Diversity of TH cytokine profiles in patients with chronic rhinosinusitis: A multicenter study in Europe, Asia, and Oceania

Chronic Rhinosinusitis is a chronic disease of the sinuses that’s seen in up to 27% of adults in Europe and 14% in the United States.  Grouped in two categories, chronic rhinosinusitis with nasal polyposis (CRwNP) and chronic rhinosinusitis without nasal polyposis (CRsNP), chronic rhinosinusitis appears to be mediated by very distinct immune mechanisms.  Interestingly, there are differences in the clinical presentations between ethnic groups as well as in the types and levels of cytokines produced by immune cells. 

Wang and colleagues expand upon this prior knowledge by looking at 435 patients with chronic rhinosinusitis, and comparing them to 138 control subjects (J Allergy Clin Immunol 2016; 138(5): 1344-1353).  They were recruited from six regions covering Europe, Australia, and Asia.  They checked the levels of cytokines, inflammatory mediators and IgE, the antibody mediating allergies, from the mucosa of subjects.  The levels of these parameters were then compared among the different subjects.

They found that there was a large variety of expression of these cytokines among the different subjects in various regions.  This suggests that chronic rhinosinusitis is more of an umbrella term and that there are actually many different endotypes of patients with chronic rhinosinusitis.