https://orcid.org/0000-0003-0943-2558
![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
ABSTRACT
Introduction
Central compartment atopic disease (CCAD) is a newly recognized variant subtype of chronic rhinosinusitis (CRS). Although CCAD has been reported to be correlated with allergy, there is still a considerable gap in our knowledge regarding CCAD.
Areas covered
We have conducted a thorough analysis of the literature on CCAD. This review provides current understanding and therapeutic strategies of CCAD. In this article, we will review the clinical presentations and parameters, allergy-related etiology, endotypes, and recommended management of CCAD.
Expert opinion
CCAD is considered as an aeroallergen-driven type 2/eosinophilic inflammatory pattern. Although CCAD can be diagnosed by endoscopy and radiology, as well as allergen test, pathogenesis and management strategies leave much to be desired, and further studies are needed.
Article highlights
CCAD is a novel allergic phenotype of chronic rhinosinusitis, which sheds light on the key role of allergy in the pathogenesis.
CCAD is an inflammatory endotype characterized by eosinophilia and type 2 inflammation.
Management strategies fighting allergies such as allergen-specific immunotherapy and a combination of nasal sprays containing corticosteroid plus antihistamine could be recommended for CCAD in addition to the regular treatments (surgery, steroids, biologics, etc.) of CRSwNP.
Abbreviations
| AERD | = | aspirin-exacerbated respiratory disease |
| AFRS | = | allergic fungal rhinosinusitis |
| AIT | = | Allergen immunotherapy |
| AR | = | allergic rhinosinusitis |
| CCAD | = | central compartment atopic disease |
| CC CRS | = | central-compartment-type CRS |
| CRSwNP/CC | = | chronic rhinosinusitis with nasal polyps and central compartment involvement |
| CRSwNP NOS | = | chronic rhinosinusitis with nasal polyp not otherwise specified |
| CT | = | computed tomography |
| ENP | = | eosinophilic chronic rhinosinusitis with nasal polyps |
| ESS | = | endoscopic sinus surgery |
| MT | = | middle turbinate |
| NENP | = | non-eosinophilic chronic rhinosinusitis with nasal polyps |
| HDM | = | house dust mite |
| LDNP | = | lateral-dominant nasal polyp |
| PCMT | = | polypoid change of the middle turbinate |
| PSNS | = | posterosuperior nasal septum |
| PSP | = | paranasal sinus polyposis |
| REAH | = | respiratory epithelial adenomatoid hamartoma |
| sIgE | = | serology specific IgE |
| SNOT-22 | = | 22-item Sino-Nasal Outcome Test |
| ST | = | superior turbinate. |
Acknowledgments
We thank staff members in Dr. Zhang’s Team for critical reading of the manuscript and for providing constructive suggestions.
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.
Author contributions
W Kong, Q Wu, and H Zhang acquired and analyzed data, and prepared the manuscript. Y Zhang and Q Yang designed the work and revised the manuscript. All authors reviewed and approved the final manuscript to be published.