Mucosal remodeling and reversibility in chronic rhinosinusitis

Ahmed Bassiouni, Philip G Chen, Peter John Wormald

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: Evidence suggests that some structural changes caused by mucosal remodeling may be primarily irreversible, which theoretically challenges the current management model of chronic rhinosinusitis (CRS). The relationship between inflammation and remodeling in the mucosa remains complex, yet better understanding of involved pathways holds potential clinical implications. This article reviews the controversies as well as current applications from the literature. RECENT FINDINGS: First, the relationship between inflammation and remodeling is a complex one involving multiple pathways, with evidence suggesting that remodeling is not a simple fibrotic end-stage process secondary to long-standing inflammation. Second, anti-inflammatory approaches alone are probably not successful in reversing changes such as collagen deposition, indicating that early treatment might be crucial for preventing disease progression. Third, a dysfunctional sinus remains a pure clinical/surgical phenomenon with lack of histological characterization. Fourth, maximal/extensive surgical techniques are advocated for patients with severe disease or dysfunctional sinuses. SUMMARY: Reversibility of remodeling holds implications for the management of CRS. Although clinical applications (both medical and surgical) exist, further research is required for solidifying current evidence as well as exploring new avenues for therapy.

Original languageEnglish (US)
Pages (from-to)4-12
Number of pages9
JournalCurrent Opinion in Allergy and Clinical Immunology
Volume13
Issue number1
DOIs
StatePublished - Feb 1 2013
Externally publishedYes

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Inflammation
Disease Progression
Mucous Membrane
Anti-Inflammatory Agents
Collagen
Therapeutics
Research

Keywords

  • chronic rhinosinusitis
  • dysfunctional sinus
  • endoscopic sinus surgery
  • irreversible mucosal disease
  • mucosal remodeling

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Mucosal remodeling and reversibility in chronic rhinosinusitis. / Bassiouni, Ahmed; Chen, Philip G; Wormald, Peter John.

In: Current Opinion in Allergy and Clinical Immunology, Vol. 13, No. 1, 01.02.2013, p. 4-12.

Research output: Contribution to journalReview article

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