The DOI matches its Crossref record; 89 of the 89 references it cites were found in a registry or an index.
Perspectives on the Etiology of Chronic Rhinosinusitis: An Immune Barrier Hypothesis
Open accessAbstract
Background: Chronic rhinosinusitis (CRS) has been defined as persistent symptomatic inflammation of the nasal and sinus mucosa resulting from the interaction of multiple host and environmental factors. Recent studies have implicated Alternaria fungi or toxigenic Staphylococcus aureus as critical agents in CRS pathogenesis. The emphasis on environmental agents in CRS etiology has focused interest toward elimination of those agents as the prime mechanism of therapy. This viewpoint is in marked contrast to the current perspective on some other chronic inflammatory epithelial disorders that afflict the skin, lungs, and gut, wherein host factors are believed to predispose to disease expression in the presence of ubiquitous environmental agents. Methods: The current review evaluates CRS etiology from this perspective and considers that CRS develops, in part, as an outcome of a dysfunctional host response. Specifically, evidence from our laboratory and others will be reviewed indicating that CRS is associated with a failure of the mechanical and immunologic barriers across the nasal mucosa. The hypothesis would further propose that genetic and epigenetic variation predisposes susceptible individuals to barrier failure in the presence of environmental stress leading to CRS. Results: From this unifying perspective, bacteria and fungi are seen as disease modifiers rather than primary etiologic agents. Conclusion: The goal is to place concepts of CRS pathophysiology in a framework consistent with a current understanding of chronic inflammation in general and epithelial disease in particular.
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Cites
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Cited by
European Position Paper on Rhinosinusitis and Nasal Polyps 2020
Fokkens, W. J., Lund, V. J., Hopkins, C., Hellings, P. W., Kern, R., Reitsma, S., Toppila-Salmi, S., Bernal-Sprekelsen, M., Mullol, J., Alobid, I., et al. (2020) · Rhinology journal · doi:10.4193/rhin20.600 · Cited by 5,882
Self-citationFokkens, W. J., Lund, V. J., Mullol, J., Bachert, C., Alobid, I., Baroody, F., Cohen, N., Cervin, A., Douglas, R., Gevaert, P., et al. (2012) · Rhinology journal · doi:10.4193/rhino12.000 · Cited by 2,387
International Consensus Statement on Allergy and Rhinology: Rhinosinusitis
Orlandi, R. R., Kingdom, T. T., Hwang, P. H., Smith, T. L., Alt, J. A., Baroody, F. M., Batra, P. S., Bernal‐Sprekelsen, M., Bhattacharyya, N., Chandra, R. K., et al. (2016) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21695 · Cited by 892
Self-citationAkdis, C. A., Bachert, C., Cingi, C., Dykewicz, M. S., Hellings, P. W., Naclerio, R. M., Schleimer, R. P., & Ledford, D. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.02.036 · Cited by 538
Self-citationIntranasal steroids versus placebo or no intervention for chronic rhinosinusitis
Chong, L. Y., Head, K., Hopkins, C., Philpott, C., Schilder, A. G., & Burton, M. J. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011996.pub2 · Cited by 192
Metadata
- Authors
- Kern, R. C., Conley, D. B., Walsh, W., Chandra, R., Kato, A., Tripathi-Peters, A., Grammer, L. C., & Schleimer, R. P.
- Venue
- American Journal of Rhinology
- Publisher
- SAGE Publications
- Published
- 2008-11
- Volume
- 22
- Issue
- 6
- Pages
- 549-559
- ISSN
- 1050-6586 (ISSN-L)
- 1539-6290
- OpenAlex
- W1999233686
- Cited by
- 317
- References
- 89
- FWCI
- 13.05
- Type
- journal article
- Language
- en
- Open access
- green
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- Kern, R. C., Conley, D. B., Walsh, W., Chandra, R., Kato, A., Tripathi-Peters, A., Grammer, L. C., & Schleimer, R. P. (2008). Perspectives on the Etiology of Chronic Rhinosinusitis: An Immune Barrier Hypothesis. American Journal of Rhinology. https://doi.org/10.2500/ajr.2008.22.3228
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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