Alterations in epithelial barrier function and host defense responses in chronic rhinosinusitis.
Chronic rhinosinusitis (CRS) is characterized by a chronic symptomatic inflammation of the nasal and paranasal sinus mucosae and is one of the most frequently reported chronic diseases in the United States, with an estimated prevalence of greater than 10% of the general population. Although the pathogenesis of CRS remains poorly understood, there is evidence for a role of bacteria and fungi, as well as the presence of a robust adaptive immune response in the upper airways and sinuses. Recent studies of CRS, as well as several other diseases in the skin and respiratory epithelium, have uncovered evidence that deficiencies in epithelial immune barrier function might compromise the interaction between the host and external immune stimuli. Recent studies suggest the hypothesis that reduced expression of antimicrobial S100 proteins, particularly psoriasin and calprotectin, might lead to increased susceptibility to bacterial and fungal colonization in patients with CRS. The main emphasis of this review will be to highlight the current literature that suggests that a defect in the expression of a broad set of epithelially derived genes might lead to barrier compromise and subsequently a dysfunctional host immune response to environmental agents in patients with CRS.
Tieu
David D
DD
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Kern
Robert C
RC
Schleimer
Robert P
RP
D001424:Bacterial Infections; D002135:Calcium-Binding Proteins / Q000378:metabolism; D004198:Disease Susceptibility; D015536:Down-Regulation; D006801:Humans; D007107:Immune System; D009297:Nasal Mucosa / Q000473:pathology* / Q000821:virology; D012222:Rhinitis, Atrophic / Q000276:immunology / Q000503:physiopathology*; D000075023:S100 Calcium Binding Protein A7; D009418:S100 Proteins
D002135:Calcium-Binding Proteins; D000075023:S100 Calcium Binding Protein A7; D009418:S100 Proteins; C089242:S100A7 protein, human