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。

The interaction between neutrophils and eosinophils in chronic rhinosinusitis and the implications on treatment options

Chronic rhinosinusitis(CRS)has traditionally been classified as T-helper(Th)2 type inflammation(type 2 inflammation)with recruitment of predominantly eosinophils or as a Th1/Th17 type inflammation with predominantly neutrophils. These two inflammatory processes have long been thought of as being mutually exclusive in CRS. However, recent studies have found that neutrophilic(NEU)and eosinophilic(EOS)infiltrates increased significantly and influenced each other in the nasal mucosa or nasal polyp tissue in severe CRS. In this review, we examined the recent investigations into this mixed NEU/EOS inflammation in CRS in terms of cellular interactions and the implications on possible clinical treatment strategies.