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Chronic Rhinosinusitis: Aetiology, Immunology and Treatment, 3rd Edition

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Immunology".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 4551

Special Issue Editor


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Guest Editor
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu 42472, Republic of Korea
Interests: mucosal immunity; airway inflammation; epithelial cell biology; eosinophils; fungal infection
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Special Issue Information

Dear Colleagues,

This Special Issue is a continuation of our previous Special Issue entitled “Chronic Rhinosinusitis: Aetiology, Immunology and Treatment 2.0” (https://www.mdpi.com/journal/ijms/special_issues/EW08YBRXM7).

Chronic rhinosinusitis (CRS) is one of the most common chronic diseases. However, the pathophysiology of CRS is not fully understood, the treatment options are limited, and it features heterogeneous disease groups.

CRS was once considered an infectious disease, with focus placed on the identification of the pathogenic microbial organisms. However, recent studies have suggested that CRS may be related to immune-mediated diseases, the involvement of which may cause the exacerbation of local inflammatory responses. CRS is classified as eosinophilic or non-eosinophilic CRS based on the dominant inflammatory cell types. CRS can also be divided into Th1-, Th2-, and Th17-dominant CRS based on the presence of lymphocyte effector cells in the sinonasal mucosa. Many researchers have attempted to determine the pathogenesis of CRS by identifying key chemical mediators or transcription factors and using various animal models. In this regard, many efforts are being made to elucidate the immunopathologic mechanism of CRS. Because CRS is a sinonasal mucosal inflammatory disease, surgical treatment options are limited. Therefore, biologics are garnering attention as a novel therapeutic strategy for CRS.

This Special Issue will focus on advances in the field of mucosal immunity and their impact on our understanding of the development of CRS and the immunologic effects of biologics for the treatment of CRS. IJMS is a journal of molecular science, so pure clinical studies are not suitable; however, biomolecular experimental studies are welcome.

Dr. Seung-Heon Shin
Guest Editor

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Keywords

  • innate immunity
  • adaptive immunity
  • protease
  • cytokine
  • inflammation
  • epithelial cells
  • fibroblasts
  • eosinophils
  • lymphocytes
  • biologics

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13 pages, 1623 KiB  
Article
Long-Term Real-World Outcomes and Insights of Biologic Therapies in Chronic Rhinosinusitis with Nasal Polyps
by Reut Book, Anna Lazutkin and Ron Eliashar
Int. J. Mol. Sci. 2025, 26(10), 4694; https://doi.org/10.3390/ijms26104694 - 14 May 2025
Viewed by 900
Abstract
Chronic rhinosinusitis with nasal polyps is a Type 2 inflammatory disease associated with a significant burden on quality of life. While biological therapies have shown efficacy in randomized controlled trials, data on long-term real-world outcomes remain limited. This retrospective cohort study evaluated the [...] Read more.
Chronic rhinosinusitis with nasal polyps is a Type 2 inflammatory disease associated with a significant burden on quality of life. While biological therapies have shown efficacy in randomized controlled trials, data on long-term real-world outcomes remain limited. This retrospective cohort study evaluated the clinical efficacy, safety, and treatment dynamics of biologics, particularly anti-IL-4 (dupilumab), over a five-year period at a tertiary medical center. Fifty-two patients with CRSwNP meeting the EPOS/EUFOREA eligibility criteria were included. Clinical parameters, including nasal polyp score, SNOT-22, and olfactory function, were assessed across follow-up intervals. Anti-IL-4 therapy demonstrated the most consistent and sustained improvements in all clinical parameters, with a significant proportion of patients maintaining response beyond 36 months. A subset of patients underwent interval extension of dupilumab injections without loss of efficacy. Subdomain analysis of the SNOT-22 questionnaire revealed improvements predominantly in nasal and emotional domains. Treatment response, assessed according to the EUFOREA criteria, favored anti-IL-4 over anti-IL-5 and anti-IgE. Side effects were infrequent and mostly mild. These findings support the durable effectiveness of biologics in real-world CRSwNP management and suggest that tapering down the injection intervals may be a feasible strategy for selected patients. Further studies are needed to refine treatment response definitions and optimize patient-specific therapeutic approaches. Full article
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Review

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54 pages, 1680 KiB  
Review
The Role of the Gut and Airway Microbiota in Chronic Rhinosinusitis with Nasal Polyps: A Systematic Review
by Manuel Gómez-García, Emma Moreno-Jimenez, Natalia Morgado, Asunción García-Sánchez, María Gil-Melcón, Jacqueline Pérez-Pazos, Miguel Estravís, María Isidoro-García, Ignacio Dávila and Catalina Sanz
Int. J. Mol. Sci. 2024, 25(15), 8223; https://doi.org/10.3390/ijms25158223 - 27 Jul 2024
Cited by 4 | Viewed by 3240
Abstract
In recent years, there has been growing interest in understanding the potential role of microbiota dysbiosis or alterations in the composition and function of human microbiota in the development of chronic rhinosinusitis with nasal polyposis (CRSwNP). This systematic review evaluated the literature on [...] Read more.
In recent years, there has been growing interest in understanding the potential role of microbiota dysbiosis or alterations in the composition and function of human microbiota in the development of chronic rhinosinusitis with nasal polyposis (CRSwNP). This systematic review evaluated the literature on CRSwNP and host microbiota for the last ten years, including mainly nasal bacteria, viruses, and fungi, following the PRISMA guidelines and using the major scientific publication databases. Seventy original papers, mainly from Asia and Europe, met the inclusion criteria, providing a comprehensive overview of the microbiota composition in CRSwNP patients and its implications for inflammatory processes in nasal polyps. This review also explores the potential impact of microbiota-modulating therapies for the CRSwNP treatment. Despite variability in study populations and methodologies, findings suggest that fluctuations in specific taxa abundance and reduced bacterial diversity can be accepted as critical factors influencing the onset or severity of CRSwNP. These microbiota alterations appear to be implicated in triggering cell-mediated immune responses, cytokine cascade changes, and defects in the epithelial barrier. Although further human studies are required, microbiota-modulating strategies could become integral to future combined CRSwNP treatments, complementing current therapies that mainly target inflammatory mediators and potentially improving patient outcomes. Full article
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