Molecular mechanisms of altered mucociliary clearance in patients with chronic rhinosinusitis with nasal polyps (CRSwNP); [Молекулярные механизмы нарушений мукоцилиарного клиренса у пациентов с хроническим полипозным риносинуситом]

Objective. To analyze literature data on molecular mechanisms of development of mucociliary clearance alterations in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Material and methods. The analysis of documents published up to 10 of March 2023 yr. in PubMed (Medline), Google Scholar and RSCI databases was carried out. A search was done by «cilia», «mucociliary», «mucus», «nasal polyp», «nasal polyposis», «CRSwNP» keywords and their Russian equivalents. Results and conclusion. The analysis of the publications shows a significant mucociliary clearance disturbance in CRSwNS which is caused by ciliary apparatus dysfunction due to altered ciliogenesis, on the one hand, and by affected characteristics of nasal mucus mainly as a result of increased MUC5AC secretion. These changes develop due to excess production of anti-inflammatory cytokines specific for CRSwNP, primarily IL-13, whose role in ciliary dysfunction is the most studied. A number of other cytokines, including IL-5, IL-6, tumor necrosis factor-α and interferon-γ also have a significant modulating effect on mucociliary transport in CRSwNP. The immediate molecular mechanisms mediating the influence of these cytokines on epithelial cells differentiation, ciliary activity or mucus secretion, may include activation of HIF-1, PI3K, TMEM16, NF-κB, STAT3/6, ERK signaling pathways, as well as modulation of transcription factors' expression involved in ciliogenesis regulation. It is suggested that the impact of mucociliary clearance alterations on molecular mechanisms in patients with CRSwNP may increase efficacy of both therapeutic and surgical treatment methods. © 2023 Media Sphera Publishing Group. All rights reserved.