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Die Klassifizierung nach immunologischen Endotypen findet immer mehr Eingang in die Krankheitsdefinition, vor allem bei der chronischen Rhinosinusitis mit Nasenpolypen (CRSwNP). Je nach den spezifischen Mechanismen f\u00fcr die chronische Gewebeentz\u00fcndung werden verschiedene Endotypen charakterisiert. Hierbei spielen genetische und epigenetische Ver\u00e4nderungen im mukosalen Immunsystem eine wichtige Rolle. Die Identifizierung von Endotypen kann dazu beitragen, die Heterogenit\u00e4t innerhalb der Erkrankung zu verstehen und personalisierte Behandlungsans\u00e4tze zu entwickeln. Im Teil\u00a01 dieser Publikation hatten wir die immunologischen Klassifizierungen der Hypersensitivit\u00e4tsreaktionen vom Typ\u00a0IV (T1-, T2-, und T3-Endotypen), in Teil\u00a02 die Hypersensitivit\u00e4tsreaktionen vom Typ\u00a0V (epitheliale Barrieresch\u00e4digungen) dargestellt.<\/jats:p>\n                    <jats:p>Ziel des nun vorliegenden Teils\u00a03 dieser \u00dcbersichtsarbeit ist es, die Hypersensitivit\u00e4ts-Immunreaktionen vom Typ\u00a0VI darzustellen und ihre Implikationen f\u00fcr eine erweiterte Diagnostik und Therapie aufzuzeigen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodik<\/jats:title>\n                    <jats:p>Die Europ\u00e4ische Akademie f\u00fcr Allergie und klinische Immunologie (EAACI) hat in einem k\u00fcrzlich erschienenen Positionspapier eine Aktualisierung der Nomenklatur f\u00fcr immunologische \u00dcberempfindlichkeitsreaktionen auf der Basis von neun verschiedenen immunologischen Reaktionstypen vorgestellt. Die urspr\u00fcnglich von Coombs und Gell klassifizierten Antik\u00f6rper-vermittelten Reaktionen vom Typ\u00a0I, Typ\u00a0II und Typ\u00a0III wurden erweitert und detailliert beschrieben. Direkte zellul\u00e4re und entz\u00fcndliche Reaktionen auf chemische Substanzen werden als Typ\u00a0VI dieser Hypersensitivit\u00e4tsreaktionen definiert und nun in Teil\u00a03 dieser Publikationsreihe er\u00f6rtert.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>Bei der CRSwNP mit Hypersensitivit\u00e4ts-Immunreaktionen vom Typ\u00a0VI findet sich ein Ungleichgewicht zwischen den Cyclooxygenase-Isoformen\u00a01 und\u00a02, das sich durch COX-1-hemmende Medikamente verschlechtert und zu einer verminderten PGE2-Synthese und einer \u00dcberproduktion von LTC4 und PGD2 f\u00fchrt. Nachfolgend werden im Rahmen der chronischen Schleimhautentz\u00fcndung Alarmine wie Interleukin-33 (IL-33) und thymisches stromales Lymphopoietin (TSLP) freigesetzt. Diese Zytokine aktivieren Th2-Lymphozyten und Innate Lymphoid Cells Typ 2 (ILC2) zur Freisetzung von Zytokinen wie IL\u20114, IL\u20115 und IL-13.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Die Erweiterung der immunologischen Klassifikation auf Hypersensitivit\u00e4tsreaktionen vom Typ\u00a0VI liefert einen wichtigen Beitrag zum besseren Verst\u00e4ndnis der Pathophysiologie der chronischen Rhinosinusitis mit Nasenpolypen (CRSwNP). Die Identifikation dieser spezifischen Reaktionsmuster \u2013\u00a0insbesondere der durch chemische Substanzen induzierten Entz\u00fcndungsprozesse\u00a0\u2013 verdeutlicht die Komplexit\u00e4t der zugrunde liegenden Immunmechanismen und unterstreicht die Notwendigkeit einer endotypenbasierten Diagnostik. Die Einbindung dieser Erkenntnisse in die klinische Praxis erm\u00f6glicht eine gezieltere, individualisierte Therapie und stellt einen weiteren Schritt in Richtung personalisierter Medizin bei CRS dar.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00106-026-01732-6","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T12:17:54Z","timestamp":1770121074000},"page":"678-690","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Verschiedene immunologische Typen der CRSwNP im Kontext der neuen Europ\u00e4ischen EAACI-Nomenklatur","Different immunological types of CRSwNP in the context of the new European EAACI nomenclature"],"prefix":"10.1007","volume":"74","author":[{"given":"L.","family":"Klimek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Haxel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Cuevas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Huber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Chaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Pfaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Laudien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Beutner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Hagemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"F\u00f6rster-Ruhrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Olze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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LK ist Herausgeber des Allergo Journal und des Allergo Journal International und er ist der derzeitige Pr\u00e4sident des AeDA (\u00c4rzteverbandes Deutscher Allergologen) und Chair der ENT Section im ROC der EAACI. B.\u00a0Haxel erhielt Studiengelder und\/oder Honorare und\/oder Reisekostenunterst\u00fctzung von ALK-Abell\u00f3, Berlin Chemie, Stallergenes Greer, Celltrion Healthcare Deutschland GmbH, Bencard Allergie GmbH\/Allergy Therapeutics, Niox GmbH, Laboratorios LETI\/LETI Pharma, GlaxoSmithKline, Novartis, Sanofi-Aventis and Sanofi-Genzyme und AstraZeneca. M.\u00a0Cuevas erhielt Honorare von ALK-Abell\u00f3, Allergopharma, AstraZeneca, Bencard Allergie\/Allergy Therapeutics, Celltrion Healthcare Deutschland GmbH, GlaxoSmithKline, HAL Allergie, Leti Pharma, Novartis, Roxall, Sanofi-Aventis, Stallergenes au\u00dferhalb der eingereichten Arbeit und Mitgliedschaften bei folgenden Organisationen: AeDA, DGHNO. O.\u00a0Pfaar gibt Studiengelder und\/oder Honorare und\/oder Reisekostenunterst\u00fctzung von ALK-Abell\u00f3, Allergopharma, Stallergenes Greer, HAL Allergy Holding B.V.\/HAL Allergie GmbH, Bencard Allergie GmbH\/Allergy Therapeutics, Laboratorios LETI\/LETI Pharma, GlaxoSmithKline, ROXALL Medizin, Novartis, Sanofi-Aventis and Sanofi-Genzyme, Med Update Europe GmbH, streamedup! GmbH, Pohl-Boskamp, John Wiley and Sons\/AS, Paul-Martini-Stiftung (PMS), Regeneron Pharmaceuticals Inc., RG \u00c4rztefortbildung, Institut f\u00fcr Disease Management, Springer GmbH, AstraZeneca, IQVIA Commercial, Inmunotek S.L., Ingress Health, Wort & Bild Verlag, Verlag ME, Procter & Gamble, ALTAMIRA, Meinhardt Congress GmbH, Deutsche Forschungsgemeinschaft, Thieme, Deutsche AllergieLiga e.\u202fV., AeDA, Alfried-Krupp Krankenhaus, Red Maple Trials Inc., K\u00f6niglich D\u00e4nisches Generalkonsulat, Medizinische Hochschule Hannover, ECM Expro&Conference Management, Technical University Dresden, Lilly, Japanese Society of Allergy, Forum f\u00fcr Medizinische Fortbildung, Dustri-Verlag, Pneumolive, ASIT Biotech, LOFARMA, Almirall, Paul-Ehrlich-Institut an, alle au\u00dferhalb der vorliegenden \u00dcbersichtsarbeit; und er ist Vizepr\u00e4sident\/Vice President der European Academy of Allergy and Clinical Immunology (EAACI) und Mitglied des Vorstands\/ExCom der EAACI, Mitglied des erweiterten Vorstandes der Deutschen Gesellschaft f\u00fcr Allergologie und Klinische Immunologie (DGAKI); Koordinator, Haupt- oder Koautor von verschiedenen Leitlinien und Positionspapieren in der Rhinologie und Allergologie; und er ist Associate Editor der Zeitschriften Allergy und Clinical Translational Allergy (CTA). M.\u00a0Laudien erhielt Unterst\u00fctzung, Vortrags- und Beraterhonorare, Zusammenarbeit in den letzten 5\u00a0Jahren von\/mit Olympus Deutschland GmbH, Olympus Europa SE & CO. KG, CSL Behring, Novartis Pharma GmbH, Sanofi-Aventis Deutschland GmbH, Brainlab Sales GmbH, GlaxoSmithKline GmbH & Co. KG, John Grube Foundation, AEDA, Meinhardt Congress GmbH, AstraZeneca, Celltrion, Stryker, MMMI, Karl Storz, Bess Medizintechnik, Medtronic, Fiagon AG Medical Technologies. C.\u00a0Beutner war Referentin\/Beraterin f\u00fcr ALK-Abello, GlaxoSmithKline, Novartis, Sanofi-Genzyme und AstraZeneca. H.\u00a0Olze erhielt Studiengelder und\/oder Vortragshonorare von AstraZeneca GmbH, Glaxo Smith Kline GmbH & Co. KG, Mylan Germany GmbH, Novartis Pharma GmbH, Sanofi-Aventis Deutschland GmbH und Eli Lilly and Company und\/oder war beratend f\u00fcr die oben genannten pharmazeutischen Unternehmen t\u00e4tig. B.P.\u00a0Ernst erhielt Honorare von GSK und Sanofi, au\u00dferhalb der eingereichten Arbeit. A.S.\u00a0Hoffmann erhielt Honorare f\u00fcr Beratert\u00e4tigkeiten\/Vortr\u00e4ge von Sanofi-Genzyme, GSK, AstraZeneca, AEDA, Novartis Pharma GmbH, Medtronic, au\u00dferhalb der eingereichten Arbeit. M.\u00a0Gr\u00f6ger erhielt Studiengelder und\/oder Honorare und\/oder Reisekostenunterst\u00fctzung von ALK-Abell\u00f3 Arzneimittel GmbH, Allergopharma GmbH & Co. KG, AstraZeneca GmbH, Bencard Allergie GmbH, Glaxo Smith Kline GmbH & Co. KG, HAL Allergie GmbH, LETI Pharma GmbH, Mylan Germany GmbH, Novartis Pharma GmbH, Phadia\u00a0\u2013 Thermo Fisher Scientific Inc., Sanofi-Aventis Deutschland GmbH, Shire Deutschland GmbH, und Stallergenes GmbH. S.\u00a0Becker, P.\u00a0Huber, A.\u00a0Chaker, J.\u00a0Hagemann, U.\u00a0F\u00f6rster-Ruhrmann, A.\u00a0Beule, C.\u00a0Rudack und C.\u00a0Betz geben an, dass kein Interessenkonflikt besteht.","order":1,"name":"Ethics","label":"Interessenkonflikt","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autor\/-innen keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}}]}}