الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 66 |  |  |
| | | from | 66 | | |
Abstract
Chronic rhinosinusitis with nasal polyposis (CRSwNP) comprises heterogeneous clinical pictures and can be categorized into two types: eosinophilic type and non-eosinophilic one. Eosinophilic type can be well-controlled by corticosteroid therapy, whereas non-eosinophilic type is responsive to both endoscopic sinus surgery and macrolide therapy. The allergy role in the pathogenesis of CRSwNP is still debatable. T-cell-mediated immune reaction may play a significant role in eosinophilic CRSwNP. The count of eosinophils has been positively correlated with the count of mast cells and the remaining inflammatory cells as a whole.
Both host and environmental Factors have been accused for the etiology and pathogenesis of CRSwNP which is a mucosal inflammation that might be activated by exogenous agent that is able to integrate and proliferate within mucosal epithelium after being inhaled through the nose. Human papillomavirus (HPV) was strongly accused in the development of inverted papilloma, but it has not been searched adequately as the culprit for the development of CRSwNP.
Human papillomavirus (HPV) is known to be a double-stranded DNA virus that can infect epithelial cells, integrate into cell’s genome. In its integrated status, the virus can make changes in cell functions that facilitate the replication of the viral elements and the cell proliferation or transformation. The infected cells begin to produce viral elements which produce low and