慢性鼻窦炎的机制与临床进展：2023-2025年

文献信息

中文摘要

慢性鼻窦炎（CRS）是一种鼻和鼻窦的慢性炎症性疾病，与生活质量差和高医疗负担相关。根据是否存在鼻息肉，CRS大致分为两种亚型：伴鼻息肉型（CRSwNP）和不伴鼻息肉型（CRSsNP）。虽然CRSsNP更为普遍，但多年来对CRSwNP发病机制的理解更为深入。CRSwNP以2型（T2）炎症以及上皮屏障功能障碍为特征，在过去3年中，定义了新的内型，识别了炎症细胞异质性，发现了新的细胞群体，并推进了导致上皮屏障功能障碍的机制。临床上，目前有4种靶向T2炎症的生物制剂被批准用于CRSwNP。随着这些疗法在临床实践中日益普遍，正在进行的研究集中于比较其疗效，并确定它们与更成熟的干预措施（如皮质类固醇和鼻窦手术）共同的作用。在这篇综述中，将重点介绍2023年至2025年间CRS的新机制发现和近期临床进展。

英文摘要

Chronic rhinosinusitis (CRS) is a chronic inflammatory condition of the nose and paranasal sinuses associated with poor quality of life and high health care burden. CRS is broadly classified into two subtypes based on whether nasal polyps are present (CRSwNP) or absent (CRSsNP). While CRSsNP is more prevalent, the underlying mechanisms contributing to CRSwNP pathogenesis have been more extensively defined over the years. CRSwNP is characterized by type 2 (T2) inflammation as well as epithelial barrier dysfunction and in the past 3 years, a new endotype has been defined, inflammatory cell heterogeneity has been identified, novel cell populations have been discovered, and mechanisms contributing to epithelial barrier dysfunction have been advanced. Clinically, 4 biologics targeting T2 inflammation are now approved for CRSwNP. As these therapies become increasingly common in clinical practice, ongoing investigations have focused on comparing their efficacy and defining their role alongside more established interventions such as corticosteroids and sinus surgery. In this review, novel mechanistic findings and recent clinical developments in CRS between 2023 and 2025 will be highlighted.