5. ASPIRE: Exploration of personal medical strategies based on the pathogenetic mechanisms of chronic rhinosinusitis in Japanese and US patient

Résumé fourni par la source

Chronic rhinosinusitis(CRS)is a heterogeneous syndrome that typically presents in the 5 th decade of life.In the United States it affects approximately 15， 000， 000 patients, with 3 million expressing the nasal polyp phenotype (CRSwNP) .Progress in understanding CRS pathogenesis has permitted the division of cases into putative molecular pathways or endotypes, with the T2 subset expressed in the overwhelming majority of CRSwNP.The T2 endotype is characterized by the sinonasal tissue expression of high levels of TSLP, IL-4, IL-13 and IL-5 as well as the presence of characteristic cell types including Th2, ILC2, eosinophils and mast cells.T2 patients exhibit resistance to standard treatment, including polyp recurrence despite sinus surgery and post-operative topical corticosteroids.Concurrent advances in pharmacotherapeutics however, have permitted the targeting of specific molecules present in the T2 cascade with improved disease control.Nevertheless, challenges remain both from the standpoint of disease resistance and cost.This presentation will briefly review the current pathophysiology of CRS in the US, including advances in endotyping and classification systems.In light of these developments, the current CRS treatment pathways in the US will be reviewed as well as opportunities for improvement in the near future.

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