Subtyping of polyposis nasi: phenotypes, endotypes and comorbidities

Michael Koennecke*, Ludger Klimek, Joaquim Mullol, Philippe Gevaert, Barbara Wollenberg

*Corresponding author for this work
17 Citations (Scopus)

Abstract

Background: Chronic rhinosinusitis (CRS) is a heterogeneous, multifactorial inflammatory disease of the nasal and paranasal mucosa. It has not been possible to date to develop an internationally standardized, uniform classification for this disorder. A phenotype classification according to CRS with (CRSwNP) and without polyposis (CRSsNP) is usually made. However, a large number of studies have shown that there are also different endotypes of CRS within these phenotypes, with different pathophysiologies of chronic inflammation of the nasal mucosa. This review describes the central immunological processes in nasal polyps, as well as the impact of related diseases on the inflammatory profile of nasal polyps. Materials and methods: The current knowledge on the immunological and molecular processes of CRS, in particular CRSwNP and its classification into specific endotypes, was put together by means of a structured literature search in Medline, PubMed, the national and international guideline registers, and the Cochrane Library. Results: Based on the current literature, the different immunological processes in CRS and nasal polyps were elaborated and a graphical representation in the form of an immunological network developed. In addition, different inflammatory profiles can be found in CRSwNP depending on related diseases, such as bronchial asthma, cystic fibrosis (CF), or NASID-Exacerbated Respiratory Disease (N‑ERD). Conclusion: The identification of different endotypes of CRSwNP may help to improvediagnostics and develop novel individual treatment approaches in CRSwNP.

Original languageEnglish
JournalAllergo Journal International
Volume27
Issue number2
Pages (from-to)56-65
Number of pages10
DOIs
Publication statusPublished - 01.03.2018

Research Areas and Centers

  • Research Area: Luebeck Integrated Oncology Network (LION)

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