How does nasal polyp formation relate to immunomodulatory effects?
Challenges in Rhinology, Springer International Publishing Ag, ss.353-364, 2020
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2020
- Doi Numarası: 10.1007/978-3-030-50899-9_35
- Yayınevi: Springer International Publishing Ag
- Sayfa Sayıları: ss.353-364
- Anahtar Kelimeler: Immune system, Immunomodulatory, Nasal polyp, Sinonasal barrier
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
The pathophysiology of nasal polyp formation depends on complex interactions between the sinonasal barriers and immune system, which sustain chronic inflammation. The molecules orchestrating these inflammatory events are important targets for the development of novel therapeutics of CRSwNP. Biological therapeutics for asthma and/or CRSwNP are monoclonal antibodies. They usually are targeted to Type 2 inflammatory molecules: omalizumab (anti-IgE), mepolizumab and reslizumab (anti IL-5), benralizumab (anti IL-5 receptor) and dupilumab (anti IL-4 receptor alpha). Omalizumab is a novel biological agent, the target of which is IgE. It is a recombinant humanised monoclonal immunoglobulin (mAb). It targets IgE and prevents binding to the high-affinity FcεRI receptor on certain cell types, notably mast cells, eosinophils, basophils and dendritic antigen-presenting cells (DAPCs). One of the other principal targets for novel therapeutic agents to target is interleukin 5. This cytokine is an important mediator in the development of Type 2 (eosinophilic) inflammatory reactions. An agent targeting IL-5 could be beneficial in managing chronic disorders of the proximal airway. IL-5 orchestrates the production, development and recruitment of eosinophils, both in the bone marrow and in the airways. Two monoclonal humanised anti-IL-5 recombinant antibodies that can target IL-5 and have acceptable safety and tolerability in patients with intranasal polyps are mepolizumab and reslizumab. In this chapter, nasal polyp formation and immunomodulatory effects are reviewed.