International Review of Medical Practice, 2019, XXV/3: 123-130 Maximize

International Review of Medical Practice, 2019, XXV/3: 123-130

Title: Pathogenesis of chronic rhinosinutis 

Author: Wojdas A. 

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Pathogenesis of chronic rhinosinutis

Wojdas A.

Department of Otolaryngology, Military Institute of Aviation Medicine, Warsaw, Poland

International Review of Medical Practice, 2019; Vol. 25, No. 3, 123

Chronic rhinosinusitis (CRS) is a disease of unknown etiology. Until now, fungal infections, biofilm formation, presence of superantigen, atopy or microbiome activity and immune barrier disorders have been considered etiopathogenogenetic factors, which result in the failure of the ostiomeatal complex and mucociliary transport. It is currently accepted that the presence of fungi and their colonization can play an important role in modifying the picture of the disease. The formation of a bacterial biofilm is associated with the presence of a bacterial infection that is found within the nasal cavity and paranasal sinuses. The presence of bacteria is the cause of inflammation, and the bacterial biofilm is responsible for the persistence of sinusitis. Moreover bacterial endotoxins acting as superantigens cause the persistence of the inflammatory process. The importance of atopy, biotome or immunlogical barrier leads to disorders related to the anatomy of the nasal cavity and paranasal sinuses, as well as damage to the natural immune response, can lead to the development of changes observed in CRS. The complexity of the CRS clinical picture in relation to ongoing pathogenesis studies indicates that disease phenotypes cannot still be precisely defined.

Key words: chronic rhinosinusitis, pathogenesis, atopy, biofilm, microbiome, superantigen, immunological barrier