Figure 3.

Expression of the S100 family of genes, which participate in epithelial repair and defense, is decreased in chronic rhinosinusitis (CRS). This suggests that CRS is associated with diminished innate defenses and a diminished capacity for epithelial repair after damage (i.e., viral injury). SPINK5, a secreted polyvalent antiprotease, is reduced in CRS with nasal polyps (CRSwNP) patients. SPINK5 protects epithelia from the attack of endogenous and exogenous proteases suggesting that CRSwNP may be associated with a more fragile mechanical barrier. (Illustration by William E. Walsh, MD, CMI, 2008 William Walsh; used with permission.)