Computational fluid dynamic modeling of the effect of dupilumab in the management of anosmia secondary to chronic rhinosinusitis with nasal polyps (CRSwNP)

摘要

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is among the most common causes of olfactory loss, potentially mediated by inflammatory sensorineural loss and/or by conductive obstruction of airflow to the olfactory receptor sites. Dupilumab is a monoclonal antibody treatment for severe, inadequately controlled CRSwNP, which often results in significant olfactory improvement compared to placebo. Yet the mechanism by which it improves olfaction remains unsettled. Previous studies have implicated the role of interleukin 13 (IL-13) in inducing damage to olfactory epithelium, suggesting a possible sensorineural anti-inflammatory mechanism. Studies have also shown a significant reduction in polyp burden after dupilumab, suggesting there may be a conductive component, although this mechanism has not been quantitatively confirmed.5 The goal of this study is to use computational fluid dynamic modeling (CFD) to examine the potential conductive mechanism of how dupilumab may alleviate olfactory loss in patients with CRSwNP.