title: Polyps, asthma, and allergy: what's new.
abstract: OBJECTIVE
  Although chronic rhinosinusitis with nasal polyps, asthma, and allergy share common inflammatory mechanisms, there is no evidence of cause-and-effect relationship. In this review, we present new studies investigating the complex immunology that links these diseases. Advances in new therapies as well as evidence regarding indication and timing of surgery, especially of more complex cases, are highlighted.
  
  
  RESULTS
  New studies have endotyped patients in an effort to describe the exact inflammatory profile of each phenotype, whereas described cytokines seem to play a significant role in amplification of T2 inflammation, directly or via innate lymphoid cells. New mAbs that block specific cytokines of these pathways have been developed and seem to show reduced asthma severity as well as improved sinonasal outcomes. Moreover, it has been shown that operating early in the course of disease leads not only to bigger improvements in SNOT-22 outcomes but also to reduced asthma incidence postoperatively in refractory cases.
  
  
  CONCLUSIONS
  Applying data from current studies in clinical practice, we could better manage refractory cases with asthma and polyps, both medically and surgically. Treatment has to be patient-centered, and this demands a multidisciplinary-team approach of the airway diseases.
authors.affiliation: aDepartment of Otorhinolaryngology, Henry Dunant Hospital, Athens bEndoscopic Skull Base Center, Hygeia Hospital, Marousi, Greece cCenter for Skull Base Patients, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Terzakis
authors.forename: Christos
authors.initials: C
authors.lastname: Georgalas
mesh_terms: D018926:Anti-Allergic Agents / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D007378:Interleukins / Q000276:immunology* / Q000378:metabolism; D008297:Male; D009298:Nasal Polyps / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology / Q000601:surgery; D011379:Prognosis; D012008:Recurrence; D065631:Rhinitis, Allergic / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D007378:Interleukins