title: Clinical and biological markers of difficult-to-treat severe chronic rhinosinusitis.
abstract: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the upper airways of which two major phenotypes exist, CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP). Some patients with CRS have suboptimal response to current guideline treatments. These patients remain severe and uncontrolled by treatment and have a poor quality of life. It is highly important to identify both clinical and biological markers, so-called biomarkers, in this subset of patients. The presence of nasal polyps and comorbidity with asthma and with aspirin-exacerbated respiratory disease (AERD) are the most common clinical traits that have been associated to difficult-to-treat severe CRS. In addition to clinical traits, numerous biological markers, with known etiopathogenic roles in CRS, have been associated to difficult-to-treat or recalcitrant CRS. This review summarizes the existing knowledge of the clinical and biological markers associated to difficult-to-treat or uncontrolled severe CRS.
authors.affiliation: Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Centre de Recerca Biomèdica CELLEX, Casanova 143, 08036, Barcelona, Catalonia, Spain, LOCHACON@clinic.cat.
authors.forename: Mauricio
authors.initials: M
authors.lastname: López-Chacón
authors.forename: Joaquim
authors.initials: J
authors.lastname: Mullol
authors.forename: Laura
authors.initials: L
authors.lastname: Pujols
mesh_terms: D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015897:Comorbidity; D006801:Humans; D011788:Quality of Life; D012220:Rhinitis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D012852:Sinusitis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*
chemical_list: D015415:Biomarkers