“Nasal polyposis is an inflammatory, disabling, chronic, often severe pathology with a great impact on the patient’s quality of life, as it presents a varied symptomatology: nasal obstruction, in which the patient has major nasal breathing problems, often an asthmatic comorbidity and the decrease or total lack of smell, called anosmia, which alters the quality of sleep. The impact of the symptoms on the patient’s quality of life is such that we specialists in diagnosing this pathology must take into account how much it impacts the patient’s social-relational abilities”. This was said by Ignazio La Mantia, director of the complex operational unit of Otolaryngology of the University Hospital Policlinico – S. Marco of Catania, speaking about chronic rhinosinusitis with nasal polyposis (Crswnp), on the occasion of the 110th National Congress of the Italian Society of ENT and neck-facial surgery – Sio, scheduled in Bergamo from 22 to 25 May 2024, whose theme is “The Future is Listening”.
Mantia delves into the theme of the eosinophil as a central factor in the recurrence of nasal polyposis and explains how it is a fundamental indicator of inflammation: “This pathology certainly causes an important problem, namely the alteration of the patient’s immunology. In fact, we have an increase in eosinophils, which we find in the blood and on the nasal mucosa. Hypereosinophilia has an important implication in managing all the symptoms – he explains – It is a situation that can give much more important pictures than simple chronic rhinosinusitis with nasal polyposis, such as syndromes such as Churg Strauss but also eosinophilic esophagitis. It follows that the eosinophil is the most important mediator and that is what we are looking for. It is the biomarker that tells us that we are faced with type 2 inflammation.”
IL-5 is an important and central therapeutic target in chronic rhinosinusitis with nasal polyposis (Crswnp), as it is able to extend its action beyond the eosinophil cell alone: ”The latest research says that interleukin 5 has a much more important than the simple activation of eosinophils. And in this sense it is important to distinguish between inflammatory and non-inflammatory eosinophils, i.e. residents. Interleukin 5 also impacts other cells present both in the blood and in the nasal mucosa. From the latest research, especially in the congress that is taking place in Bergamo these days, very important data have emerged on even genetic factors of interleukin 5. It follows, therefore, that interleukin 5 plays a central role in the genesis of this type of inflammation (Crswnp)”, he concludes.
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