Chronic rhinosinusitis (CRS) is a clinical syndrome defined by typical sinonasal symptoms persisting for at least 12 weeks. CRS is divided into two distinct phenotypes, CRS with nasal polyps (CRSwNP) and without (CRSsNP). The aim of the review is to provide an update on the current knowledge in CRS endotypes. The prevailing hypothesis regarding the pathogenesis of CRS suggests that dysfunctional interactions between the host and environmental stressors at the mucosal surface drive the diverse inflammatory mechanisms. Genetic and epigenetic variations in the mucosal immune system are believed to play a significant role in the pathomechanisms of CRS. Various environmental agents (such as microbes and irritants) have been implicated in CRS. In a healthy state, the sinonasal mucosa acts as a barrier, modulating environmental stimulation and mounting appropriate immune responses against pathogens with minimal tissue damage. Different endotypes may exist based on the specific mechanistic pathways driving the chronic tissue inflammation of CRS. There is a need to understand endotypes in order to better predict, diagnose, and treat CRS. This literature review provides an update on the role of the endotypes in CRS and the limitations of endotyping CRS in clinical practice. Understanding of the pathogenesis and optimal management of CRS has progressed significantly in the last decades; however, there still are several unmet needs in endotype research.

中文翻译：

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慢性鼻窦炎的内质分型 - EAACI 工作组报告


慢性鼻-鼻窦炎 （CRS） 是一种临床综合征，定义为典型的鼻窦症状持续至少 12 周。CRS 分为两种不同的表型，伴鼻息肉的 CRS （CRSwNP） 和无鼻息肉的 CRS （CRSsNP）。本综述的目的是提供 CRS 内型当前知识的最新信息。关于 CRS 发病机制的普遍假设表明，宿主与粘膜表面环境压力源之间的功能障碍相互作用驱动了不同的炎症机制。粘膜免疫系统的遗传和表观遗传变异被认为在 CRS 的病理机制中起着重要作用。各种环境因素（如微生物和刺激物）都与 CRS 有关。在健康状态下，鼻窦粘膜充当屏障，调节环境刺激并针对病原体产生适当的免疫反应，同时将组织损伤降至最低。根据驱动 CRS 慢性组织炎症的特定机制途径，可能存在不同的内型。需要了解内型，以便更好地预测、诊断和治疗 CRS。本文献综述提供了内型在 CRS 中的作用以及临床实践中内型 CRS 的局限性的最新信息。在过去几十年中，对 CRS 发病机制和最佳管理的理解取得了显著进展;然而，内型研究中仍然存在一些未满足的需求。