Chronic rhinosinusitis with nasal polyps (CRSwNP) is common and is multifactorial with increased T-helper 2 response and active role of interleukin 5. It can be associated with asthma and control of CRSwNP improves lower airway disease. Due to constant cellular turn out, stem cell and progenitor cells might have a critical role to play. The authors conducted a review of the literature to investigate the role of stem / progenitor cells in nasal polyposis. Authors explained about multiple types of stem cells including embryonic stem cells, adult stem cells (with subtypes such as neural and mesenchymal) and induced multipotent stem cells. They went on to describe the potential role of mesenchymal stem cells (MSC) in chronic obstructive pulmonary disease. Such a role was studied in a placebo controlled trial and showed that MSC administration has no disadvantages and causes no harm. The authors then cited studies showing stemness and progenitor properties of basal cells in nasal epithelium. They went on to describe studies performed on air-liquid interface cultures of human nasal mucosa and polyp epithelial cells showing reduction in a population (ΔNP63+) of nasal basal cells and of human nasal epithelial stem / progenitor cells. Other subtypes of multipotent MSC were found to have potential role in nasal polyps such as those derived from adipose tissue with negative effect on the proportion activated CD4+, CD8+. While those MSC derived from bone marrow inhibited CD4+, CD8+ proliferation. Other studies cited by the authors identified the presence of multiple stem cell markers in epithelium of nasal polyps. The findings of this review are thought-provoking and future research into potential stem cell related treatment of CRSwNP is needed. 

A possible role of stem cells in nasal polyposis.
Klimek L, Koennecke M, Mullol J, et al.
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Hassan Mohammed

North East Deanery, Newcastle, UK.

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