{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:52:16Z","timestamp":1782323536264,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic rhinosinusitis (CRS) represents a spectrum of inflammatory endotypes, driven by distinct T helper (Th) immune responses. The high rate of recurrent disease despite appropriate medical and surgical interventions highlights the need for improved characterization beyond the traditional type 2 and non\u2010type 2 phenotypes to better inform personalized treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sinonasal tissue samples were obtained from 105 CRS patients undergoing endoscopic sinus surgery. Histopathologic evaluation classified inflammatory patterns by predominant cell type and severity. Levels of Th1, Th2, and Th17\u2010 and epithelial\u2010derived cytokines were quantified using a multiplex immunoassay targeting 12 markers. Clinical, radiologic, and follow\u2010up data were correlated with inflammatory patterns and cytokine profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Type 2 CRS, identified in 65 patients (62%), was associated with higher levels of IL\u20105, IL\u201013, and TSLP (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0002, &lt;0.0001, and 0.02, respectively), whereas IL\u20108 was elevated in non\u2010type 2 disease (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.022). Recurrence occurred in 22 patients (21%) and was associated with asthma (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), anosmia (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006), prior steroids use (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.044), lymphoplasmacytic inflammatory pattern (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.022), higher IL\u201013 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.045), and IL\u201033 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.031). Recurrence rates did not differ between inflammatory profiles (Th2, Th1\/Th17, and mixed). Asthma remained the only independent predictor of recurrence in multivariable Cox model (HR 2.48, 95% CI 1.003\u20138.042,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.049).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated IL\u201033 levels and lymphoplasmacytic inflammation were associated with postoperative recurrence, underscoring the role of epithelial\u2012immune signaling in persistent mucosal inflammation, whereas comorbid asthma remained the only independent predictor of refractory CRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70210","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:34:15Z","timestamp":1782322455000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inflammatory Signatures Beyond Th1\/Th2 Endotypes Provide Insights Into Postoperative Recurrence in Chronic Rhinosinusitis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2745-2088","authenticated-orcid":false,"given":"Liyona","family":"Kampel","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"},{"name":"Head and Neck Cancer Research Laboratory Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0628-1942","authenticated-orcid":false,"given":"Narin N.","family":"Carmel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"},{"name":"Head and Neck Cancer Research Laboratory Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun","family":"Edalati","sequence":"additional","affiliation":[{"name":"Head and Neck Cancer Research Laboratory Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2433-0798","authenticated-orcid":false,"given":"Hen","family":"Chaushu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Forsan","family":"Jahshan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaniv","family":"Hadi","sequence":"additional","affiliation":[{"name":"Pathology and Cancer Research Institute Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timur","family":"Pestrikov","sequence":"additional","affiliation":[{"name":"Pathology and Cancer Research Institute Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonor Leider","family":"Trejo","sequence":"additional","affiliation":[{"name":"Pathology and Cancer Research Institute Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidal","family":"Muhanna","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"},{"name":"Head and Neck Cancer Research Laboratory 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