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Diverse Endotypes of Chronic Rhinosinusitis and Clinical Implications

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Abstract

Chronic rhinosinusitis (CRS) is a highly heterogeneous disease characterized by inflammation in the nasal and sinus mucosa. The CRS phenotypes, based on the presence or absence of nasal polyps, are known as CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). However, this classification has limitations in fully capturing the mechanisms and clinical manifestations of CRS. To address the heterogeneity of CRS, there has been a growing focus on classifying the condition into distinct endotypes. Endotype classification involves grouping patients based on specific molecular, immunological, and clinical characteristics, allowing for more personalized and targeted treatment approaches.

This review delves into the current state of endotype classifications for CRS. It explores the role of geographic factors, microbiome, and subphenotype in shaping different endotypes. Additionally, the review examines how various clinical features are associated with specific endotypes, providing valuable insights into tailoring treatment options for better outcomes and transitions between different endotypes.

Overall, this review offers a comprehensive and up-to-date perspective on the intricate realm of CRS endotype classifications. By unraveling the molecular and clinical intricacies, this review lays the foundation for more precise, effective, and individualized treatment strategies in the management of CRS.

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Funding

This work was supported by grants from the national natural science foundation of China (82101189, 82171110), the program for Changjiang scholars and innovative research team (IRT13082), CAMS Innovation Fund for Medical Sciences (2019-I2M-5–022), and Beijing municipal science and technology project (Z181100001618002), the Beijing Natural Science Foundation (7222024), the Beijing New-star Plan of Science and Technology (20220484226), the Public Welfare Development and Reform Pilot Project (2019–10), the High Level Public Health Technical Talent Training Plan (Lingjunrencai-01–08, Lingjunrencai-02–09).

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  1. Xiran Xie and Lijia Xuan have contributed equally to this work..

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China

    Xiran Xie, Lijia Xuan, Yajuan Zhao, Xiangdong Wang & Luo Zhang

  2. Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China

    Lijia Xuan, Xiangdong Wang & Luo Zhang

  3. Department of Otolaryngology, Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing, 101300, China

    Yajuan Zhao

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Contributions

X. Xie and L. Xuan wrote the main manuscript text. Y. Zhao prepared Fig. 1. X. Xie prepared Fig. 2–3. X. Wang directed writing and article structure. L. Zhang designed the theme and structure. All authors reviewed the manuscript.

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Correspondence to Xiangdong Wang or Luo Zhang.

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Xie, X., Xuan, L., Zhao, Y. et al. Diverse Endotypes of Chronic Rhinosinusitis and Clinical Implications. Clinic Rev Allerg Immunol 65, 420–432 (2023). https://doi.org/10.1007/s12016-023-08976-y

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