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Pathological mechanisms and clinical features of eosinophilic chronic rhinosinusitis in the Japanese population.
MedLine Citation:
PMID:  20567131     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
The overall pathological view of paranasal sinus inflammation in the Japanese population has profoundly changed in recent years. Eosinophilic chronic rhinosinusitis (ECRS) is a clinical entity of intractable chronic sinus inflammation accompanied by numerous infiltrations of activated eosinophils in the paranasal sinus mucosa and/or nasal polyps. Several pathologic processes are considered to act in concert to promote the accumulation of eosinophils in ECRS. They include infiltration of progenitor cells, increase in local IL-3, IL-5, IL-13, GM-CSF and eotaxin production, and upregulation of adhesion molecules. The role of nasal allergen sensitization and innate immunity responses in the sinus mucosa has also been proposed in the development of ECRS. Various pathogens including TLRs ligands may trigger an abnormal immune response at the mucosal surface. The objectives of ECRS management should focus directly on inhibition of local eosinophil infiltration. Surgical procedures include widely opening the bony wall septum of every affected sinus and mechanical removal of diseased mucosal lesion. The use of local and/or systemic steroids, leukotriene receptor antagonists, and Th2 cytokine antagonists is recommended. Local administration of steroids is a potent treatment strategy for preventing relapse of nasal polyposis and is considered to be the first-line treatment for ECRS patients.
Authors:
Sachio Takeno; Katsuhiro Hirakawa; Takashi Ishino
Publication Detail:
Type:  Journal Article     Date:  2010-06-25
Journal Detail:
Title:  Allergology international : official journal of the Japanese Society of Allergology     Volume:  59     ISSN:  1440-1592     ISO Abbreviation:  Allergol Int     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616296     Medline TA:  Allergol Int     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  247-56     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. takeno@hiroshima-u.ac.jp
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