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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
Luke A. DONATELLI, Andrew P. LANE
Department of Otolaryngology, Head and Neck Surgery, Sinus Center, Johns Hopkins School of Medicine, Baltimore, MD, USA
Chronic rhinosinusitis (CRS) is an inflammatory process that occurs within the sinonasal mucosa. While the pathophysiology of CRS is not completely understood, dysfunction of several elements of the immune system have been implicated. The nose and the paranasal sinuses serve as a natural contact point for the external environment, and innate and adaptive immune defenses are active within the sinonasal respiratory epithelium and sub-epithelium. The innate immune system, which includes all immune measures that do not rely on immunologic memory, contributes significantly to the immune mechanisms within the sinonasal mucosa. Innate immune defenses include the natural barrier of the mucosal epithelium and the process of mucociliary clearance, as well as constitutively expressed and locally recruited immune effectors, which serve to mount an antimicrobial response and activate additional components of the innate and adaptive immune system. The innate immune system provides a rapid, nonspecific antimicrobial defense during the interval required to develop an adaptive immune response. Dysfunction of several innate immune processes has been implicated in CRS. The current review describes the activity of the innate immune system within the nose and sinuses, and its role in the pathophysiology of CRS. Within this discussion, particular attention is dedicated to innate lymphoid cells, which are recently discovered components of the innate immune system, and are thought to influence the course of chronic rhinosinusitis in ways that are under active investigation.