WIML

The Polish Journal of Aviation Medicine, Bioengineering and Psychology

Kwartalnik Polskiego Towarzystwa Medycyny Lotniczej

2020, Volume 26, Issue 4

EFFECT OF INFLAMMATORY FACTORS IN THE PATHOGENESIS OF CHRONIC PARANASAL SINUSITIS


ANDRZEJ WOJDAS1
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1Department of Otolaryngology, Military Institute of Aviation Medicine


Autor korenspondencyjny: ANDRZEJ WOJDAS; Department of Otolaryngology, Military Institute of Aviation Medicine; email: awojdas@wiml.waw.pl



Streszczenie

Abstract: Immunological mechanisms, involved in inflammatory processes induced by viral and bacterial pathogens or factors inducing allergic processes, and non-immune mechanisms play an indirect role in the pathogenesis of chronic paranasal sinusitis (CPS). Contrary to popular belief, bacterial contamination plays a much smaller role. As a rule, it is a secondary process, i.e. as a result of inflammatory processes in the mucosa of the paranasal sinuses, its defence mechanisms are disturbed, which favours the development of infection. Bacterial infection of the paranasal sinuses is associated with the formation of a biofilm responsible for the persistence of sinusitis or the production of bacterial endotoxins that act as superantigens that cause the inflammation to persist.
CD4 + and CD8 + T cells play a major role in the inflammatory process as regulating centres for cytotoxic and humoral responses. They act in various directions, mainly cytotoxic, and as such they can interact with virtually all nucleated host cells expressing endogenous antigens and mediated by cytokines, mainly pro-inflammatory cytokines. They increase the migration of inflammatory cells to the mucosa of the nasal cavity and paranasal sinuses. The work discusses in detail the interaction of immune-competent immune cells and their influence on chronic inflammatory processes in the mucosa of the paranasal sinuses.
Another factor contributing to CPS is atopy, enhancing the action of pro-inflammatory cytokines and promoting the processes leading to obstruction of the mouth-ductal complex.
The complexity of the clinical picture of CPS in relation to the conducted pathogenesis studies indicates that it is still not possible to precisely define the phenotypes of the disease.


Słowa kluczowe

atopy, biofilm, chronic paranasal sinusitis (CPS), CD4 + T cells, CD8 + T cells, cytokines, pathogenesis