Remodeling and Repair in Rhinosinusitis

Abstract

Remodeling refers to the development of specific but potentially irreversible structural changes in tissue. Caucasian eosinophilic chronic rhinosinusitis (CRS) with polyps associated or not with cystic fibrosis was discriminated by edema from CRS without nasal polyps, characterized by extensive fibrotic fields. However, changes in epithelial and extracellular matrix structures are common findings in all types of chronic inflammatory diseases of upper airways, but rarely specific and highly variable in extend. Recent studies have shown that remodeling in CRS appears to occur in parallel, rather than purely subsequent to inflammation. Furthermore, some preferential remodeling associations can be recognized. Tremendous efforts have been put in research on coagulation factors, cytokines, growth factors, and proteases supporting all phases of upper airway remodeling. The current exploration of other CRS sub-groups and of the particular link with concomitant asthma aims to optimize the classification of CRS and its staging modes and to develop novel therapies.

Prolonged denervation induces remodeling of nasal mucosa in rat model of posterior nasal neurectomy

“…As far as we know, there is no prior study demonstrating a relationship between mucosal denervation and remodeling. Tissue remodeling is usually seen as a consequence of inflammatory reaction . It remains unclear whether the tissue remodeling in our study was induced primarily by mucosal denervation or secondarily by chronic inflammation following mucosal denervation.…”

Different effects of allergic rhinitis on nasal mucosa remodeling in chronic rhinosinusitis with and without nasal polyps

“…Researchers found a close relationship between inflammation and remodeling [20, 21]. Traditionally, chronic inflammation is believed to be the cause of remodeling.…”

“…Traditionally, chronic inflammation is believed to be the cause of remodeling. However, new evidence suggests that remodeling is an active primary process that could occur with ongoing inflammation and contribute to inflammation [21]. Inflammatory cells such as EOS and neutrophil cells are proved to be associated with mucosa remodeling in CRS.…”

“…Airway diseases such as asthma, chronic obstructive pulmonary disorder (COPD) and CRS are all characterized by both inflammation and remodeling. Researchers found a close relationship between inflammation and remodeling [ 20 , 21 ]. Traditionally, chronic inflammation is believed to be the cause of remodeling.…”

IL-19 Induced by IL-13/IL-17A in the Nasal Epithelium of Patients with Chronic Rhinosinusitis Upregulates MMP-9 Expression via ERK/NF-kB Signaling Pathway

“…Recent studies have suggested tissue remodeling of CRS to occur concurrently with in ammation. [20] Studies, principally in Chinese patients, have shown CRSsNP to be characterized by type 1 in ammatory patterns while CRSwNP was characterized by mixed type 2/3 in ammatory pro les. [21,22] Whether IL-19 could serve as a common downstream factor of type 1/2/3 cytokines in nasal epithelia, resulting in the regulation of MMP-9, remains unknown.…”