Impact of chronic rhinosinusitis on severe asthma patientsReportar como inadecuado

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Coexistence of chronic rhinosinusitis CRS with asthma appears to impair asthma control. Type-2 innate lymphoid cells ILC2s respond to the cytokines of thymic stromal lymphopoietin TSLP, interleukin IL-25 and IL-33, thus contributing to airway diseases such as CRS and asthma. We investigate whether the augmented Th2-cytokines in CRS might be related to sinonasal tract ILC2s corresponding to enhanced IL-25, IL-33 and TSLP release in severe asthmatics, and be involved in asthma control. Twenty-eight asthmatics 12 non-severe and 16 severe with CRS receiving nasal surgery were enrolled. The predicted FEV1 inversely associated with CRS severity of CT or endoscopy scores. Higher expression of Th2-driven cytokines IL-4, IL-5, IL-9, and IL-13, TSLP, IL-25 and IL-33 in nasal tissues was observed in severe asthma. Severe asthmatics had higher ILC2 cell counts in their nasal tissues. ILC2 counts were positively correlated with Th2-cytokines. Nasal surgery significantly improved asthma control and lung function decline in severe asthma and CRS. The higher expression of IL-33-ILC2 axis-directed type 2 immune responses in nasal tissue of CRS brought the greater decline of lung function in severe asthma. ILC2-induced the upregulated activity of Th2-related cytokines in asthmatics with CRS may contribute to a recalcitrant status of asthma control.

Autor: Ta-Jen Lee , Chia-Hsiang Fu , Chun-Hua Wang, Chi-Che Huang, Chien-Chia Huang, Po-Hung Chang, Yi-Wei Chen, Chia-Chen Wu, Ching-Lun



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