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Current Allergy and Asthma Reports

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01-10-2019 | Chronic Otitis Media | Otitis (DP Skoner, Section Editor)

Chronic Rhinosinusitis with Nasal Polyps in Older Adults: Clinical Presentation, Pathophysiology, and Comorbidity

Authors: Woo-Jung Song, Ji-Hyang Lee, Ha-Kyeong Won, Claus Bachert

Published in: Current Allergy and Asthma Reports | Issue 10/2019

Abstract

Purpose of Review

Chronic rhinosinusitis and nasal polyps (CRSwNP) is a common condition that significantly affects patients’ life. This work aims to provide an up-to-date overview of CRSwNP in older adults, focusing on its aging-related clinical presentations, pathophysiology, and comorbidity associations including asthma.

Recent Findings

Recent large population-based studies using nasal endoscopy have shown that CRSwNP is a mostly late-onset disease. Age-related changes in physiologic functions, including nasal epithelial barrier dysfunction, may underlie the incidence and different clinical presentations of CRSwNP in older adults. However, there is still a paucity of evidence on the effect of aging on phenotypes and endotypes of CRSwNP. Meanwhile, late-onset asthma is a major comorbid condition in patients with CRSwNP; they frequently present with type 2 inflammatory signatures that are refractory to conventional treatments when they are comorbid. However, as they are more commonly non-atopic, causative factors other than classical atopic sensitization, such as Staphylococcus aureus specific IgE sensitization, are suggested to drive the type 2 inflammation. There are additional comorbidity associations in older patients with CRSwNP, including those with chronic otitis media and head and neck malignancy.

Summary

Age is a major determinant for the incidence and clinical presentations of CRSwNP. Given the heterogeneity in phenotypes and endotypes, longitudinal investigations are warranted to elucidate the effects of aging on CRSwNP.

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Title: Chronic Rhinosinusitis with Nasal Polyps in Older Adults: Clinical Presentation, Pathophysiology, and Comorbidity
Authors: Woo-Jung Song
Ji-Hyang Lee
Ha-Kyeong Won
Claus Bachert
Publication date: 01-10-2019
Publisher: Springer US
Keywords: Chronic Otitis Media
Rhinosinusitis
Bronchial Asthma
Published in: Current Allergy and Asthma Reports / Issue 10/2019
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI: https://doi.org/10.1007/s11882-019-0880-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chronic Rhinosinusitis with Nasal Polyps in Older Adults: Clinical Presentation, Pathophysiology, and Comorbidity

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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