Influence of P-Glycoprotein Function on Chronic Rhinosinusitis/Nasal Polyps Pathophysiology

Cheng, Yang; Bleier, Benjamin S.

doi:10.1159/000445094

Cited by 6 publications

(5 citation statements)

References 88 publications

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“…P-gp, also referred to as multidrug resistance protein, functions as an adenosine triphosphate-dependent efflux pump and is expressed in a variety of cell types, including both immune cells and epithelial cells. Patients with CRSwNP and eosinophilic CRSsNP had higher expression levels of P-gp in nasal mucosa than healthy controls [33][34][35]. It was demonstrated that P-gp exhibited immunomodulatory activity and affected the secretion of inflammatory cytokines and chemokines [36].…”

Section: Eosinophilic Remodelingmentioning

confidence: 99%

Crosstalk Between Mucosal Inflammation and Bone Metabolism in Chronic Rhinosinusitis

Khalmuratova

Shin

2021

Clin Exp Otorhinolaryngol

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Chronic rhinosinusitis (CRS) is a multifactorial and highly heterogeneous upper airway disease that affects approximately 12% of the general population. There is increasing evidence supporting the impact of osteitis on the pathophysiology of CRS. Osteitis is frequently observed in patients with CRS, and is associated with severe sinonasal inflammation and recalcitrant cases. The overlying inflammatory sinonasal mucosa plays a critical role in the initiation of osteitis; however, the underlying molecular mechanisms and functional significance remain unclear. Increasingly many studies have suggested that immune cells play a crucial role in the bone remodeling process in CRS. The purpose of this review is to summarize the current state of knowledge regarding the specific role of sinonasal inflammation in bone remodeling in CRS patients.

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Section: Eosinophilic Remodelingmentioning

confidence: 99%

Crosstalk Between Mucosal Inflammation and Bone Metabolism in Chronic Rhinosinusitis

Khalmuratova

Shin

2021

Clin Exp Otorhinolaryngol

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“…TSLP promotes Th2 response and its increased activity has been noticed in nasal polyps of CRSwNP patients in comparison to healthy subjects [ 177 ]. Recently, a significant increase in P-glycoprotein (P-gp) was noticed in CRSwNP patients as compared to other CRS and is associated with secretion of IL-5, TSLP, IL-6 and GM-CSF skewing the response towards Th2 type [ 178 ]. These observations suggest an important role of IL-33, IL-25 and TSLP in immunopathogenesis of AFRS.…”

Section: Pathogenesis and Immunology: Recent Conceptsmentioning

confidence: 99%

“…However, lack of evidence creates a dilemma about its use. Other possible therapeutic targets include TSLP inhibitors and P glycoprotein inhibitors [ 178 , 262 ].…”

Section: Managementmentioning

confidence: 99%

Allergic Aspergillus Rhinosinusitis

Chakrabarti

Kaur

2016

JoF

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Allergic fungal rhinosinusitis (AFRS) is a unique variety of chronic polypoid rhinosinusitis usually in atopic individuals, characterized by presence of eosinophilic mucin and fungal hyphae in paranasal sinuses without invasion into surrounding mucosa. It has emerged as an important disease involving a large population across the world with geographic variation in incidence and epidemiology. The disease is surrounded by controversies regarding its definition and etiopathogenesis. A working group on “Fungal Sinusitis” under the International Society for Human and Animal Mycology (ISHAM) addressed some of those issues, but many questions remain unanswered. The descriptions of “eosinophilic fungal rhinosinusitis” (EFRS), “eosinophilic mucin rhinosinusitis” (EMRS) and mucosal invasion by hyphae in few patients have increased the problem to delineate the disease. Various hypotheses exist for etiopathogenesis of AFRS with considerable overlap, though recent extensive studies have made certain in depth understanding. The diagnosis of AFRS is a multi-disciplinary approach including the imaging, histopathology, mycology and immunological investigations. Though there is no uniform management protocol for AFRS, surgical clearing of the sinuses with steroid therapy are commonly practiced. The role of antifungal agents, leukotriene antagonists and immunomodulators is still questionable. The present review covers the controversies, recent advances in pathogenesis, diagnosis, and management of AFRS.

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“…P-glycoprotein (P-gp) has been reported as a key immunoregulator of eosinophilic inflammation in both CRSwNP and CRSsNP (Bleier et al, 2013 ; Feldman et al, 2013 ; Cheng and Bleier, 2016 ). Protease inhibitors have been reported to induce the expression of P-gp suggesting that an imbalance in the protease system may further exacerbate inflammation through the induction of P-gp expression(Perloff et al, 2000 ; Huang et al, 2001 ; Chandler et al, 2003 ; Zastre et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Emerging Role of Proteases in the Pathogenesis of Chronic Rhinosinusitis with Nasal Polyps

Wei

Bleier

2018

Front. Cell. Infect. Microbiol.

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Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous upper airway disease with multiple etiologies. Clinically, CRSwNP can be classified into either eosinophilic or non-eosinophilic subtypes. The eosinophilic phenotype of CRSwNP is widely thought to be highly associated with recurrence of nasal polyps or surgical failure. Epithelial cells have a crucial role in the development of Th2-biased airway diseases. Recent studies have shown that a wide range of external stimuli such as allergens and microorganisms can elicit the release of epithelial-derived Th2-driving cytokines and chemokines. Protease activity is a feature common to these multiple environmental insults and there is growing evidence for the concept that an imbalance of proteases and protease inhibitors in the epithelial barrier leads to both the initiation and maintenance of chronic eosinophilic airway inflammation. In this review, we analyze recent work on the role of proteases in the development of the sinonasal mucosal type 2 immune response with an emphasis on the molecular pathways promoting adaptive Th2 cell immunity.

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Influence of P-Glycoprotein Function on Chronic Rhinosinusitis/Nasal Polyps Pathophysiology

Cited by 6 publications

References 88 publications

Crosstalk Between Mucosal Inflammation and Bone Metabolism in Chronic Rhinosinusitis

Crosstalk Between Mucosal Inflammation and Bone Metabolism in Chronic Rhinosinusitis

Allergic Aspergillus Rhinosinusitis

Emerging Role of Proteases in the Pathogenesis of Chronic Rhinosinusitis with Nasal Polyps

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