慢性鼻窦炎伴鼻息肉的内型研究及其指导下的精准控制与治疗

慢性鼻窦炎伴鼻息肉(CRSwNP)是指病程超过12周、伴息肉形成的鼻腔鼻窦慢性炎症,是一组表型相似但内在机制存在显著差异的复杂疾病。基于其中参与的炎症因子及其病理机制的不同可将其分为1、2、3型炎症,其中2型炎症对应于嗜酸粒细胞浸润为主的CRSwNP。不同内型(endotype)的临床表现、人口学特征、治疗反应性、预后均存在差异。因此,在深入了解不同内型病理机制的基础上,可根据其临床特点建立多种间接预测模型,以优化诊断;还可在内型指导下实现症状的精准控制与治疗,以改善预后。本文就CRSwNP内型的研究进展及其指导下的精准控制与治疗作一综述。

An endotype study of chronic rhinosinusitis with nasal polyps and precise control and treatment under the guidance

Chronic rhinosinusitis with nasal polyps(CRSwNP)refers to chronic inflammation of the nasal cavity and paranasal sinuses with polyp formation over a course of more than 12 weeks. CRSwNP covers a group of complex diseases with similar phenotypes, but significantly different underlying mechanisms. Based on the inflammatory factors involved and the pathological mechanisms, CRSwNP can be divided into type 1, 2, and 3 inflammation, among which type 2 inflammation corresponds to CRSwNP dominated by eosinophil infiltration. There are many differences in the clinical manifestations, demographic characteristics, treatment responses, and prognosis of the different endotypes. Therefore, to optimize diagnosis, it is necessary to establish indirect predictive models that are based on the clinical characteristics and an in-depth of the different pathological mechanisms. Furthermore, the accurate control and treatment of symptoms can also be achieved to improve prognosis, under the guidance of endotypes. This article reviews the current progresses in the field of CRSwNP endotypes and their precise control and treatment under clinical guidance.