Nasal Polyposis: More than a Chronic Inflammatory Disorder—A Disease of Mechanical Dysfunction—The São Paulo Position

Author:

Pezato Rogerio1ORCID,Voegels Richard Louis2,Pignatari Shirley1,Gregório Luiz Carlos1,Pinto Bezerra Thiago Freire3,Gregorio Luciano1,Balsalobre Leonardo1,Tepedino Miguel Soares4,Coronel Nathália1,Pinna Fabio de Rezende2,Mendes Neto José1,Oliveira Pedro1,Macoto Eduardo1,Stefanini Renato1,Figueiredo Claudia1,Haddad Fernanda1,Pilan Renata2,Bezerra Soter Ana2,Melo Nelson Almeida2,Candido Danilo Almeida5,Amaral Jonatas do1,Santos Rodrigo de Paula1,Van Zele Thibaut6,Fujita Reginaldo1,Dreyfuss Juliana L.7,Chamon Wallace89,Alencar Adriano Mesquita10,Perez-Novo Claudina11,Stamm Aldo Cassol1

Affiliation:

1. Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil

2. Department of Otolaryngology, USP, São Paulo, SP, Brazil

3. Department of Otolaryngology, UFPE, Recife, PE, Brazil

4. Department of Otolaryngology, UERJ, Rio de Janeiro, RJ, Brazil

5. Department of Medicine, Nephrology Division, Unifesp, São Paulo, SP, Brazil

6. Ear, Nose and Throat Department,, University of Ghent, Ghent, Belgium

7. Department of Biochemistry, Unifesp, São Paulo, SP, Brazil

8. Department of Ophthalmology and Visual Sciences, Unifesp, São Paulo, SP, Brazil

9. Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States

10. Laboratory of Microrheology and Molecular Physiology, Institute of Physics, USP, São Paulo, SP, Brazil

11. Proteinscience, Proteomics and Epigenetic Signaling, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium

Abstract

Introduction The importance of our study lies in the fact that we have demonstrated the occurrence of mechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP.

Publisher

Georg Thieme Verlag KG

Subject

Otorhinolaryngology

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