Justification of a personalized approach to the treatment of patients with recurrent chronic rhinosinusitis with nasal polyps based on cytokine-induced Th2 inflammation (interleukin-4, interleukin-13)

OBJECTIVE: To investigate the features of cytokine-induced Th2 inflammation (IL-4 and IL-13) in patients with recurrent chronic rhinosinusitis with nasal polyps (CRSwNP) in order to improve therapeutic effectiveness. MATERIAL AND METHODS: =35). Dense mucus was associated with tissue remodeling within the inflammatory focus, an increased risk of intraoperative complications, frequent recurrences, and resistance to standard therapy. Concentrations of IL-4 and IL-13 in lavage fluids were measured using enzyme-linked immunosorbent assay (ELISA). CONCLUSION: Assessment of key Th2-related cytokines (IL-4 and IL-13) demonstrated their pathogenetic relevance in patients with recurrent CRSwNP and dense mucus. Elevated IL-13 levels were associated with more severe clinical manifestations and mucus densification. Dupilumab therapy showed significant clinical efficacy. Thus, dense mucus may be considered a clinical marker of IL-13-driven pathology and a potential criterion for a personalized approach to targeted biologic therapy.