Endotype-Driven Management of Chronic Rhinosinusitis
Summary
Chronic rhinosinusitis (CRS) is a multifaceted inflammatory disorder of the paranasal sinuses affecting up to 10 per cent of the population. Traditional classification by clinical features or the presence of nasal polyps has given way to a deeper understanding of underlying molecular and cellular mechanisms, leading to the concept of endotypes. Endotypes stratify patients according to distinct pathophysiological pathways—for example, type 2 eosinophilic inflammation, type 1 interferon‐driven responses or neutrophil‐predominant profiles. This refined taxonomy enables the identification of biomarkers that predict treatment response and long‐term disease control. Advances in endotyping have driven the introduction of targeted biologic therapies, such as monoclonal antibodies against key cytokines, and informed the development of precision approaches to surgery and medical management. Integration of molecular diagnostics, imaging techniques and patient‐centred outcome measures is shaping a holistic model of care in which interventions are tailored to the individual’s inflammatory signature, with the aim of improving symptom control, reducing steroid exposure and minimising the need for revision surgery.
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Endotype-Driven Management of Chronic Rhinosinusitis publication trend
The graph below shows the total number of articles in endotype-driven management of chronic rhinosinusitis across all publications each year (not limited to Nature Index journals).
Technical terms
Endotype: A subtype of disease defined by distinct molecular or cellular mechanisms rather than by clinical presentation alone.
Phenotype: Observable characteristics or clinical manifestations of disease, such as presence of nasal polyps or pattern of symptoms.
Type 2 inflammation: An immune response dominated by eosinophils and type 2 cytokines (IL-4, IL-5, IL-13) often associated with atopic conditions and nasal polyps.
Biologic therapy: Treatment using monoclonal antibodies or fusion proteins that selectively target specific immune mediators or receptors.
Biomarker: A measurable indicator of a biological state or condition used to guide diagnosis, prognosis or treatment selection.
References
- Neutrophils in nasal polyps exhibit transcriptional adaptation and proinflammatory role depend on local polyp milieu. JCI Insight (2024).
- Deep Learning-Based Fully Automatic Segmentation of the Paranasal Sinuses in Chronic Rhinosinusitis Patients Using Computed Tomographic Images. IEEE Access (2025).
- Endotype‐driven treatment in chronic upper airway diseases. Clinical and Translational Allergy (2017).
- Inflammation and Endotyping in Chronic Rhinosinusitis—A Paradigm Shift. Medicina (2019).
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