The Neutrophil and Chronic Rhinosinusitis
Descriptions of chronic rhinosinusitis (CRS) are frequently characterized by references to the eosinophilia present in CRS and in allergic diseases. However, the focus in assessment of inflammation in chronic rhinosinusitis is increasingly shifting away f
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The Neutrophil and Chronic Rhinosinusitis Martin Y. Desrosiers and Shaun J. Kilty
Keywords
Chronic rhinosinusitis • CRS • Neutrophils • Neutrophilic inflammation • Neutrophil extravasation traps • Inflammation • Pathophysiology of CRS • Upper airway • Sinus physiology • Sinus
Core Messages
• Chronic rhinosinusitis (CRS) is a complex heterogeneous inflammatory disease that has traditionally been characterized as primarily “eosinophilic” in nature but in which contributions from other cell types may lead to different sub-phenotypes of disease. • Neutrophils are key inflammatory cells in the immune response, and while their
M.Y. Desrosiers, MD, FRCSC (*) Division of Otolaryngology-Head and Neck Surgery, Université de Montréal/Centre Hospitalier de l’Université de Montréal (CHUM) Hôpitale Hôtel-Dieu de Montréal, 3840 rue St-Urbain, Montréal, QC H2W 1T8, Canada e-mail: [email protected] S.J. Kilty, MD, FRCSC Department of Otolaryngology-Head and Neck Surgery, The University of Ottawa/ The Ottawa Hospital, 737 Parkdale Avenue, Room 242, Ottawa, ON K1Y 4E9, Canada e-mail: [email protected]
role is less well understood in CRS, it may nevertheless be significant • A better understanding of neutrophilic inflammation in CRS could lead to the development of new therapeutic strategies for CRS.
Descriptions of chronic rhinosinusitis (CRS) are frequently characterized by references to the eosinophilia present in CRS and in allergic diseases. However, the focus in assessment of inflammation in chronic rhinosinusitis is increasingly shifting away from Th2-dominated mechanisms to a consideration of the contributions by Th1 and Th17 mechanisms as well. This has led to an increased focus of interest in assessment of lymphocyte subpopulations and of cytokines associated with these inflammatory pathways. Throughout this, the neutrophil, a somewhat ubiquitous inflammatory cell associated with both Th1 and Th17 patterns of inflammation, has been somewhat ignored. In this chapter,
T.M. Önerci (ed.), Nasal Physiology and Pathophysiology of Nasal Disorders, DOI 10.1007/978-3-642-37250-6_7, © Springer-Verlag Berlin Heidelberg 2013
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we review the structure and function of the neutrophil and review evidence for its potential implication in chronic rhinosinusitis.
7.1
Histologic Description
Neutrophils are the most abundant leukocyte in humans representing up to 60% of the circulating white blood cells. It is a member of the family of granulocytes, which also includes basophils and eosinophils. Neutrophils are considered an essential component of the innate immune system by virtue of their multiple actions in bacterial killing and sequestration. Neutrophils cause microbial death by three means: phagocytosis, by generating neutrophil extracellular traps (NETs), and through the release of soluble antimicrobials from their primary and specific granules (Brinkmann and Zychlinsky 2012). Neutrophils derived their name from their differential response in staining from other granulocytes wi
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