PMID- 27103607
OWN - NLM
STAT- MEDLINE
DCOM- 20171120
LR  - 20181113
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Print)
IS  - 2042-6976 (Linking)
VI  - 6
IP  - 9
DP  - 2016 Sep
TI  - Is there a future for biologics in the management of chronic rhinosinusitis?
PG  - 935-42
LID - 10.1002/alr.21780 [doi]
AB  - BACKGROUND: Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory 
      condition of the sinonasal mucosa consisting of poorly defined subtypes and 
      characterized by variable clinical manifestations, responses to therapy, and 
      underlying pathophysiologies. In the related disorder of asthma, progress has 
      been made in defining disease subtypes on both clinical and pathophysiologic 
      levels, facilitating the development of targeted biologic pharmacotherapy. The 
      potential role of these drugs for the management of CRS will be reviewed. The 
      objective of this work is to highlight the emerging therapeutic targets in CRS in 
      light of evolving treatment options for asthma and enhanced understandings of the 
      clinical manifestations and pathophysiology of CRS. METHODS: This article is a 
      review of recent studies regarding current and future advances in 
      biomarker-directed therapies in the medical treatment of CRS. RESULTS: Various 
      biologic therapies used in the management of asthma have demonstrated clinical 
      promise for CRS, particularly within the CRS with nasal polyposis (CRSwNP) 
      phenotype. Several randomized, double-blind, placebo-controlled studies 
      increasingly support the targeting of immunoglobulin E (IgE) and interleukin 
      (IL)-5 pathways to improve outcome measures in CRSwNP patients. The IL-4/IL-13 
      pathway and other type 2 inflammatory pathways have also shown potential as 
      targets for CRSwNP, but all pathways require further investigation. CONCLUSION: 
      Recalcitrant CRS in the United States and Europe is most commonly associated with 
      nasal polyposis and a type 2 cytokine skewing in the tissue, resulting in tissue 
      infiltration of eosinophils, mast cells, and basophils. Targeting biomarkers of 
      the associated type 2 pathways may be a practical treatment option for 
      recalcitrant CRSwNP in the future.
CI  - (c) 2016 ARS-AAOA, LLC.
FAU - Lam, Kent
AU  - Lam K
AD  - Department of Otolaryngology-Head and Neck Surgery, Northwestern University 
      Feinberg School of Medicine, Chicago, IL.
AD  - Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School 
      at, The University of Texas Health Science Center at Houston, Houston, TX.
FAU - Kern, Robert C
AU  - Kern RC
AD  - Department of Otolaryngology-Head and Neck Surgery, Northwestern University 
      Feinberg School of Medicine, Chicago, IL.
FAU - Luong, Amber
AU  - Luong A
AD  - Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School 
      at, The University of Texas Health Science Center at Houston, Houston, TX. 
      amber.u.luong@uth.tmc.edu.
LA  - eng
GR  - KL2 TR000370/TR/NCATS NIH HHS/United States
GR  - UL1 TR000371/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
DEP - 20160422
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
RN  - 0 (Biological Products)
RN  - 0 (Cytokines)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Biological Products/*therapeutic use
MH  - Chronic Disease
MH  - Cytokines/immunology
MH  - Epithelial Cells/immunology
MH  - Humans
MH  - Immunoglobulin E/immunology
MH  - Phenotype
MH  - Rhinitis/*drug therapy/immunology
MH  - Sinusitis/*drug therapy/immunology
PMC - PMC5012929
MID - NIHMS768438
OTO - NOTNLM
OT  - asthma
OT  - biologic therapy
OT  - chronic rhinosinusitis
OT  - eosinophils
OT  - molecular biomarkers
OT  - monoclonal antibodies
OT  - nasal polyps
COIS- None
EDAT- 2016/04/23 06:00
MHDA- 2017/11/29 06:00
PMCR- 2017/09/01
CRDT- 2016/04/23 06:00
PHST- 2016/01/10 00:00 [received]
PHST- 2016/02/22 00:00 [revised]
PHST- 2016/03/08 00:00 [accepted]
PHST- 2016/04/23 06:00 [entrez]
PHST- 2016/04/23 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2017/09/01 00:00 [pmc-release]
AID - 10.1002/alr.21780 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2016 Sep;6(9):935-42. doi: 10.1002/alr.21780. Epub 2016 
      Apr 22.