Pathophysiology of chronic rhinosinusitis with nasal polyp

Background: Chronic rhinosinusitis (CRS) is a common inflammatory condition of the paranasal sinuses and nasal passages. CRS with nasal polyp (CRSwNP) is a subtype of CRS, and the pathogenesis of CRSwNP remains largely unclear. Methods: This article reviews the literature regarding the pathophysiology of CRSwNP. Results: Evidence suggests that altered innate immunity, adaptive immunity, tissue remodeling, and/or effects of microorganisms may play a role in the development of CRSwNP. Aberrant arachidonic acid metabolism may also contribute to the pathogenesis of CRSwNP in patients with aspirin-exacerbated respiratory disease. Conclusion: There have been significant advances in the understanding pathophysiology of CRSwNP. Additional research is needed to elucidate these mechanisms and to determine their relative importance in the pathogenesis of CRSwNP. (Am J Rhinol Allergy 25, 285-290, 2011; doi: 10.2500/ajra.2011.25.3680)