Chronic sinusitis: Decoding the triad of epithelial dysfunction, mucosal inflammation, and microbial dynamics

Abstract

Chronic sinusitis, a persistent and long-lasting condition, has a significant effect on an individual’s quality of life. This review offers an in-depth analysis of the complex relationship between epithelial failure, mucosal inflammation, and microbial dynamics, explaining their combined role in the pathophysiology of chronic sinusitis. We address the important role of the epithelial barrier and the effects of its disturbance on immune responses. This review focuses on the mucosal inflammation found in chronic sinusitis cases, highlighting the cytokines and cells that contribute to the ongoing inflammatory response. We provide an in-depth overview of the sinus microbiome’s role in both health and disease states, looking at the effects of bacterial, viral, and fungal colonization on sinus inflammation and their relationship with the epithelial barrier. We also discuss the role of mucociliary clearance and the consequences of its disruption on ongoing inflammation. Each of these factors has a relationship with the others, and together they contribute to chronic inflammation. Current treatment methods are somewhat effective but have limitations. These treatments include methods to improve epithelial function, reduce inflammation, use antibiotics and antifungals, introduce probiotics, and improve mucociliary function. As we learn more, we look at potential new treatments and the need for a complete approach that covers all areas. In short, understanding these areas is key to improving patient care and encouraging more research.