Clinical and immunologic implication of neo-osteogenesis in chronic rhinosinusitis

ABSTRACT

Introduction

Chronic rhinosinusitis (CRS) is a multifactorial disease characterized by long-term inflammation of the nasal and sinus passages. Neo-osteogenesis which is a major finding of recalcitrant CRS is clinically related to the disease severity and surgical outcomes of CRS.

Areas covered

The immunological and molecular mechanisms underlying neo-osteogenesis of CRS remain unclear, and many recent studies have suggested the importance of inflammatory mediators secreted by immune cells. This paper provides a broader understanding of neo-osteogenesis in CRS by reviewing recent updates and evidence of the association between CRS pathophysiology and neo-osteogenesis.

Expert opinion

Crosstalk between the bone and mucosa eventually results in refractory CRS. In addition, both eosinophilic and non-eosinophilic CRS cytokines can play a role in neo-osteogenesis and trigger an enhanced CRS-associated immune response. The significance of predicting neo-osteogenesis in advance or during postoperative care could be essential for effectively managing refractory CRS and enhancing the prognosis of CRS patients.

KEYWORDS:

• Chronic rhinosinusitis
• Cytokine
• Immune response
• Neo-osteogenesis
• Osteitis

Article highlights

• Neo-osteogenesis is thought to be a major finding of recalcitrant CRS. However, the relationship between neo-osteogenesis and CRS with its various endotype remains unclear.

• The interaction of various inflammatory cytokines not only affects neo-osteogenesis but also triggers CRS immune response.

• The crosstalk between bone and mucosa exacerbates each other and results in persistent, refractory CRS

Acknowledgments

The authors would like to thank Minjae Kim, Dr Minju Kim and Dr Suyeon Pyo for formatting assistance and contributions to original figures.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This research was supported by the clinical research grant-in-aid from the Seoul Metropolitan Government Seoul National University (SMG-SNU) Boramae Medical Center (02-2020-7).