EOSINOPHILIC IMMUNE DYSFUNCTION
ACROSS INFLAMMATORY DISEASES
Chronic rhinosinusitis with nasal polyps (CRSwNP)
Eosinophilic
asthma (EA)
Chronic rhinosinusitis with nasal polyps (CRSwNP)
Eosinophilic
esophagitis (EoE)
Eosinophilic granulomatosis with polyangiitis (EGPA)
Hypereosinophilic
syndrome (HES)
WHAT IS CHRONIC RHINOSINUSITIS WITH NASAL POLYPS (CRSwNP)?
Chronic rhinosinusitis (CRS) is characterized by persistent, symptomatic inflammation of the mucosa of the nose and paranasal sinuses.1
Nasal polyps (NP) are benign inflammatory masses arising from the mucosa of the nose and paranasal sinuses.1
The estimated prevalence of CRSwNP is 2%-7%.2,3
Approximately
1 in 20
people have CRS4
Up to 30%
of patients
with CRS have CRSwNP in the US1
Up to 90%
of CRSwNP
patients have eosinophil-dominant infiltration5
THE ROLE OF EOSINOPHILIC IMMUNE DYSFUNCTION IN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS
Eosinophilic inflammation potentially contributes to key pathological mechanisms in chronic rhinosinusitis with nasal polyps.6-10
Adapted from Kita and Bochner, in Middleton’s Allergy: Principles and Practice, 8th Edition, 2014.6
ECP=eosinophil cationic protein; EDN=eosinophil-derived neurotoxin; EPX=eosinophil peroxidase; GM-CSF=granulocyte-macrophage colony-stimulating factor; MBP=major basic protein; MMP=matrix metalloproteinase; RANTES=regulated on activation, normal T cells expressed and secreted; TGF=transforming growth factor.
CLINICAL CONSEQUENCES OF CHRONIC RHINOSINUSITIS WITH NASAL POLYPS
Clinical manifestations of CRSwNP: nasal obstruction, reduction in sense of smell, nasal discharge, sleep disturbance, and adverse effects on quality of life.1,11
Surgery to remove polyps may be required in patients whose symptoms are not controlled with corticosteroids. However, rates of relapse and repeated intervention can be high.1,11