Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press77310.36691/RJA773ArticlesСтатьиTriggernye faktory khronicheskogoretsidiviruyushchego polipoznogorinosinusitaТриггерные факторы хроническогорецидивирующего полипозногориносинуситаMokronosovaM AМокроносоваМ А

ГУ НИИ вакцин и сывороток им. И.И. Мечникова, г. Москва

mmokronosova@mail.ruГУ НИИ вакцин и сывороток им. И.И. Мечникова, г. Москва1502201181NO1 (2011)№1 (2011)253110032020Copyright ©; 2011, Pharmarus Print MediaCopyright ©; 2011, Фармарус Принт Медиа2011Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/773

Обзор посвящен патогенетическим аспектам хронического рецидивирующего полипозного риносинусита (ХРПР ). Рассматриваются аргументы в пользу «грибковой» и «стафилококковой» гипотез. Обсуждаются факты, противоречащие теории об инфекционной природе ХРПР . Отражены основные иммунологические нарушения при полипозе носа: дисфункция металлопротеиназ, циклооксигеназного цикла, гипрепродукция IL-5, IL-16 с последующим развитием эозинофильного воспаления. С учетом разнообразия клинических проявлений хронического риносинусита предполагается, что только многофакторный анализ триггерных факторов может пролить свет на патогенез этого заболевания.

хронический рецидивирующий риносинуситполипоз носастафилококковые суперантигеныплесневые грибыцитокиныEPOS Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 - a summary. Prim Care Respir J., 2008, v. 17, No. 2, p. 79-89.Лопатин А.С. Современные теории патогенеза полипозного риносинусита. Пульмонология, 2003. № 5, с. 110-115.Crampette L., Serrano E., Klossek J.M. et al. French multicenter prospective epidemiologic study (ORLI Group) of allergic and lung diseases associated with nasal polyposis. Rev. Laryngol Otol. Rhinol. (Bord). 2001, v. 122, No. 4, p.231-236.Larsen K., Tos M. The estimated incidence of symptomatic nasal polyps. Acta Otolaryngol. 2002, v. 122, No. 2, p. 179-182.Settipane G.A. Epidemiology of nasal polyps Allergy Asthma Proc. 1996, v. 17, No. 5, p. 231-236.Портенко Г.М. Заболеваемость полипозным риносинуситом среди населения. Вестн. оториноларингол. 1989, No. 1, с. 52-54.Lacroix J.S., Zheng C.G., Goytom S.H. et al. Histological comparison of nasal polyposis in black African, Chinese and Caucasian patients. Rhinology. 2002, v. 40, No. 3, p. 118-121.Braun J.J., Haas F., Conraux C. Polyposis of the nasal sinuses. Epidemiology and clinical aspects of 350 cases. Treatment and results with a follow-up over 5 years on 93 cases. Ann. Otolaryngol Chir. Cervicofac. 1992, v. 109, No. 4, p. 189-199.Toledano Mu≈noz A., Herr, aiz Puchol C., Navas Molinero C. et al. Epidemiological study in patients with nasal polyposis. Acta Otorhinolaringol Esp. 2008, v. 59, No. 9, p. 438-443.Kim J.E., Kountakis S.E.The prevalence of Samter's triad in patients undergoing functional endoscopic sinus surgery. Ear. Nose Throat. J. 2007, v. 86, No. 7, p. 396-399.Rachelefsky G.S., Coulson A., Siegel S.C., Stiehm E.R. Aspirin intolerance in chronic childhood asthma: Detected by oral challenge. Pediatrics. 1975, v. 56, No. 3, p. 443-448.Delagrand A., Gilbert-Dussardier B. et al. Nasal polyposis: is there an inheritance pattern? A single family study. Rhinology. 2008, v. 46, No. 2, p. 125-30.Stankovic K.M., Goldsztein H., Reh D.D. et al. Gene expression profiling associated with chronic sinusitis and aspirin sensitive asthma. Laryngoscope. 2008, v. 118, No. 5, p. 881-889.Zhai L., Sun Y., Tang L., Liu H. Polymorphism between loci for human leukocyte antigens DR and DQ in patients with nasal polyps. Ann. Otol. Rhinol. Laryngol. 2007, v. 116, No. 1, p. 66-68.Ponikau J.U., Sherris D.A., Kern E.B. et al. The diagnosis and incidence of allergic fungal sinusitis. J. Immunol. Mayo Clin. Proc. 1999, v. 74, No. 9, p. 877-884.Ponikau J.U., Sherris D.A., Kephart G.M. et al. Striking deposition of toxic eosinophil major basic protein in mucus: implications for chronic rhinosinusitis. J. Allergy Clin. Immunol. 2005, v. 116, No. 2, p. 362-369.Yoon J., Ponikau J.U., Lawrence C.B., Kita H. Innate antifungal immunity of human eosinophils mediated by a beta 2 integrin, CD11b. J. Immunol. 2008, v. 181, No. 4, p. 2907-2915.Ponikau J.U., Sherris D.A., Weaver A., Kita H. Treatment of chronic rhinosinusitis with intranasal amphotericin B: a randomized, placebo-controlled, double-blind pilot trial. J. Allergy Clin. Immunol. 2005, v. 115, No. 1, p. 125-131.Schubert M.S. Allergic fungal sinusitis: pathophysiology, diagnosis and management. Medю Mycol. 2009, v. 47, Suppl., p. 324-330.Aydil U., Kalkanci A., Ceylan A. et al. Investigation of fungi in massive nasal polyps: microscopy, culture, polymerase-chain reaction, and serology. Am. J. Rhinol. 2007, v. 21, No. 4, p. 417-22.Braun H., Stammberger H., Buzina W. et al. Incidence and detection of fungi and eosinophilic granulocytes in chronic rhinosinusitis. Laryngorhinootologie. 2003, v. 21, No. 4, p. 417-422, v. 82 (5), p. 330-340.Gosepath J., Brieger J., Vlachtsis K., Mann W.J. Fungal DNA is present in tissue specimens of patients with chronic rhinosinusitis. Am. J. Rhinol. 2004 , v. 18, No. 1, p. 9-13.Shin S.H., Ye M.K., Lee Y.H. Fungus culture of the nasal secretion of chronic rhinosinusitis patients: seasonal variations in Daegu, Korea. Am. J. Rhinol. 2007, v. 21, No. 5, p. 556-559.Munoz-Del-Castillo F., Jurado-Ramos A., Soler R. et al. Fungal sensitization in nasal polyposis. J. Investig. Allergol. Clin. Immunol. 2009, v. 19, No. 1, p. 6-12.Weschta M., Rimek D., Formanek M. et al. Local production of Aspergillus fumigatus specific immunoglobulin E in nasal polyps. Laryngoscope. 2003, v.113, No. 10, p. 1798-1802.Tosun F., Hidir Y., Saracli M.A. et al. Intranasal fungi and chronic rhinosinusitis: what is the relationship? Ann Otol Rhinol Laryngol. 2007, v. 116, No. 6, p. 425-429.Wise S.K., Ahn C.N., Lathers D.M. et al. Antigen-specific IgE in sinus mucosa of allergic fungal rhinosinusitis patients. Am. J. Rhinol. 2008, v. 22, No. 5, p. 451-456.Ebbens F.A., Georgalas C., Luiten S. et al. The effect of topical amphotericin B on inflammatory markers in patients with chronic rhinosinusitis: a multicenter randomized controlled study. Laryngoscope. 2009, v. 119, No. 2, p. 401-408.Weschta M., Rimek D., Formanek M. et al. Topical antifungal treatment of chronic rhinosinusitis with nasal polyps: a randomized, double-blind clinical trial. J. Allergy Clin. Immunol. 2004, v. 113, No. 6, p. 1122-1128.Sabirov A., Hamilton R.G., Jacobs J.B. et al. Role of local immunoglobulin E specific for Alternaria alternata in the pathogenesis of nasal polyposis.Laryngoscope. 2008, v. 118, No. 1, p. 4-9.Pitzurra L., Bellocchio S., Nocentini A. et al. Antifungal immune reactivity in nasal polyposis. Infect. Immun. 2004, v. 72, No. 12, p. 7275-7281.Baruah P., Trimarchi M., Dumitriu I.E. et al. Innate responses to Aspergillus: role of C1q and pentraxin 3 in nasal polyposis. Am. J. Rhinol. 2007, v. 21, No. 2, p. 224-230.Shin S.H., Lee Y.H., Jeon C.H. Protease-dependent activation of nasal polyp epithelial cells by airborne fungi leads to migration of eosinophils and neutrophils. Acta Otolaryngol. 2006, v. 126, No. 12, p. 1286-1294.Bachert C., Zhang N., Patou J. et al. Role of staphylococcal superantigens in upper airway disease. Curr. Opin. Allergy Clin. Immunol. 2008 v. 8, No. 1, p. 34-38.Fleischer B. Superantigens. APMIS., 1994, v. 102, p. 3-12.Perez-Novo C.A., Claeys C., Van Zele T. et al. Eicosanoid metabolism and eosinophilic inflammation in nasal polyp patients with immune response to Staphylococcus aureus enterotoxins. Am. J. Rhinol. 2006, v. 20, No. 4, p. 456-460.Patou J., Gevaert P., Van Zele T. et al. Staphylococcus aureus enterotoxin B, protein A, and lipoteichoic acid stimulations in nasal polyps. J. Allergy Clin. Immunol. 2008, v. 121, No. 1, p. 110-115.Yu R.L., Dong Z. Proinflammatory impact of Staphylococcus aureus enterotoxin B on human nasal epithelial cells and inhibition by dexamethasone. Am. J. Rhinol Allergy. 2009, v. 23, No. 1, p. 15-20.Wang M., Shi P., Yue Z. et al. Superantigens and the expression of T-cell receptor repertoire in chronic rhinosinusitis with nasal polyps. Acta Otolaryngol. 2008, v. 128, No. 8, p. 901-908.Bernstein J.M., Kansal R. Superantigen hypothesis for the early development of chronic hyperplastic sinusitis with massive nasal polyposis. Curr. Opin. Otolaryngol Head Neck Surg. 2005, v. 13, No. 1, p. 39-44.Conley D.B., Tripathi A., Seiberling K.A. et al. Superantigens and chronic rhinosinusitis II: analysis of T-cell receptor V beta domains in nasal polyps. Am. J. Rhinol. 2006, v. 20, No. 4, p. 451-455.Niederfuhr A., Kirsche H., Riechelmann H., Wellinghausen N. The bacteriology of chronic rhinosinusitis with and without nasal polyps. Arch. Otolaryngol Head Neck Surg. 2009, v. 135, No. 2, p. 131-136.El Fiky L.M., Khamis N., Mostafa Bel D., Adly A.M. Staphylococcal infection and toxin production in chronic rhinosinusitis. Am. J. Rhinol. Allergy. 2009, v. 22, No. 3, p. 264-267.Niederfuhr A., Kirsche H., Deutschle T. et al. Staphylococcus aureus in nasal lavage and biopsy of patients with chronic rhinosinusitis. Allergy. 2008, v. 63, No. 10, p. 1359-1367.Fan Y.P., Xu G., Zuo K.J. et al. Detection of specific IgE of anti-Staphylococcus aureus enterotoxins in nasal polyps and analysis theoretically about the superantigen hypothesis. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006, v. 41, No. 11, p. 825-829.Perez-Novo C.A., Kowalski M.L., Kuna P. et al. Aspirin sensitivity and IgE antibodies to Staphylococcus aureus enterotoxins in nasal polyposis: studies on the relationship. Int. Arch. Allergy Immunol. 2004, v. 133, No. 3, p. 255-260.Busaba N.Y., Siegel N.S., Salman S.D. Microbiology of chronic ethmoid sinusitis: is this a bacterial disease? Am. J. Otolaryngol. 2004 , v. 25, № 6, p. 379-384.Fan G.K., Wang H., Takenaka H. Eosinophil infiltration and activation in nasal polyposis. Acta. Otolaryngol. 2007, v. 127, No. 5, p. 521-526.Lackner A., Raggam R.B., Stammberger H. et al. The role of interleukin - 16 in eosinophilic chronic rhinosinusitis. Eur. Arch. Otorhinolaryngol. 2007, v. 264, No. 8, p. 887-893.Riechelmann H., Deutschle T., Rozsasi A. et al. Nasal biomarker profiles in acute and chronic rhinosinusitis. Clin. Exp. Allergy. 2005, v. 35, No. 9, p. 1186-1191.Wang J., Matsukura S., Watanabe S. et al. Involvement of Toll-like receptors in the immune response of nasal polyp epithelial cells. Clin. Immunol. 2007, v. 124, No. 3, p. 345-352.Li H.B., Cai K.M., Liu Z. et al. Foxp3+T regulatory cells (T regs) are increased in nasal polyposis after treatment with intranasal steroid. Clin. Immunol. 2008, v. 129, No. 3, p. 394-400.Chen Y.S., Langhammer T., Westhofen M., Lorenzen J. Relationship between matrix metalloproteinases MMP-2, MMP-9, tissue inhibitor of matrix metalloproteinases -1 and IL-5, IL-8 in nasal polyps. Allergy. 2007, v. 62, No. 1, p. 66-72.Can I.H., Ceylan K., Caydere M. et al. The expression of MMP-2, MMP-7, MMP-9 and TIMP-1 in chronic rhinosinusitis and nasal polyposis. Otolaryngol Head Neck Surg-2008, v. 139, No. 2, p. 211-215.Gosepath J., Brieger J., Mann W.J. New immunohistologic findings on differential role of cyclooxygenase 1 and cyclooxygenase 2 in nasal polyposis. Am. J. Rhinol. 2008, v. 19, No. 2, p. 111-116.Ebbens F.A., Maldonado M., de Groot E.J. et al. Topical glucocorticoids downregulate COX-1/positive cells in nasal polyps. Allergy. 2009, v. 64, No. 1, p. 96-103.Dennis D.P. Chronic sinusitis: defective T-cells responding to superantigens, treated by reduction of fungi in the nose and air. Arch. Environ. Health. 2003, v. 58, No. 7, p. 433-441.