Asia Pac Allergy.  2017 Jul;7(3):121-130. 10.5415/apallergy.2017.7.3.121.

Classification of chronic rhinosinusitis according to a nasal polyp and tissue eosinophilia: limitation of current classification system for Asian population

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea. csrhee@snu.ac.kr
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
  • 3Research Center for Sensory Organs, Seoul National University Medical Research Center, Seoul 03080, Korea.
  • 4Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.

Abstract

Chronic rhinosinusitis (CRS) can be classified according to the presence of a nasal polyp (NP): CRS with NP (CRSwNP) and CRS without NP (CRSsNP). CRSwNP has characteristics with high infiltration of tissue eosinophilia with a burst of Th2 inflammatory cytokine. However recent findings in Eastern Asia countries suggest that CRSwNP can be divided according to the presence of tissue eosinophilia. Thus, CRSwNP can be classified into eosinophilic and noneosinophilic. Eosinophilic CRSwNP seems to have different immunological and clinical feature compared to noneosinophilic CRSwNP. From the same point of view, CRSsNP can also be divided according to tissue eosinophilia. However, the meaning of this dichotomous categorization in CRS seems to be not quite clear. This review focus on the limitations in current subclassification of CRS according to the presence of NP and tissue eosinophilia and discuss other factors related to tissue remodeling and NP generation which may provide clues for the further understanding of CRS pathogenesis.

Keyword

Sinusitis; Classification; Nasal polyps; Eosinophilia; Caucasians; Asians

MeSH Terms

Asian Continental Ancestry Group*
Classification*
Eosinophilia*
Eosinophils
Far East
Humans
Nasal Polyps*
Sinusitis

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