polyposis with asthma presents challenges in terms of disease management. This comorbidity is associated with higher susceptibility to exacerbations, heightened airway obstruction, and a greater extent of Eosinophilic inflammation. Individuals diagnosed with chronic rhinosinusitis with nasal polyps (CRSwNP) who also have concurrent aspirin-exacerbated respiratory disease (AERD) are a subgroup characterized by the presence of very severe and challenging-to-manage symptoms. Moreover, these patients typically exhibit a high degree of nasal polyp severity. The diagnosis and treatment of respiratory co-morbidities can be greatly aided by the identification and understanding of shared pathophysiology pathways in the lower as well as the upper airways. The compelling justification for developing systemic medicines that precisely target prevalent type 2 inflammatory mechanisms is the systemic inflammatory link that exists among rhinosinusitis that is chronic with polyps in the nasal passages (CRSwNP) and asthma.
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