Advances in rhinitis and rhinosinusitis in 2015
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- 作者：Claus Bachert ; MD ; PhDa ; b ; Claus.Bachert@ugent.be" class="auth_mail" title="E-mail the corresponding author ; Elien Gevaert ; PhDa
- 关键词：Allergic rhinitis ; allergen components ; allergen-specific immunotherapy ; house dust mite ; chronic rhinosinusitis ; endotype ; type 2 cytokines
- 刊名：Journal of Allergy and Clinical Immunology
- 出版年：2016
- 出版时间：November 2016
- 年：2016
- 卷：138
- 期：5
- 页码：1277-1283
- 全文大小：577 K
文摘
The last year has seen great progress in the understanding of upper airway disease and in its management. For allergic rhinitis, authors focused on the prediction of and effect on the natural course of disease. New evidence was published for the disease-modifying effect of allergen immunotherapy in terms of avoidance of new sensitizations and prevention of asthma in either randomized or real-life studies. Specifically, for patients with house dust mite allergies, which are often underestimated and difficult to diagnose, the efficacy of SQ house dust mite sublingual immunotherapy tablets has been demonstrated in patients with allergic rhinitis and asthma. For the first time, allergen immunotherapy significantly reduced asthma exacerbations. In patients with chronic rhinosinusitis, a novel endotyping approach purely based on T helper cell biomarkers has been developed and has shown clinical relevance through associations with asthma comorbidity and recurrence after surgery. Severe nasal polyposis with high risk for asthma comorbidity and disease recurrence is characterized by type 2 inflammatory patterns, including IgE antibodies to staphylococcal superantigens; several studies using biologic agents have targeted exactly this spectrum of mediators. This goes in parallel with new knowledge on even more type 2 mediators derived from epithelial cells, which will expand the number of possible candidates for innovative intervention.