1
|
Zhang C, Zhang H, Tang Q, Zhang J, Wang S, Xie Z, Jiang W. Allergic Rhinitis as an Independent Risk Factor for Postoperative Recurrence of Children Chronic Sinusitis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1207. [PMID: 37508704 PMCID: PMC10378190 DOI: 10.3390/children10071207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/28/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: The recurrence rate of childhood recurrent sinusitis varies widely between 12% and 50%, with the postoperative recurrence risk factors remaining largely unidentified. We sought to enhance the understanding of chronic rhinosinusitis (CRS) via a retrospective observational childhood cohort. (2) Methods: The study recruited 125 cases. Demographic data and univariate and multivariate logistic regression analyses were conducted to investigate potential risk factors of childhood recurrent sinusitis following functional endoscopic sinus surgery (FESS). (3) Results: A postoperative recurrence rate of 21.6% was determined. Among the participants, 21 cases presented a history of allergic rhinitis (AR), with the remaining 104 cases being AR-free. A significantly heightened recurrence rate was noted in those bearing a history of AR compared to their counterparts devoid of such history (p < 0.000). The fully adjusted logistic regression model indicated a 21.04-fold increased risk of postoperative recurrence in childhood CRS bearing a history of AR compared to those without an AR history (p = 0.000), highlighting the history of AR as an independent risk factor for postoperative childhood recurrent sinusitis (p = 0.001); (4) Conclusions: The data implicate AR as an independent risk factor for postoperative childhood recurrent sinusitis.
Collapse
Affiliation(s)
- Caixia Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, China
- Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
- Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hua Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, China
- Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
- Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
| | - Qingping Tang
- Department of Rehabilitation, Brain Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha 410008, China
| | - Junyi Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, China
- Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
- Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
| | - Shuo Wang
- Department of Pediatric, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhihai Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, China
- Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
- Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
| | - Weihong Jiang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, China
- Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
- Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
| |
Collapse
|
2
|
Zhao Y, Chen J, Hao Y, Wang B, Wang Y, Liu Q, Zhao J, Li Y, Wang P, Wang X, Zhang P, Zhang L. Predicting the recurrence of chronic rhinosinusitis with nasal polyps using nasal microbiota. Allergy 2022; 77:540-549. [PMID: 34735742 DOI: 10.1111/all.15168] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent studies have revealed that the nasal microbiota in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) is profoundly altered and is correlated with systemic inflammation. However, little is known regarding whether the microbiota can be utilized to predict nasal polyp recurrence. This study is aimed to determine whether altered nasal microbiota constituents could be used as biomarkers to predict CRSwNP recurrence. METHODS Nasal microbiota constituents were quantified and characterized using bacterial 16S ribosomal RNA gene sequencing. Selected features for least absolute shrinkage and selection operator regression-based predictors were the nasal microbiota community composition and CRSwNP patient clinical characteristics. The primary outcome was recurrence, which was determined post-admission. RESULTS By distinguishing recurrence-associated nasal microbiota taxa and exploiting the distinct nasal microbiota abundance between patients with recurrent and non-recurrent CRSwNP, we developed a predictive classifier for the diagnosis of nasal polyps' recurrence with 91.4% accuracy. CONCLUSIONS Key taxonomical features of the nasal microbiome could predict recurrence in CRSwNP patients. The nasal microbiome is an understudied source of clinical variation in CRSwNP and represents a novel therapeutic target for future prevention and treatment.
Collapse
Affiliation(s)
- Yan Zhao
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
- Beijing Key Laboratory of Nasal Diseases and Beijing Laboratory of Allergic Diseases Beijing Institute of Otolaryngology Beijing China
| | - Junru Chen
- Reproductive and Genetic Hospital of CITIC‐Xiangya Changsha China
| | - Yun Hao
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
| | - Boqian Wang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
| | - Yue Wang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
| | - Qinghua Liu
- Department of Otorhinolaryngology Head and Neck Surgery Fujian Provincial Hospital Fuzhou China
| | - Jinming Zhao
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
| | - Ying Li
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
- Beijing Key Laboratory of Nasal Diseases and Beijing Laboratory of Allergic Diseases Beijing Institute of Otolaryngology Beijing China
| | - Ping Wang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
- Beijing Key Laboratory of Nasal Diseases and Beijing Laboratory of Allergic Diseases Beijing Institute of Otolaryngology Beijing China
| | - Xiangdong Wang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
- Beijing Key Laboratory of Nasal Diseases and Beijing Laboratory of Allergic Diseases Beijing Institute of Otolaryngology Beijing China
| | - Peng Zhang
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical University Beijing China
- Beijing Key Laboratory of Nasal Diseases and Beijing Laboratory of Allergic Diseases Beijing Institute of Otolaryngology Beijing China
- Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| |
Collapse
|
3
|
Kinoshita I, Jin D, Higashino M, Terada T, Kurisu Y, Takai S, Kawata R. Increase in Chymase-Positive Mast Cells in Recurrent Pleomorphic Adenoma and Carcinoma Ex Pleomorphic Adenoma of the Parotid Gland. Int J Mol Sci 2021; 22:ijms222312613. [PMID: 34884420 PMCID: PMC8657626 DOI: 10.3390/ijms222312613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Incomplete excision of pleomorphic adenoma (PA) may result in recurrent pleomorphic adenoma (RPA). Furthermore, long-term neglected PA may become carcinoma ex pleomorphic adenoma (CXPA). In the present study, the relationships between mast cell-derived chymase and these tumors were examined. The tumor tissues of PA consisted of either or both glandular and fibrotic structures. Histological features of RPA were almost similar to those of PA, except that they showed multinodular structures. CXPA is composed of a mixture of PA and carcinoma. The main stromal cells in PA were myofibroblasts, whereas fibroblasts constituted the main cellular portion in the stromal tissue of RPA. Cancer-associated fibroblasts (CAFs) were present abundantly in CXPA. With increased VEGF expression, neovascularization tended to increase in RPA or CXPA. Compared with PA, chymase-positive mast cells, as well as chymase gene expression, were increased in the tumor tissues from patients with RPA or CXPA. SCF, TGFβ1, and PCNA-positive staining was widely observed in these tumor tissues. The above results suggest that mast cell-derived chymase through its direct or cooperative effects with other mediators may participate in the pathophysiology of RPA and CXPA.
Collapse
Affiliation(s)
- Ichita Kinoshita
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan; (I.K.); (M.H.); (T.T.); (R.K.)
| | - Denan Jin
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan;
- Correspondence: ; Tel.: +81-72-683-1221
| | - Masaaki Higashino
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan; (I.K.); (M.H.); (T.T.); (R.K.)
| | - Tetsuya Terada
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan; (I.K.); (M.H.); (T.T.); (R.K.)
| | - Yoshitaka Kurisu
- Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan;
| | - Shinji Takai
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan;
| | - Ryo Kawata
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan; (I.K.); (M.H.); (T.T.); (R.K.)
| |
Collapse
|
4
|
Tan H, Chen Z, Chen F, Xu W, Liu X. CKAP4 participates in tryptase-induced phenotypic conversion in atrial fibroblasts through PAR2/p38/JNK pathway. Am J Transl Res 2021; 13:2270-2282. [PMID: 34017388 PMCID: PMC8129387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
Our previous study found that tryptase activated atrial fibroblasts, increased collagen synthesis in atrial fibroblasts through protease activated receptor-2 (PAR2) receptors. Recent studies showed that cytoskeleton-associated protein 4 (CKAP4) played an important role in ventricular fibroblast activation. The present study aimed to investigate the role of CKAP4 in tryptase-induced atrial fibroblast activation, atrial fibrosis, and molecular regulatory mechanisms. We cultured atrial fibroblasts in vitro, gave cells tryptase stimulation, then overexpressed or silenced PAR2 and CKAP4 genes in the cells. Their effects on atrial fibroblast proliferation, migration, extracellular matrix remodeling (Collagen I and fibronectin) and downstream key molecules (TGF-β1, c-jun and c-fos, JNK, p38) were investigated. The results showed that the expression of CKAP4 was significantly increased by tryptase and further increased by pcDNA3.1-PAR2, but decreased by FALLRY-NH2 and PAR2 siRNA. CKAP4 overexpression significantly increased the cell proliferation, migration and levels of Collagen I and fibronectin, matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinases-1 (TIMP-1) levels in atrial fibroblasts, while CKAP4 siRNA significantly reduced them. CKAP4 overexpression significantly increased the expression of TGF-β1, c-jun and c-fos, and activated the JNK/p38 pathway, which were suppressed by CKAP4 siRNA. In conclusion, CKAP4 is involved in tryptase-induced phenotypic conversion in atrial fibroblasts through PAR2/p38/JNK pathway, which may provide novel targets in the prevention of atrial fibrosis.
Collapse
Affiliation(s)
- Hongwei Tan
- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Zhisong Chen
- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Fei Chen
- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Wenjun Xu
- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Xuebo Liu
- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| |
Collapse
|
5
|
史 亚, 季 冉, 张 桂, 王 巍, 林 鹏. [The influence of contoured sinus endoscopy on the recurrence of nasal polyps]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:155-159. [PMID: 33540999 PMCID: PMC10127875 DOI: 10.13201/j.issn.2096-7993.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Indexed: 11/12/2022]
Abstract
Objective:The aim of this stusy is to study the effect of endoscopic surgery quality on the recurrence of nasal polyps. Methods:A total of 32 patients(64 sides) with recurrent nasal polyps were collected from December 2016 to June 2018, all of which were bilateral type Ⅱ diffuse nasal polyps in stage 3. According to the post-operative pathological results, patients were divided into eosinophilic nasal polyps group(EOS) and non-eosinophilic nasal polyps group(NEOS). All patients underwent sinus CT scan and three-dimensional reconstruction, combined with the sinus CT image performance and intraoperative findings, the quality of the patients' previous endoscopic sinus surgery was analyzed, and the CT L-M scores of sinuses before and after reoperation were compared between the two groups. Endoscopic L-K score, nasal symptoms VAS score, quality of life Snot-20 score. Results:Among 32 patients with recurrent nasal polyps, 17 cases (53.1%) of EOS nasal polyps were confirmed pathologically after surgery, and 15 cases (46.9%) of NEOS nasal polyps were confirmed. After the previous operation, the patient still has 60 sides(93.8%) of ethmoidal cells or ethmoidal septum, 56 sides(87.5%) of bone hyperplasia, 50 sides(78.1%) of bones in frontal recess air-cell or bone air-cell, and nasal cavity adhesion there were 10 sides(15.6%), residual uncinate process 8(12.5%), improper treatment of maxillary sinus ostia or atresia were 6(9.4%), sphenoid sinus not open or atresia were 8(12.5%), nasal septal deviation untreated were 4 cases(12.5%), 1 case(3.1%) had recurrence without ethmoidal cells and residual bone interval. Patients both in the EOS group or the NEOS group were followed up with L-M score, L-K score, VAS score, and Snot-20 score after surgery, the result were significantly improved compared with the preoperative results. After follow-up of 1.5-3 years, 25 cases of polyps were completely controlled and 7 cases were partially controlled. Among them, 2 cases of EOS nasal polyps and asthma patients still had some polypoid changes in local mucosa one year after operation and was currently under medication control. Conclusion:Although the recurrence of nasal polyps is closely related to its intrinsic type, the technique of endoscopic surgery is also an important factor affecting the recurrence of nasal polyps. For patients with bilateral symmetric diffuse nasal polyps, high-quality sinus surgery of first time combined with standardized follow-up can reduce the recurrence rate of nasal polyps and prolong the relapse time.
Collapse
Affiliation(s)
- 亚男 史
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市耳鼻喉科学临床重点学科(天津,300192)Department of Otolaryngology Head and Neck Surgery, the First Center Hospital, Institute of Otolaryngology of Tianjin, Key Clinical Discipline of Otolaryngology, Tianjin, 300192, China
| | - 冉 季
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市耳鼻喉科学临床重点学科(天津,300192)Department of Otolaryngology Head and Neck Surgery, the First Center Hospital, Institute of Otolaryngology of Tianjin, Key Clinical Discipline of Otolaryngology, Tianjin, 300192, China
| | - 桂敏 张
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市耳鼻喉科学临床重点学科(天津,300192)Department of Otolaryngology Head and Neck Surgery, the First Center Hospital, Institute of Otolaryngology of Tianjin, Key Clinical Discipline of Otolaryngology, Tianjin, 300192, China
| | - 巍 王
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市耳鼻喉科学临床重点学科(天津,300192)Department of Otolaryngology Head and Neck Surgery, the First Center Hospital, Institute of Otolaryngology of Tianjin, Key Clinical Discipline of Otolaryngology, Tianjin, 300192, China
| | - 鹏 林
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市耳鼻喉科学临床重点学科(天津,300192)Department of Otolaryngology Head and Neck Surgery, the First Center Hospital, Institute of Otolaryngology of Tianjin, Key Clinical Discipline of Otolaryngology, Tianjin, 300192, China
| |
Collapse
|
6
|
Teranishi Y, Jin D, Takano S, Sunami K, Takai S. Decrease in number of mast cells in resected nasal polyps as an indicator for postoperative recurrence of chronic rhinosinusitis. IMMUNITY INFLAMMATION AND DISEASE 2019; 7:191-200. [PMID: 31210032 PMCID: PMC6688085 DOI: 10.1002/iid3.261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 05/21/2019] [Indexed: 11/13/2022]
Abstract
Background In the clinical setting, chronic rhinosinusitis with nasal polyps (CRSwNP) is usually divided into eosinophilic‐CRS (ECRS) and non‐ECRS (NECRS) in Japan. Patients with the former are believed to be at risk for postoperative recurrence of CRS. However, some patients have been missed according to these phenotypic classifications due to the low number of infiltrating eosinophils in polyp tissues. Objective In the present study, we attempted to identify cellular or molecular candidate markers to predict nasal polyp recurrence. Methods Nasal polyps were collected from 32 patients with CRSwNP who had undergone an endoscopic sinus surgery. These patients were divided into ECRS and NECRS groups in accordance with the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scoring system and the number of eosinophils in polyp tissues. Unclassifiable patients were referred to as the unknown group. Results Eosinophil infiltration in resected nasal polyps was most evident in the ECRS group. However, the number of mast cells and tryptase‐positive cells in nasal polyps were significantly lower in ECRS and unknown groups compared with the NECRS group. A significant positive correlation was detected between the JESREC score and number of eosinophils. The numbers of mast cells and tryptase‐positive cells were negatively correlated with the JESREC score in all included samples. Significant positive correlations were detected between the number of transforming growth factor β1‐positive cells and the number of mast cells, tryptase‐positive cells, and chymase‐positive cells mast cells. Conclusions and clinical relevance These findings indicated that the enumeration of mast cells in resected polyps may be another approach to predict postoperative polyp recurrence in CRSwNP patients.
Collapse
Affiliation(s)
- Yuichi Teranishi
- Department of Otolaryngology, Head and Neck Surgery, Osaka City University Graduate School of Medicine, Osaka City University, Osaka-City, Osaka, Japan
| | - Denan Jin
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Sakurako Takano
- Department of Otolaryngology, Head and Neck Surgery, Osaka City University Graduate School of Medicine, Osaka City University, Osaka-City, Osaka, Japan
| | - Kishiko Sunami
- Department of Otolaryngology, Head and Neck Surgery, Osaka City University Graduate School of Medicine, Osaka City University, Osaka-City, Osaka, Japan
| | - Shinji Takai
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| |
Collapse
|