Abstract

Background: The epithelial immune regulation is an essential and protective feature of the barrier function of the mucous membranes of the airways. Damage to the epithelial barrier can result in chronic inflammatory diseases, such as chronic rhinosinusitis (CRS) or bronchial asthma. Thymic stromal lymphopoietin (TSLP) is a central regulator in the epithelial barrier function and is associated with type 2 (T2) and non-T2 inflammation. Materials and methods: The immunology of chronic rhinosinusitis with polyposis nasi (CRSwNP) was analyzed in a literature search, and the existing evidence was determined through searches in Medline, Pubmed as well as the national and international study and guideline registers and the Cochrane Library. Human studies or studies on human cells that were published between 2010 and 2020 and in which the immune mechanisms of TSLP in T2 and non-T2 inflammation were examined were considered. Results: TSLP is an epithelial cytokine (alarmin) and a central regulator of the immune reaction, especially in the case of chronic airway inflammation. Induction of TSLP is implicated in the pathogenesis of many diseases like CRS and triggers a cascade of subsequent inflammatory reactions. Conclusion: Treatment with TSLP-blocking monoclonal antibodies could therefore open up interesting therapeutic options. The long-term safety and effectiveness of TSLP blockade has yet to be investigated.

Author Details

Authors

• Ludger Klimek¹,²
• Jan Hagemann²
• Hans-Jürgen Welkoborsky³
• Mandy Cuevas⁴
• Ingrid Casper¹
• Ulrike Förster-Ruhrmann⁵
• Felix Klimek¹
• Constantin A. Hintschich⁶
• Tilman Huppertz²
• Christoph Bergmann⁷
• Peter-Valentin Tomazic⁸
• Sven Becker⁹

Departments

• ¹ Center for Rhinology and Allergology, Wiesbaden,
• ² Clinic and Polyclinic for Otolaryngology, University Medical Center Mainz, Mainz,
• ³ Clinic for Ear, Nose and Throat Medicine, Head and Neck Surgery, Nordstadt Clinic of the KRH, Hannover,
• ⁴ Clinic and Polyclinic for Otolaryngology, University Hospital Carl Gustav Carus, TU Dresden, Dresden,
• ⁵ HNO-University Clinic Charité, Berlin,
• ⁶ Clinic and Polyclinic for Ear, Nose and Throat Medicine, University Hospital Regensburg, Regensburg,
• ⁷ HNO RKM
• ⁷ 
• ⁴ 
• ⁰  Interdisciplinary Specialist Clinic, Düsseldorf, Germany,
• ⁸ HNO-University Clinic Graz, Medical University Graz, Austria, and
• ⁹ HNO-University Clinic Tübingen, Germany

Address

Prof. Dr. med. L. Klimek, Zentrum für Rhinologie und Allergologie Wiesbaden, An den Quellen 10, 65183 Wiesbaden, Germany
Email: [email protected]

Citation