Respiratory Epithelium Clinical Challenges| 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.

DESPITE CURRENT APPROACHES FOR CRSwNP,
CLINICAL CHALLENGES REMAIN^1-3

Up to 40% of patients may not be optimally controlled with INCs or sinus surgery^4-6

While INCs or surgery can be effective for some patients, they

Current approaches focusing on downstream mediators may leave patients exposed to the possibility of an inadequate response to treatment due to unaddressed inflammation^1-3

~50^% of patients with CRSwNP starting a biologic may require one OCS burst within 12 months²*

More than 1 in 4 patients may require ≥2 OCS bursts
within 12 months²*

By focusing on epithelial cytokines at the top of the inflammatory cascade, you have the potential to help patients with CRSwNP.

DESPITE CURRENT APPROACHES FOR CRSwNP, CLINICAL CHALLENGES REMAIN1-3

Up to 40% of patients may not be optimally controlled with INCs or sinus surgery4-6

While INCs or surgery can be effective for some patients, they

Current approaches focusing on downstream mediators may leave patients exposed to the possibility of an inadequate response to treatment due to unaddressed inflammation1-3

~50% of patients with CRSwNP starting a biologic may require one OCS burst within 12 months2*

More than 1 in 4 patients may require ≥2 OCS bursts within 12 months2*

By focusing on epithelial cytokines at the top of the inflammatory cascade, you have the potential to help patients with CRSwNP.

DESPITE CURRENT APPROACHES FOR CRSwNP,
CLINICAL CHALLENGES REMAIN^1-3

Up to 40% of patients may not be optimally controlled with INCs or sinus surgery^4-6

Current approaches focusing on downstream mediators may leave patients exposed to the possibility of an inadequate response to treatment due to unaddressed inflammation^1-3

~50^% of patients with CRSwNP starting a biologic may require one OCS burst within 12 months²*

More than 1 in 4 patients may require ≥2 OCS bursts
within 12 months²*