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Immune Mechanisms of Chronic Rhinosinusitis

  • Allergens (RK Bush and JA Woodfolk, Section Editors)
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Abstract

Chronic rhinosinusitis (CRS) is a common inflammatory disease that results in a significant decrease in patient quality of life and a large economic burden. However, the lack of population-based epidemiologic studies and robust model systems has made it difficult to fully elucidate the key inflammatory pathways that drive the chronic inflammatory responses observed in CRS. This review will highlight the wide variety of factors that likely contribute to CRS disease pathogenesis. Defects in the innate immune function of the airway epithelium, including decreases in barrier function, mucociliary clearance, and production of antimicrobial peptides, all likely play a role in the initial inflammatory response. Subsequent recruitment and activation of eosinophils, mast cells, and innate lymphoid cells (ILCs) further contributes to the chronic inflammatory response and directly activates adaptive immune cells, including T and B cells. However, development of new tools and model systems is still needed to further understand the chronicity of this inflammatory response and which specific factors are necessary or sufficient to drive CRS pathogenesis. Such studies will be critical for the development of improved therapeutic strategies aimed at treating this highly prevalent and costly disease.

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Abbreviations

BAFF:

B cell-activating factor of the TNF family

CRS:

Chronic rhinosinusitis

CRSsNP:

CRS without nasal polyps

CRSwNP:

CRS with nasal polyps

EBI2:

Epstein-Barr virus-induced protein 2

ILC:

Innate lymphoid cell

OSM:

Oncostatin M

PLUNC:

Palate lung and nasal epithelium clone protein

TLR:

Toll-like receptor

TSLP:

Thymic stromal lymphopoietin

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Authors and Affiliations

  1. Division of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 240 E. Huron St., McGaw Rm M-302, Chicago, IL, 60611, USA

    Kathryn E. Hulse

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Correspondence to Kathryn E. Hulse.

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Dr. Hulse declares a grant from NIH.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Funding

This study was funded by NIH P01 106683-01, K12 HD055884, and the Ernest S. Bazley Trust.

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This article is part of the Topical Collection on Allergens

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Hulse, K.E. Immune Mechanisms of Chronic Rhinosinusitis. Curr Allergy Asthma Rep 16, 1 (2016). https://doi.org/10.1007/s11882-015-0579-0

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