Regarding chronic rhinosinusitis (CRS) phenotypes, CRS with nasal polyps (CRSwNP) differs from CRS without nasal polyps (CRSsNP) in that it is predominantly characterized by:

• A Neutrophilic inflammation with Th1 cytokine profile
• B Bacterial biofilm formation as the primary pathogenic mechanism
• C Osteitis and subepithelial fibrosis without mucosal oedema
• D Eosinophilic inflammation with Th2 cytokine dominance (IL-4, IL-5, IL-13) ✓

Explanation

CRS with nasal polyps is predominantly a type 2 (Th2) inflammatory condition characterised by eosinophilia, elevated IL-4, IL-5 and IL-13, IgE production and epithelial barrier dysfunction. This understanding underpins the use of anti-IL-4/IL-13 (dupilumab) and anti-IL-5 (mepolizumab) biologics in CRSwNP refractory to surgery and steroids. CRSsNP tends to have more neutrophilic, Th1/Th17 characteristics in Asian populations.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.