Epithelial immune regulation of inflammatory airway diseases: Chronic rhinosinusitis with nasal polyps (CRSwNP)

Research output: Contribution to journalReview articleContributedpeer-review


  • Ludger Klimek - , Center for Rhinology and Allergology Wiesbaden (Author)
  • Jan Hagemann - , University Medical Center Mainz (Author)
  • Hans-Jürgen Welkoborsky - , Clinic for Ear (Author)
  • Mandy Cuevas - , Department of Otorhinolaryngology, Head and Neck Surgery (Author)
  • Ingrid Casper - , Center for Rhinology and Allergology Wiesbaden (Author)
  • Ulrike Förster-Ruhrmann - , Charité – Universitätsmedizin Berlin (Author)
  • Felix Klimek - , Center for Rhinology and Allergology Wiesbaden (Author)
  • Constantin A Hintschich - , University Hospital Regensburg (Author)
  • Tilman Huppertz - , University Medical Center Mainz (Author)
  • Christoph Bergmann - , Klinik RKM 740 (Author)
  • Peter-Valentin Tomazic - , Medical University of Graz (Author)
  • Sven Becker - , University Hospital Tübingen (Author)


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.


Original languageEnglish
Pages (from-to)148-166
Number of pages19
JournalAllergologie select
Publication statusPublished - 2022

External IDs

PubMedCentral PMC9097524


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