Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 11-12, Pages: 740-746
https://doi.org/10.2298/SARH1412740P
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Inflammatory mechanisms in nasal polyposis
Perić Aleksandar (University of Defense, Faculty of Medicine, Belgrade + Military Medical Academy, Department of Otorhinolaryngology, Rhinology Unit, Belgrade)
Vojvodić Danilo (Faculty of Medicine, University of Defense, Belgrade + Military Medical Academy, Institute for Medical Research, Division of Clinical and Experimental Immunology, Belgrade)
Nasal polyposis is a chronic inflammatory disease of the nasal and paranasal
sinuses mucosa, characterized by prolaps of edematous mucosa, most commonly
from the area of anterior ethmoid. The mean histological characteristics are
proliferation of pseudostratified respiratory epithelium, thickening of the
basement membrane, focal fibrosis and eosinophilic and lymphocytic
infiltration of the lamina propria. Although etiology is unknown, two
hypotheses are dominant among the scientists: ”hypothesis of staphylococcal
superantigens“ and ”hypothesis of immune barrier dysfunction“. Although we
have not yet achieved a full understanding of the precise mechanisms
underlying the pathogenesis of this disease, it is known that nasal polyposis
is associated with intensive chronic inflammation, followed by dysregulation
of chemotaxis, migration, activation and function of eosinophils. A great
number of cytokines, chemokines, and adhesion molecules are involved in the
regulation of these complex mechanisms. After activation, eosinophils produce
and release enzymes, which can lead to the damage of mucosa and tissue
remodeling. Hyperactive eosinophils release a new amount of chemokines and
cytokines, attracting new eosinophils into the site of inflammation, and may
cause the persistence of chronic inflammation.
Keywords: nasal polyposis, etiology and pathogenesis, pathohistological analysis, cytokines, chemokines