Advances in the management of chronic rhinosinusitis: immunological approach and emerging biological therapies

Abstract Chronic rhinosinusitis (CRS) is a multifactorial inflammatory disease that affects the quality of life of patients. Its pathophysiology involves epithelial barrier dysfunction, microbiological dysbiosis and dysregulated immune responses. Although intranasal corticosteroids and endoscopic surgery have been the mainstays of treatment, biological therapies targeting specific inflammatory mediators such as IL-4, IL-5 and IL-13 have emerged in recent years. Monoclonal antibodies such as dupilumab have shown efficacy in patients with refractory nasal polyposis. However, questions remain regarding patient selection and optimal treatment duration. This review assesses advances in the pathophysiology and treatment of CRS, highlighting the role of immunomodulation in disease control. Keywords: Chronic rhinosinusitis, nasal polyposis, biological therapies, IL-5, dupilumab.