半乳糖凝集素-10与夏科-莱登晶体在伴鼻息肉的慢性鼻窦炎中的作用：发病机制见解与临床意义

文献信息

中文摘要

伴鼻息肉的慢性鼻窦炎（CRSwNP）是一种异质性炎症性疾病，在西方人群的大多数患者中以2型炎症为主。半乳糖凝集素-10（Gal-10）和夏科-莱登晶体（CLCs）与嗜酸性粒细胞活化、细胞溶解和嗜酸性粒细胞胞外诱捕网细胞死亡（EETosis）相关，已成为嗜酸性炎症的潜在生物标志物和介质。本叙述性综述总结了关于它们在CRSwNP中生物学作用和临床相关性的当前证据。文献通过检索PubMed/MEDLINE、Web of Science和Google Scholar确定，重点关注机制研究、临床研究以及关于2型炎症性气道疾病的最新证据。现有证据表明，Gal-10和CLCs与嗜酸性粒细胞活化相关，并可能通过上皮损伤、黏液黏度增加、黏液纤毛清除受损、组织重塑和炎症放大导致持续性2型炎症。Gal-10/CLCs可能作为疾病活动度、术后复发和生物制剂治疗反应的研究性生物标志物具有价值。当前的生物制剂可能通过减少嗜酸性粒细胞存活、募集或活化间接调节Gal-10/CLC通路，尽管直接证据仍然有限。Gal-10和CLCs是CRSwNP中有前景的研究性生物标志物和机制上合理的治疗靶点。然而，由于缺乏标准化分析方法、经过验证的截断值以及证明其超越现有生物标志物增量价值的前瞻性研究，临床应用受到限制。需要进一步研究以阐明它们在分层、预后和生物制剂治疗监测中的作用。

英文摘要

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease in which type 2 inflammation predominates in most patients in Western populations. Galectin-10 (Gal-10) and Charcot-Leyden crystals (CLCs), linked to eosinophil activation, cytolysis and eosinophil extracellular trap cell death (EETosis), have emerged as potential biomarkers and mediators of eosinophilic inflammation. This narrative review summarises current evidence on their biological role and clinical relevance in CRSwNP. The literature was identified through searches of PubMed/MEDLINE, Web of Science and Google Scholar, with emphasis on mechanistic studies, clinical investigations and recent evidence concerning type 2 inflammatory airway diseases. Available evidence suggests that Gal-10 and CLCs are associated with eosinophil activation and may contribute to persistent type 2 inflammation through epithelial injury, increased mucus viscosity, impaired mucociliary clearance, tissue remodelling and inflammatory amplification. Gal-10/CLCs may have value as investigational biomarkers of disease activity, postoperative recurrence and response to biologic therapy. Current biologics may indirectly modulate the Gal-10/CLC pathway by reducing eosinophil survival, recruitment or activation, although direct evidence remains limited. Gal-10 and CLCs are promising investigational biomarkers and mechanistically plausible therapeutic targets in CRSwNP. However, clinical application is limited by the lack of standardised analytical methods, validated cut-off values and prospective studies demonstrating incremental value beyond established biomarkers. Further research is required to clarify their role in stratification, prognosis and monitoring of biologic therapy.