Immunomodulators in chronic rhinosinusitis

Objective: To provide new insight into how chronic rhinosinusitis (CRS) is conceptualized and treated with a focus on immunomodulator therapy. Data sources: Pubmed, Medline, and Embase. Methods: A current review of the evidence is provided for immunomodulators investigated for treatment of CRS with...

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Autores principales:	Philippe Lavigne, Stella E. Lee
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2018
Materias:	Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/efba3a4b7d0b4c6dae1a8c22fc058049
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spelling	oai:doaj.org-article:efba3a4b7d0b4c6dae1a8c22fc0580492021-12-02T13:23:00ZImmunomodulators in chronic rhinosinusitis2095-881110.1016/j.wjorl.2018.09.002https://doaj.org/article/efba3a4b7d0b4c6dae1a8c22fc0580492018-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881118301379https://doaj.org/toc/2095-8811Objective: To provide new insight into how chronic rhinosinusitis (CRS) is conceptualized and treated with a focus on immunomodulator therapy. Data sources: Pubmed, Medline, and Embase. Methods: A current review of the evidence is provided for immunomodulators investigated for treatment of CRS with nasal polyps (CRSwNP). Results: Biologic therapies targeting IgE, IL-4, IL-5, and IL-13 for the treatment of CRSwNP have shown promise and are currently in phase 3 trials. Anti-immunoglobin E (IgE) therapy with omalizumab was assessed in 6 studies, anti-interleukin (IL)-5 therapy in 3 studies (2 mepolizumab, 1 reslizumab) and anti IL-4/IL-13 (dupilumab) therapy in one study. Studied outcomes varied, but the majority of trials identified clinical benefit of therapy over placebo. Other potential targets include thymic stromal lymphopoetin (TSLP), IL-25, IL-33, and sialic acid-binding immunoglobulin-type lectin (Siglec)-8. Small molecule drugs that target the dysregulation of the immune system in CRS are also being investigated for their immunomodulatory effects on inflammation. Conclusion: Immunomodulator therapies for CRS currently in development will likely provide another therapeutic option for patients who have severe disease unresponsive to corticosteroids and surgery. Targeted monoclonal antibody therapies have shown encouraging results and phase 3 trials are underway. IL-4/IL-13 inhibition has shown the most promise to date. Further larger, well-designed trials are needed to improve understanding of these molecules and to offer endotype-driven therapies in the management of CRS. None of these therapeutics have shown long-term immunomodulation when discontinued and therefore further investigation into the pathomechanism of disease continues to be needed. Keywords: Biologic, Immunotherapy, Chronic rhinosinusitis, Nasal polyps, ImmunomodulatorPhilippe LavigneStella E. LeeKeAi Communications Co., Ltd.articleOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 4, Iss 3, Pp 186-192 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Otorhinolaryngology RF1-547 Surgery RD1-811 Philippe Lavigne Stella E. Lee Immunomodulators in chronic rhinosinusitis
description	Objective: To provide new insight into how chronic rhinosinusitis (CRS) is conceptualized and treated with a focus on immunomodulator therapy. Data sources: Pubmed, Medline, and Embase. Methods: A current review of the evidence is provided for immunomodulators investigated for treatment of CRS with nasal polyps (CRSwNP). Results: Biologic therapies targeting IgE, IL-4, IL-5, and IL-13 for the treatment of CRSwNP have shown promise and are currently in phase 3 trials. Anti-immunoglobin E (IgE) therapy with omalizumab was assessed in 6 studies, anti-interleukin (IL)-5 therapy in 3 studies (2 mepolizumab, 1 reslizumab) and anti IL-4/IL-13 (dupilumab) therapy in one study. Studied outcomes varied, but the majority of trials identified clinical benefit of therapy over placebo. Other potential targets include thymic stromal lymphopoetin (TSLP), IL-25, IL-33, and sialic acid-binding immunoglobulin-type lectin (Siglec)-8. Small molecule drugs that target the dysregulation of the immune system in CRS are also being investigated for their immunomodulatory effects on inflammation. Conclusion: Immunomodulator therapies for CRS currently in development will likely provide another therapeutic option for patients who have severe disease unresponsive to corticosteroids and surgery. Targeted monoclonal antibody therapies have shown encouraging results and phase 3 trials are underway. IL-4/IL-13 inhibition has shown the most promise to date. Further larger, well-designed trials are needed to improve understanding of these molecules and to offer endotype-driven therapies in the management of CRS. None of these therapeutics have shown long-term immunomodulation when discontinued and therefore further investigation into the pathomechanism of disease continues to be needed. Keywords: Biologic, Immunotherapy, Chronic rhinosinusitis, Nasal polyps, Immunomodulator
format	article
author	Philippe Lavigne Stella E. Lee
author_facet	Philippe Lavigne Stella E. Lee
author_sort	Philippe Lavigne
title	Immunomodulators in chronic rhinosinusitis
title_short	Immunomodulators in chronic rhinosinusitis
title_full	Immunomodulators in chronic rhinosinusitis
title_fullStr	Immunomodulators in chronic rhinosinusitis
title_full_unstemmed	Immunomodulators in chronic rhinosinusitis
title_sort	immunomodulators in chronic rhinosinusitis
publisher	KeAi Communications Co., Ltd.
publishDate	2018
url	https://doaj.org/article/efba3a4b7d0b4c6dae1a8c22fc058049
work_keys_str_mv	AT philippelavigne immunomodulatorsinchronicrhinosinusitis AT stellaelee immunomodulatorsinchronicrhinosinusitis
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Immunomodulators in chronic rhinosinusitis

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