摘要
AbstractAspirin-exacerbated respiratory disease (AERD) patients with CRSwNP suffer from reduced quality of life, reduced economic productivity, and higher risk of depression and sleep dysfunction. These patients often require frequent medical and surgical therapy, including functional endoscopic sinus surgery for recalcitrant disease. Given this severity, anti-type 2 biologic treatments are being investigated for use in this subgroup of patients with CRSwNP, including Omalizumab and Dupilumab. Preliminary data suggests that SNOT-22 related quality of life improvements following treatment with biologics are comparable to the current standard of care in the short term, but there is a lack of long-term data and standardized regimen that makes direct comparison difficult. Biologic therapies additionally require continuous use to avoid recurrence, and currently cost many times more than existing medical or surgical therapies. Aspirin-Exacerbated Respiratory Disease (AERD) is a type 2 (Th2)-mediated inflammatory disease characterized by chronic rhinosinusitis (CRS), nasal polyposis, rhinorrhea and asthma exacerbated by nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (aspirin/ASA).1 From a rhinologic standpoint, AERD patients are recognized as a subset of patients CRS with nasal polyps (CRSwNP), with AERD affecting approximately 1% of the United States population.2 Broadly, CRSwNP patients demonstrate derangements of several Th2 pathways, including dysregulation of the interleukin (IL)-4, IL-5, and IL-13. Cytokine levels are altered systemically, in the nasal mucosa, and in polyp tissue itself, while mast cells and eosinophils are also increased locally.3,4,5,6 From a rhinologic standpoint, patients with AERD are often considered to be among the most difficult to treat CRS patients, due to severity and disease recalcitrance.6 This is reflected at the cellular and molecular level; nasal polyps from patients with AERD have over 3 times as many eosinophils and higher IL-5 concentrations when compared to polyps taken from subjects with non-AERD CRS.7,8
出版日期
2020年12月13日（中国期刊网平台首次上网日期，不代表论文的发表时间）
