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Overall, multiple endotypes of CRSsNP together describe a mixed inflammatory condition with helper T type 1, 2, and 17 components, although CRSsNP is proportionally more neutrophilic and less eosinophilic than CRSwNP ( In vitro data and mouse studies suggest that NE proteolytic activity triggers an inflammatory process that induces goblet cell metaplasia, which results in overexpression of mucins that contribute to the symptomatology of CRS ( 3.2 Antineutrophil cytoplasmic autoantibodies associated vasculitis Antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitides (AAV) are a group of autoimmune systemic small vessel diseases (132, 133) or myeloperoxidase (MPO) (134), which are both autoantigens exclusively expressed by neutrophils and monocytes