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The Proceedings of the American Thoracic Society 6:288-294 (2009)
© 2009 The American Thoracic Society
doi: 10.1513/pats.200808-088RM
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Epithelium, Inflammation, and Immunity in the Upper Airways of Humans

Studies in Chronic Rhinosinusitis

Robert P. Schleimer1, Atsushi Kato1, Anju Peters1, David Conley2, Jean Kim3, Mark C. Liu4, Kathleen E. Harris1, Douglas A. Kuperman1, Rakesh Chandra2, Silvio Favoreto, Jr.1, Pedro C. Avila1, Leslie C. Grammer1 and Robert C. Kern2

1 Division of Allergy-Immunology, Department of Medicine, and 2 Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; 3 Department of Otolaryngology, and 4 Divisions of Allergy and Clinical Immunology, Pulmonary, and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland

Correspondence and requests for reprints should be addressed to Robert P. Schleimer, Ph.D., Northwestern University Feinberg School of Medicine, Division of Allergy-Immunology, 240 E. Huron, McGaw M318, Chicago, IL 60611. E-mail: rpschleimer{at}northwestern.edu

ABSTRACT

The purpose of this review is to discuss recent findings made during studies of the upper airways and sinuses of people with chronic rhinosinusitis (CRS) in the context of the literature. CRS is a chronic inflammatory disorder affecting nearly 30 million Americans and is generally resistant to therapy with antibiotics and glucocorticoids (Meltzer EO and coworkers, J Allergy Clin Immunol 2004;114:155–212). We have formed a collaboration that consists of otolaryngologists, allergists, and basic scientists to address the underlying immunologic and inflammatory processes that are occurring in, and possibly responsible for, this disease. The main emphasis of our work has been to focus on the roles that epithelium, in the sinuses and upper airways, plays as both a mediator and regulator of immune and inflammatory responses. It is not our intention here to provide a comprehensive review of the literature in this area, but we will try to put our work in the context of the findings of others (Kato A and Schleimer RP, Curr Opin Immunol 2007;19:711–720; Schleimer RP and coworkers, J Allergy Clin Immunol 2007;120:1279–1284). In particular, we discuss the evidence that epithelial cell responses are altered in CRS, including those relevant to regulation of dendritic cells, T cells, B cells, and barrier function.

Key Words: chronic rhinosinusitis • inflammation • epithelium • immunology






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