慢性鼻-鼻窦炎小鼠模型及应用现状

慢性鼻-鼻窦炎(CRS)是上呼吸道常见的慢性炎症性疾病,严重影响了患者生活质量,目前其发病机制尚不明确。CRS的动物模型是研究人类CRS病理机制和疗效的理想手段。小鼠是目前CRS常用的造模动物。就小鼠CRS的造模方法、模型评价指标及模型的应用现状等做研究综述。     

慢性鼻窦炎合并哮喘研究进展[综述]

慢性鼻窦炎（chronic rhinosinusitis，CRS）和哮喘（asthma，AS）分别是上、下呼吸道常见的慢性炎症性疾病。人群中有7%～71%的CRS患者合并AS（CRS+AS），其症状严重且更容易复发，对生活质量影响更大，治疗也最具挑战性。联合气道学说认为上、下气道有相似的炎症特征及发病机制，并提出“同一气道，同一疾病”的观点。CRS与AS之间的关系目前尚未有明确的解释，并且CRS+AS的炎症特征和发病机制尚不完全清楚，临床上也缺少最佳的治疗方案。本文就CRS+AS的最新研究进展做一综述，为进一步研究CRS+AS可能的致病机制和治疗策略提供参考。     

IL-34对Th17细胞及其细胞因子在慢性鼻-鼻窦炎调节机制中的研究前景

慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)是一种慢性炎症性疾病,由多种炎性细胞参与,其病程大于12周,主要临床表现为黏性或黏脓性鼻涕、鼻塞、头痛、嗅觉丧失或减退,使得患者的生活质量受到了很大的变化。目前临床上一般将CRS分为慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)和慢性鼻-鼻窦炎不伴鼻息肉(chronic rhinosinusitis without nasal polyps,CRSsNP)。在炎症反应过程中,辅助性T淋巴细胞(Th)类细胞因子是最主要的一类细胞因子,Th细胞及其所产生的细胞因子在其炎症的发展过程中都起到了关键性的作用。CRS的发病机制目前为止还未完全阐释清楚,本文将对IL-34(interleukin-34,IL-34)、Th17细胞极其相关细胞因子在慢性鼻-鼻窦炎发病机制中的研究前景做一综述。     

细菌超抗原对慢性鼻-鼻窦炎中辅助性T淋巴细胞的作用

慢性鼻-鼻窦炎(chronic rhino-sinusitis,CRS)是鼻腔-鼻窦黏膜的慢性炎症性疾病,其患病率呈逐年递增之势,给人们生活质量及身体健康带来严重影响,同时也给社会造成沉重的经济负担。因此,针对CRS发病机制的研究,开发更有效的治疗手段,是降低CRS危害的根本途径。Schurbert等研究发现,金黄色葡萄球菌超抗原可以激活并增殖辅助性T     

转化生长因子β1参与慢性鼻窦炎发病机制的研究进展

慢性鼻窦炎(chronic rhinosinusitis, CRS)作为耳鼻咽喉科常见疾病之一, 其临床症状严重影响到患者的健康和生活质量。目前转化生长因子β1(TGF-β1)作为影响CRS发病的关键因子, 在CRS不同亚型的表达差异造成不同亚型的重塑及炎症模式的不同。关于TGF-β1经典信号通路及相关分子的检测已成为近年来探索CRS发病机制的重要方向。本文就CRS不同亚型中TGF-β1信号通路及其与相关蛋白和分子之间的关系做一综述。     

慢性鼻-鼻窦炎的内在型:从基础到临床

慢性鼻-鼻窦炎(CRS)是多因素作用下鼻及鼻窦黏膜的慢性持续性炎症,具有高度异质性,病理机制非常复杂,临床表现型相同,其内在型和预后可能不同。CRS内在型是对不同个体CRS发病内在本质的研究,是从细胞和分子生物学角度探索疾病的发病本质,随着CRS内在型研究的不断深入,期望能找到某些特定的分子标志物,以这些分子标志物为靶标实现个体化的精准治疗。     

慢性鼻窦炎特异性生物治疗研究进展

慢性鼻窦炎(CRS)是一种常见的鼻窦鼻腔黏膜炎症所引起的一组临床综合征, 具有高异质性。在临床常用的治疗方法中并没有基于CRS内在型不同的病理生理学发病机制的针对性治疗, 且常规治疗存在各种不良反应及潜在并发症, 这使得生物治疗CRS进入大众视野, 被认为是CRS治疗后效果维持和改变CRS自然过程的潜在性治疗选择。本研究就CRS的内在分型, 特异性生物治疗的作用机制, 常用靶向药物及最新研究进展做一综述。     

中性粒细胞和嗜酸性粒细胞在慢性鼻窦炎中的相互影响及临床治疗思考

慢性鼻窦炎(CRS)按其病理特征分为嗜酸性粒细胞(EOS)型和非嗜酸性粒细胞(nEOS)型,其中nEOS型中最常见的是中性粒细胞(neutrophil, NEU)浸润。EOS主导Th2型炎症,NEU浸润更多见于Th1和Th17型炎症。长期以来,认为NEU和EOS在CRS发病机制中可能处于相互排斥的对立关系。但近年研究发现,在临床症状最重的难治性CRS鼻黏膜或鼻息肉组织中,NEU和EOS浸润均明显增多,并且相互影响。通过文献复习,对CRS中NEU和EOS混合性炎症及两者之间相互影响的研究进展进行综述,并就临床治疗对策进行讨论。     

NLRP3炎症小体在慢性鼻窦炎和变应性鼻炎中的研究进展

慢性鼻窦炎(CRS)和变应性鼻炎(AR)作为上气道常见的炎症性疾病,其发生发展机制与炎症小体Nod样受体(NLRs)过度激活相关。核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)作为NLRs家族中最受关注的炎症小体,近年来在CRS和AR中的报道也越来越多。本综述既往文献,阐述NLPR3炎症小体在CRS和AR的发病机制、病情进展和疾病治疗等方面所起的作用,为临床工作中探索治疗靶点提供借鉴。     

慢性鼻窦炎动物模型应用现状及评价指标

目的慢性鼻窦炎（chrohic rhinosinusitis,CRS）是上呼吸道常见的慢性炎症性疾病,已经成为严重影响公众健康的慢性疾病之一,根据目前国内外指南的治疗方法难以根治,主要原因是该疾病病因复杂呈异质性、发病机制尚不完全清楚,而基础研究缺乏成熟稳定的动物模型是重要原因。目前建立的CRS动物模型还存在各种争议,未形成成熟稳定公认的动物模型。本文就近十年来国内外建立CRS动物模型的现状进行简要综述,分析各种动物模型的优缺点,以期对未来研究CRS选择正确的模型起指导作用。     

Staphylococcus aureus in chronic rhinosinusitis: the effect on the epithelial chloride channel (cystic fibrosis transmembrane conductance regulator,CFTR) and the epithelial sodium channel (ENaC) physiology

Background: Chronic rhinosinusitis (CRS) is an inflammatory disease of the nose and the paranasal sinuses, often associated with an infection by Staphylococcus aureus (S. aureus). Disturbance in the function of ion channels is regarded as an etiological factor for pathogenesis of CRS.

Aims: The study aims to measure the mRNA expression of the ENaC and CFTR ion channels in nasal epithelial cells (NECs) and to investigate the effect of both the budesonide and S. aureus on these ion channels.

Materials and method: NECs biopsies obtained from healthy volunteers and patients with CRS. NECs were infected with S. aureus strains and/or budesonide to study the mRNA expression levels of the ENaC and CFTR ion channels.

Results: The mRNA expression level of CFTR was increased while that of ENaC was decreased. S. aureus infection and budesonide treatment induced a significant modulation of ENaC and CFTR ion channels expression.

Conclusion: The CFTR and ENaC ion channel physiology are of importance in the pathogenesis of CRS. Exposure to S. aureus infection and treatment with budesonide modulated the mRNA expression of CFTR and ENaC ion channels.

Significance: Better understanding of the pathophysiology of CRS.     

紧密连接与慢性鼻-鼻窦炎发病机制的研究进展

慢性鼻-鼻窦炎(CRS)是常见的鼻腔鼻窦黏膜炎症性疾病。紧密连接是位于上皮细胞连接的最顶部的连接蛋白复合体,在维持上皮细胞屏障功能上发挥重要的作用。研究表明,紧密连接蛋白缺陷和CRS发病机制存在关联。紧密连接蛋白组成及其与CRS的关系已经成为当前的研究热点,综述其研究进展。     

P-glycoprotein and chronic rhinosinusitis

Chronic rhinosinusitis (CRS) is a heterogeneous definition that includes different disease states that usually are associated with abnormal inflammatory responses. Besides being prevalent, the mechanisms involved in its pathogenesis are not clear and there are few therapeutic options with tolerable side effects. P-glycoprotein (P-gp) is an efflux pump responsible of extruding xenobiotics and cellular metabolites from multiple cell types. It has been widely studied in the cancer field, due to its ability to confer resistance to chemotherapy. It also promotes Type 2 helper T-cell polarizing cytokine secretion in CRS and may represent a potential target to differentiate subtypes of CRS and personalize treatment. This state-of-the-art review explores current knowledge on the participation of P-gp in the pathogenesis of CRS, the P-gp inhibition as a novel targeted therapeutic strategy and the exosomal P-gp test, a non-invasive biomarker that can represent an important advance in the field of rhinology.     

Innate immunity in the paranasal sinuses: a review of nasal host defenses

BACKGROUND: Chronic rhinosinusitis (CRS) is a common inflammatory disorder of the paranasal sinuses. An abnormal host response to common bacterial or fungal pathogens is thought to be an important factor in the disease process. Host sinonasal epithelium plays an important role in initially recognizing the presence of microbes and responding by increasing production of antimicrobial peptides and cytokines, with recruitment of phagocytes and lymphocytes of the adaptive immune system, to eliminate the infection. Recently, the innate immune system and its complex interplay with the adaptive immune system are increasingly being recognized as important in the pathogenesis of chronic inflammatory diseases such as asthma and CRS. METHODS: Review of recent findings on innate immunity in the pathogenesis of CRS. RESULTS: New areas of research into potentially novel therapies for CRS are highlighted in this review, with emphasis on toll-like receptors, antimicrobial peptides (cathelicidins and defensins), and surfactant proteins. CONCLUSION: This review provides an overview of innate immunity in the sinonasal tract and discusses potential use of innate immune peptides as treatments against fungi, biofilms, and superantigens in CRS.     

慢性鼻窦炎生物靶向药物治疗的研究进展

慢性鼻窦炎(CRS)是一种鼻腔鼻窦的慢性炎症性疾病,根据其发病机制可分为1型、2型和3型炎症内在型。目前CRS的药物治疗及手术治疗方法均存在发生各种不良反应和并发症的风险,其中部分难治性鼻窦炎虽经适当的药物和手术治疗仍不能取得满意效果并极易复发,严重影响患者的生活质量。生物靶向药物的应用和发展为CRS的治疗提供了一种有效和安全的替代方案。本文着重介绍针对CRS三种炎症内在型的相关细胞因子(包括TNF-α、IL-4、IL-5、IL-13、IgE和IL-17等)的生物靶向药物治疗的研究进展。     

T细胞在慢性鼻窦炎中的作用机制

慢性鼻窦炎(CRS)的基本病理特征为鼻窦黏膜的慢性炎症反应,其发病机制尚未完全阐明,但目前认为免疫应答紊乱及免疫细胞分化异常密切相关。已有研究表明,各种亚型的T细胞及其分泌的炎性因子都对CRS的发生发展具有一定的推动作用。Th1细胞介导细胞免疫,Th2细胞介导体液免疫,CRS患者体内存在Th1和Th2细胞比例失衡,当Th2免疫活性过度增高,造成Th2细胞浸润鼻黏膜局部,Th2细胞分泌的IL-4在鼻黏膜组织和血清中的含量明显增加。IL-4可以对Th1细胞产生抑制作用,让T细胞与B细胞的相互作用得到增强,进一步促进体液免疫应答。本文重点对CD4⁺T细胞、CD8⁺T细胞在CRS中的发生机制进展进行综述分析。     

The incidence of concurrent osteitis in patients with chronic rhinosinusitis: a clinicopathological study

BACKGROUND: The pathogenesis of chronic rhinosinusitis (CRS) has been found to be multifactorial, with environmental, general host, and local anatomic factors all contributing to its development. Recent studies have indicated that local osteitis of the underlying bone also may play a critical role in the elaboration of CRS by inducing persistent inflammatory changes in the surrounding mucosa. The purpose of this study was to determine the clinical incidence rate of osteitis in patients with CRS undergoing functional endoscopic sinus surgery. METHODS: From January to July 2003, a prospective study was performed on 121 patients undergoing functional endoscopic sinus surgery for CRS. Age, number of previous surgeries, radiographic bony characteristics, and pathological findings were all documented. The presence of concurrent osteitis was assessed using both radiographic (neoosteogenesis) and pathological (bony remodeling) criteria. RESULTS: The mean age of the patients was 44.3 years. Fifty-eight percent of the cases were revision surgeries, with each patient having an average of 2.2 operative procedures in the past. Computed tomography (CT) showed neoosteogenesis in 36% of patients, and 53% showed pathological evidence of osteitis on histological analysis of surgical specimens. CONCLUSION: Concurrent osteitis can be found in 36-53% of patients with CRS, using both radiographic and pathological criteria, respectively. Although a causal relationship between osteitis and CRS can not be inferred from this data, these clinical findings correlate well with previous evidence of bone involvement in CRS found in animal models, further reaffirming the association between underlying osteitis and the pathogenesis of CRS.     

TGF-β胞外活化调控及对慢性鼻-鼻窦炎不同病理表型的影响

慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)是鼻腔-鼻窦黏膜的慢性炎症性疾病〔1〕,患病率高达15%,经过规范化的药物治疗后,仍有35%的患者在药物治疗结束后2个月内复发,给患者的身体健康和生活质量带来严重的负面影响。针对CRS的发病机制,开发更有效的治疗手段,是提高治愈     

三叉神经痛的病理机制及治疗进展

三叉神经痛是最为常见的颅面部疼痛,发病机制尚未完全清楚,常表现为其一个或多个分支中的突然、严重、短暂、尖锐性和复发性疼痛。针对目前各家提出的不同的分类方法、多种发病机制如中枢性假说、神经受压迫学说、炎症反应学说、生物共振假说、离子通道改变学说以及临床多学科参与的治疗手段进展作一综述,为三叉神经病理性疼痛的个性化治疗提供参考。