Epithelial Mechanism of Disease | Epicascade

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IL=interleukin; TSLP=thymic stromal lymphopoietin.

REFERENCES

1. Langdon C, Mullol J. Nasal polyps in patients with asthma: prevalence, impact, and management challenges. J Asthma Allergy. 2016;9:45-53. 2. Ha J-G, Cho H-J. Unraveling the role of epithelial cells in the development of chronic rhinosinusitis. Int J Mol Sci. 2023;24(18):14229. 3. Kato A, Schleimer RP, Bleier BS. Mechanisms and pathogenesis of chronic rhinosinusitis. J Allergy Clin Immunol. 2022;149(5):1491-1503. 4. Calvén J, Ax E, Rådinger M. The airway epithelium—a central player in asthma pathogenesis. Int J Mol Sci. 2020;21(23):8907. 5. Peters A, Zhao X, Near AM, et al. Real-world outcomes following biologic initiation in US patients with chronic rhinosinusitis with nasal polyps. Adv Ther. 2025;42(4):1783-1799. 6. Bachert C, Zhang N, Cavaliere C, Weiping W, Gevaert E, Krysko O. Biologics for chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2020;145(3):725-739.

CRSwNP=chronic rhinosinusitis with nasal polyps.

REFERENCES

*Data refers to patients starting a biologic targeting downstream mediators.

CRSwNP=chronic rhinosinusitis with nasal polyps; INCs=intranasal corticosteroids; OCS=oral corticosteroid.

REFERENCES

1. Kato A, Schleimer RP, Bleier BS. Mechanisms and pathogenesis of chronic rhinosinusitis. J Allergy Clin Immunol. 2022;149(5):1491-1503. 2. Peters A, Han J, Spahn J, et al. Real-world outcomes following biologic initiation in US patients with chronic rhinosinusitis with nasal polyps. Presented at: ACAAI Annual Scientific Meeting; October 24-28, 2024; Boston, MA. 3. Bachert C, Zhang N, Cavaliere C, Weiping W, Gevaert E, Krysko O. Biologics for chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2020;145(3):725-739. 4. Mullol J, Azar A, Buchheit KM, Hopkins C, Bernstein JA. Chronic rhinosinusitis with nasal polyps: quality of life in the biologics era. J Allergy Clin Immunol Pract.
2022;10(6):1434-1453.e9. 5. van der Veen J, Seys SF, Timmermans M, et al. Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral
centre. Allergy. 2017;72(2):282-290. 6. DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2017;127(3):550-555. 7. Claeys N, Teeling MT, Legrand P, et al. Patients unmet needs in chronic rhinosinusitis with nasal polyps care: a patient advisory board statement of EUFOREA. Front Allergy. 2021;2:761388. 8. Starry A, Hardtstock F, Wilke T, et al. Epidemiology and treatment of patients with chronic rhinosinusitis with nasal polyps in Germany—a claims data study. Allergy. 2022;77(9):2725-2736.

1. Kato A, Schleimer RP, Bleier BS. Mechanisms and pathogenesis of chronic rhinosinusitis. J Allergy Clin Immunol. 2022;149(5):1491-1503. 2. Peters A, Han J, Spahn J, et al. Real-world outcomes following biologic initiation in US patients with chronic rhinosinusitis with nasal polyps. Presented at: ACAAI Annual Scientific Meeting; October 24-28, 2024; Boston, MA. 3. Bachert C, Zhang N, Cavaliere C, Weiping W, Gevaert E, Krysko O. Biologics for chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2020;145(3):725-739.
4. Mullol J, Azar A, Buchheit KM,
Hopkins C, Bernstein JA. Chronic rhinosinusitis with nasal polyps: quality of life in the biologics era. J Allergy Clin Immunol Pract.
2022;10(6):1434-1453.e9. 5. van der
Veen J, Seys SF, Timmermans M, et al. Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre. Allergy. 2017;72(2):282-290. 6. DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2017;127(3):550-555. 7. Claeys N, Teeling MT, Legrand P, et al. Patients unmet needs in chronic rhinosinusitis with nasal polyps care: a patient advisory board statement of EUFOREA. Front Allergy. 2021;2:761388. 8. Starry A, Hardtstock F, Wilke T, et al. Epidemiology and treatment of patients with chronic rhinosinusitis with nasal polyps in Germany—a claims data study. Allergy. 2022;77(9):2725-2736.

Image adapted from Kato A, et al. 2022² and Bachert C, et al. 2020.⁷
CRSwNP=chronic rhinosinusitis with nasal polyps; IL=interleukin; ILC2=type 2 innate lymphoid cell; Th=T helper; TSLP=thymic stromal lymphopoietin.

REFERENCES

1. Ha J-G, Cho H-J. Unraveling the role of epithelial cells in the development of chronic rhinosinusitis. Int J Mol Sci. 2023;24(18):14229. 2. Kato A, Schleimer RP, Bleier BS. Mechanisms and pathogenesis of chronic rhinosinusitis. J Allergy Clin Immunol. 2022;149(5):1491-1503. 3. Calvén J, Ax E, Rådinger M. The airway epithelium—a central player in asthma pathogenesis. Int J Mol Sci. 2020;21(23):8907. 4. Laulajainen-Hongisto A, Toppila-Salmi SK, Luukkainen A, Kern R. Airway epithelial dynamics in allergy and related chronic inflammatory airway diseases. Front Cell Dev Biol. 2020;8:204. 5. Stevens WW, Peters AT, Tan BK, et al. Associations between inflammatory endotypes and clinical presentations in chronic rhinosinusitis. J Allergy Clin Immunol Pract. 2019;7(8):2812-2820.e3. 6. Staudacher AG, Peters AT, Kato A, Stevens WW. Use of endotypes, phenotypes, and inflammatory markers to guide treatment decisions in chronic rhinosinusitis. Ann Allergy Asthma Immunol. 2020;124(4):318-325. 7. Bachert C, Zhang N, Cavaliere C, Weiping W, Gevaert E, Krysko O. Biologics for chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2020;145(3):725-739.

TAKE IT FROM THE TOP IN CRSwNP^1-3

The epithelium is the first point of contact for INSULTS^1-3

In response to insults, the epithelium releases EPITHELIAL CYTOKINES (such as TSLP, IL-33, and IL-25),^1-4

which can drive multiple DOWNSTREAM INFLAMMATORY PATHWAYS^1-4

AND CAN LEAD TO MULTIPLE CLINICAL MANIFESTATIONS^1-3,5,6

GUIDE TO EPITHELIAL-DRIVEN INFLAMMATION

TAKE IT FROM THE TOP IN CRSwNP1-3

The epithelium is the first point of contact for INSULTS1-3

In response to insults, the epithelium releases EPITHELIAL CYTOKINES (such as TSLP, IL-33, and IL-25),1-4

which can drive multiple DOWNSTREAM INFLAMMATORY PATHWAYS1-4

AND CAN LEAD TO MULTIPLE CLINICAL MANIFESTATIONS1-3,5,6

GUIDE TO EPITHELIAL-DRIVEN INFLAMMATION

TAKE IT FROM THE TOP IN CRSwNP^1-3

The epithelium is the first point of contact for INSULTS^1-3

In response to insults, the epithelium releases EPITHELIAL CYTOKINES (such as TSLP, IL-33, and IL-25),^1-4

which can drive multiple DOWNSTREAM INFLAMMATORY PATHWAYS^1-4

AND CAN LEAD TO MULTIPLE CLINICAL MANIFESTATIONS^1-3,5,6