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Biomedicines
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Recent Advances in Chronic Rhinosinusitis and Asthma: 2nd Edition
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Recent Advances in Chronic Rhinosinusitis and Asthma: 2nd Edition

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 30 March 2026 | Viewed by 214

Special Issue Editors

Dr. Giuseppe Guida

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Guest Editor
1. Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy
2. Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, 10043 Orbassano, Turin, Italy
Interests: severe asthma; EGPA; eosinophils; nitric oxide; T cell immunology; chronic rhinosinusitis
Special Issues, Collections and Topics in MDPI journals
Dr. Cristiano Caruso

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Guest Editor
Department of di Medical and Surgical Science, Fondation Universitary Policlinic A. Gemelli IRCCS, University Cattolica Sacro Cuore, 20123 Rome, Italy
Interests: allergic asthma; epithelial barrier damage; protease allergen; type 2 inflammation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Asthma and chronic rhinosinusitis (CRS) are often clinically associated, and they reciprocally influence prognosis and outcome. The basis of this close relationship is found in their common immunopathology. Nowadays, both asthma and CRS are classified into different phenotypes, with the main defined as a Type-2 inflammatory disease. Nasal polyps are one of the main clues for a Type-2 phenotype. This phenotype is characterized by epithelial barrier disfunction; activation of Type-2 immune cells, including T helper 2 lymphocytes, dendritic cells, innate lymphoid cells Type-2, eosinophils, and mast cells; and imbalance at the host airway–microbial interface. Additional immune mechanisms involve neuroepithelial damage, remodeling and epithelial–mesenchymal transition, and B cell activation by allergens and superantigens, leading to either specific or polyclonal IgE synthesis. The Type-2 low phenotypes are less understood but often represent clinical challenges due to their low response to medical treatment. Environmental and pathogen exposure of the airway epithelium concur in the evolving steps of the natural history of united airway diseases. The era of precision medicine led to pharmacological interventions able to modulate a specific immunological Type-2 pathway and provided clinical significant benefits. The aim of this Special Issue is to document new advances in the field of asthma and CRS immunopathogenesis through original articles and reviews. Translational research from basic hypothesis to clinical observations is encouraged.

Dr. Giuseppe Guida
Dr. Cristiano Caruso
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • asthma
  • chronic rhinosinusitis
  • nasal polyps
  • severe asthma
  • type-2 inflammation
  • phenotypes
  • endotypes
  • biologics
  • epithelial disfunction
  • remodeling

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Published Papers (1 paper)

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9 pages, 634 KB  
Brief Report
Biomarker-Associated Remission After Switching to Dupilumab in Severe Asthma Following Failure of Prior Biologics
by Fabio Romano Selvi, David Longhino, Gabriele Lucca, Ilaria Baglivo, Maria Antonietta Zavarella, Chiara Laface, Laura Bruno, Arianna Delfino Spiga, Sara Gamberale, Ludovica Fabbroni, Angela Rizzi, Arianna Aruanno, Marina Curci, Alessandro Buonomo, Stefania Colantuono, Marinella Viola, Gianluca Ianiro, Antonio Gasbarrini and Cristiano Caruso
Biomedicines 2025, 13(9), 2096; https://doi.org/10.3390/biomedicines13092096 (registering DOI) - 28 Aug 2025
Abstract
Background/Objectives: Severe asthma remains difficult to treat, even with the range of biologics we now have that target type 2 inflammation. Some patients do not respond well enough to the first biologic they try, which raises the question of whether switching to [...] Read more.
Background/Objectives: Severe asthma remains difficult to treat, even with the range of biologics we now have that target type 2 inflammation. Some patients do not respond well enough to the first biologic they try, which raises the question of whether switching to another option can help. In this study, we looked at how patients who had unsatisfactory therapeutic outcomes on other biologics responded—both clinically and at the biomarker level—after switching to dupilumab. Methods: We reviewed data from the Allergy and Clinical Immunology Unit of Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy, between January and June 2025. The study included fifteen adults with uncontrolled severe asthma who had previously been treated for at least six months with benralizumab, omalizumab, or mepolizumab before switching to dupilumab. We evaluated demographic, clinical and laboratory data. Lung function (Forced Expiratory Volume in 1 s (FEV1)), blood eosinophils, total and specific IgE to staphylococcal enterotoxins, eosinophil cationic protein (ECP), free light chains (FLC), and FeNO were assessed at the time of the switch and again after 12 months. Comparisons were made using paired tests, and a p-value < 0.05 was considered statistically significant. Results: After a year on dupilumab, we saw clear improvements: mean FEV1 went up by about 10.8% predicted (p = 0.002), FeNO dropped by an average of 22 ppb (p = 0.005), blood eosinophils fell by roughly 400 cells/µL (p = 0.003), and ECP levels decreased by 13 µg/L (p = 0.009). Kappa FLCs also showed a significant drop (p = 0.04). Clinically, 40% of patients met criteria for a meaningful response, and 20% achieved complete remission. Dependence on oral corticosteroids was notably reduced. Baseline levels of eosinophils, ECP, IgE, and FLCs correlated with response to treatment. Conclusions: Our study, despite the small sample size, highlights that in patients with severe asthma who do not show a good response to their first biologic, switching to dupilumab can lead to significant improvements. Markers of type 2 inflammation at baseline might help predict who benefits most. Larger, multi-center, prospective studies are needed to confirm these results. Full article
(This article belongs to the Special Issue Recent Advances in Chronic Rhinosinusitis and Asthma: 2nd Edition)
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