In July, 2016, 1500 nose and sinus physicians and researchers from around the world gathered in Stockholm, Sweden for the bi-annual meeting of the combined European Rhinologic Society (ERS) and the International Society of Infection and Allergy of the Nose. Hot topics presented at the meeting included new insights into factors underlying development of disease, novel approaches to treatment, and patient-focussed initiatives.
New factors identified in development of sinus disease include disorders of the epithelial lining, or ‘skin’ lining the sinus cavities. Researchers presented work showing how tight junctions, which ensure integrity of sinus lining by maintaining cells in close contact with one another, were “leaky” in CRS. This allowed facilitated penetration of allergens deep to the sinus lining into underlying tissues and increased water loss causing drying. In other work, researchers showed how regeneration and repair of these cells following injury was hampered in CRS patients, offering additional suggestions into how disease develops. This exciting new concept was followed up in a plenary session on genetics, where research was presented suggesting that genetic variations in the genes responsible for epithelial structure were potentially unappreciated causes of CRS.
New treatment methods were discussed. A strong focus of interest was the results of a clinical trial of a new a monoclonal antibody, Dupilumab, which improved symptoms and quality of life in patients with nasal polyposis. This was discussed as well in the session on ‘precision’ or personalised medicine, as researchers focus on finding ways of better selecting the ‘right’ drug for a given patient, using blood test or tissue samples, in an attempt to improve on current methods using trial and error.
Finally, it was CRS patients that were the real stars at this meeting! Several groups presented data from long-range surveys of sinus health and ways to assess and optimize response to medication and surgery. Canadian researchers were especially active here as they presented work on the ‘Sinus Action Plan’ , which helps patients better understand and assess their sinus condition and offers practical advice on when to change their medication or consult their physician when faced with a change in symptoms. In addition, our own Canadian Sinusitis Working Group website was featured as an example of patient centered health care initiatives.
In all, this highlights the real progress being made in helping understand sinus disease and in making patients feel better.
Prepared by: Martin Desrosiers, MD, Clinical Professor, Université de Montréal
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