Barrier function of the nasal mucosa in health and type-2 biased airway diseases

Allergy

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

1. Nan Zhang¹, 
2. Koen van Crombruggen¹,
3. Elien Gevaert¹ and
4. Claus Bachert^1,2,*
5. 1. • Abstract
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      Keywords:

      • allergic rhinitis;
      • chronic rhinosinusitis with nasal polyps;
      • eosinophil extracellular traps;
      • immune response;
      • nasal epithelial barrier

      Abstract

      The mucosal lining of the upper airways represents the outer surface of the body to the ambient air and its contents and is prepared for it as the first line of defense. Apart from the well described physical barrier and the mucociliary clearance, a variety of systems including the airway microbiome, antimicrobial proteins and damage associated molecular patterns, innate lymphoid cells and epithelial derived cytokines and chemokines, and finally the adaptive immune system, and eosinophils as newly appreciated defense cells form different levels of protection against and response to any possible intruder.

      Of interest especially for allergic airway disease, mucosal germs might not just elicit a classical Th1/Th17 biased inflammatory response, but may directly induce a type 2 mucosal inflammation. Innovative therapeutic interventions may be possible at different levels also; however, whether modulations of the innate or adaptive immune responses will finally be more successful, and how the correction of the adaptive immune response might impact on the innate side, will be determined in the near future.
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