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Arima M, Ito K, Abe T, Oguma T, Asano K, Mukherjee M, Ueki S. Eosinophilic mucus diseases. Allergol Int 2024; 73:362-374. [PMID: 38594175 DOI: 10.1016/j.alit.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 04/11/2024] Open
Abstract
Eosinophilic inflammation is primarily characterized by type 2 immune responses against parasitic organisms. In the contemporary human being especially in developed countries, eosinophilic inflammation is strongly associated with allergic/sterile inflammation, and constitutes an undesired immune reaction. This situation is in stark contrast to neutrophilic inflammation, which is indispensable for the host defense against bacterial infections. Among eosinophilic inflammatory disorders, massive accumulation of eosinophils within mucus is observed in certain cases, and is often linked to the distinctive clinical finding of mucus with high viscosity. Eosinophilic mucus is found in a variety of diseases, including chronic allergic keratoconjunctivitis, chronic rhinosinusitis encompassing allergic fungal sinusitis, eosinophilic otitis media, eosinophilic sialodochitis, allergic bronchopulmonary aspergillosis/mycosis, eosinophilic plastic bronchitis, and eosinophilic asthma. In these pathological conditions, chronic inflammation and tissue remodeling coupled with irreversible organ damage due to persistent adhesion of toxic substances and luminal obstruction may impose a significant burden on the body. Eosinophils aggregate in the hyperconcentrated mucus together with cell-derived crystals, macromolecules, and polymers, thereby affecting the biophysical properties of the mucus. This review focuses on the clinically significant challenges of mucus and discusses the consequences of activated eosinophils on the mucosal surface that impact mucus and persistent inflammation.
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Affiliation(s)
- Misaki Arima
- Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Keisuke Ito
- Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Tomoe Abe
- Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Manali Mukherjee
- Department of Medicine, McMaster University & St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Shigeharu Ueki
- Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
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Yu X, Yuan J, Shi L, Dai S, Yue L, Yan M. Necroptosis in bacterial infections. Front Immunol 2024; 15:1394857. [PMID: 38933265 PMCID: PMC11199740 DOI: 10.3389/fimmu.2024.1394857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Necroptosis, a recently discovered form of cell-programmed death that is distinct from apoptosis, has been confirmed to play a significant role in the pathogenesis of bacterial infections in various animal models. Necroptosis is advantageous to the host, but in some cases, it can be detrimental. To understand the impact of necroptosis on the pathogenesis of bacterial infections, we described the roles and molecular mechanisms of necroptosis caused by different bacterial infections in this review.
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Affiliation(s)
- Xing Yu
- Department of Pathogen Biology and Immunology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, China
| | - Jin Yuan
- Clinical Laboratory, Puer Hospital of Traditional Chinese Medicine, Puer, China
| | - Linxi Shi
- Department of Pathogen Biology and Immunology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, China
| | - Shuying Dai
- Department of Pathogen Biology and Immunology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, China
| | - Lei Yue
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Min Yan
- Department of Pathogen Biology and Immunology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, China
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Lu H, Liu H, Wang K, Shi J, Sun Y. Association Between Serum Amyloid A Expression and Disease Control after Endoscopic Sinus Surgery in Patients With Chronic Rhinosinusitis With Nasal Polyps. EAR, NOSE & THROAT JOURNAL 2024; 103:NP331-NP339. [PMID: 34814741 DOI: 10.1177/01455613211051311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Our previous study revealed that serum amyloid A (SAA) levels in polyp tissues could serve as a biomarker for the prediction of corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). However, their association with disease control status in the patients after endoscopic sinus surgery remains to be assessed. METHODS Polyp tissues and control uncinate process mucosa were collected from 48 patients with CRSwNP and 10 healthy control subjects. SAA expression was examined using immunohistochemistry and enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curves were performed to determine the predictive value of SAA in nasal polyps. The clinical characteristics of 2 CRSwNP subtypes (SAAhigh and SAAlow) were evaluated. RESULTS The SAA expression levels in polyp tissues were significantly elevated both in non-eosinophilic and eosinophilic CRSwNP as compared to the healthy controls. In patients with CRSwNP, the tissue SAA level was significantly higher in the disease-controlled patients than those of the partly controlled and uncontrolled. ROC curve analysis revealed that a cut-off value of 114.9 ng/mL for the tissue SAA level predicted the patients with disease-controlled status with 93.33% sensitivity and 63.64% specificity (AUC = .8727, P < .001). Furthermore, The SAAhigh subgroup showed higher tissue eosinophil numbers and percentage of the disease-controlled patients compared to the SAAlow subgroup. CONCLUSIONS Our findings suggest that measurements of SAA in polyp tissues may provide useful information for evaluating CRSwNP conditions, especially identifying the CRSwNP patients with disease-controlled status after endoscopic sinus surgery.
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Affiliation(s)
- Hangui Lu
- Department of Otolaryngology, Shantou Central Hospital, Shantou, China
| | - Haiyan Liu
- Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Kanghua Wang
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianbo Shi
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yueqi Sun
- Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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Lin YT, Tsai MH, Su YY, Huang SC. Comparison of cytokine expression and disease severity between plasma cell-dominant and eosinophil-dominant patients in chronic rhinosinusitis with nasal polyps. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:34. [PMID: 38773574 PMCID: PMC11110371 DOI: 10.1186/s13223-024-00896-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/29/2024] [Indexed: 05/24/2024]
Abstract
PURPOSE Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease characterized by inflammation of the nasal and sinus mucosa. The inflammatory patterns may differ among patients, leading to different subtypes based on the dominant inflammatory cell type. This study aimed to compare the differences in cytokine expression and disease severity between plasma cell-dominant and eosinophil-dominant subtypes in patients with CRSwNP. METHODS This study included 53 CRSwNP patients and 19 control subjects who did not have asthma or a history of cigarette smoking. The expression of cytokines and inflammatory cells was assessed via enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry, respectively. RESULTS Among the cytokines analyzed, only IL-6 was significantly different between the two subtypes. A greater proportion of mast cells and IgE cells was present in plasma cell-dominant CRSwNP patients than in eosinophil-dominant group. For the three disease severity scores (LMK-CT, TPS and SNOT-22), objective scores (LMK-CT and TPS) were greater in the eosinophil-dominant CRSwNP group, while the opposite result was shown for the subjective score (SNOT-22). Additionally, the percentage of plasma cell-dominant cells was significantly positively correlated with disease severity according to the TPS and SNOT-22 scores. CONCLUSIONS Our data revealed that plasma cell-dominant inflammation, a subtype of type 2 CRS, was significantly correlated with subjective disease severity. The study also highlights the role of IL-6, IgE and mast cells as distinguishing factors between eosinophil-dominant and plasma cell-dominant CRSwNP. This information could be useful for clinical diagnosis and personalized treatment.
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Affiliation(s)
- Yu-Tsai Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
- Department of Otolaryngology, Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Song District, Kaohsiung, 833, Taiwan.
| | - Ming-Hsien Tsai
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Yan-Ye Su
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Shun-Chen Huang
- Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung, Taiwan.
- Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, 123 Ta-Pei Road, Niao-Song District, Kaohsiung, 833, Taiwan.
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Toppila-Salmi S, Bjermer L, Cardell LO, Cervin A, Heinikari T, Lehtimäki L, Lundberg M, Richter JC, Sillanpää S. Multi-Disciplinary Expert Perspective on the Management of Type 2 Inflammation-Driven Severe CRSwNP: A Brief Overview of Pathophysiology and Recent Clinical Insights. J Asthma Allergy 2024; 17:431-439. [PMID: 38745838 PMCID: PMC11093112 DOI: 10.2147/jaa.s447093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/01/2024] [Indexed: 05/16/2024] Open
Abstract
Severe chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disabling airway disease that significantly impacts patients' lives through the severity of symptoms, the need for long-term medical treatment and the high risk of recurrence post-surgery. Biological agents targeting type 2 immune responses underlying the pathogenesis of CRSwNP have shown effectiveness in reducing polyp size and eosinophilic infiltrate, and in decreasing the need for additional sinus surgeries. However, despite recent progress in understanding and treating the disease, type 2 inflammation-driven severe CRSwNP continues to pose challenges to clinical management due to several factors such as persistent inflammation, polyp recurrence, heterogeneity of disease, and comorbidities. This article presents the findings of a scientific discussion involving a panel of ear, nose and throat (ENT) specialists and pulmonologists across Sweden and Finland. The discussion aimed to explore current management practices for type 2 inflammation-driven severe CRSwNP in the Nordic region. The main topics examined encompassed screening and referral, measurements of disease control, treatment goals, and future perspectives. The experts emphasized the importance of a collaborative approach in the management of this challenging patient population. The discussion also revealed a need to broaden treatment options for patients with type 2 inflammation-driven CRSwNP and comorbid conditions with shared type 2 pathophysiology. In light of the supporting evidence, a shift in the disease model from the presence of polyps to that of type 2 inflammation may be warranted. Overall, this discussion provides valuable insights for the scientific community and can potentially guide the future management of CRSwNP.
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Affiliation(s)
- Sanna Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leif Bjermer
- Department of Clinical Sciences, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Lars-Olaf Cardell
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Cervin
- Centre for Clinical Research, University of Queensland, Brisbane, Australia
- Faculty of Medicine, Lund University, Lund, Sweden
| | - Tuuli Heinikari
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Lauri Lehtimäki
- Allergy Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Marie Lundberg
- Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jens C Richter
- Department of Asthma and Allergology, Clinic of Lung Medicine, Skåne University Hospital and Lund University, Lund, Sweden
| | - Saara Sillanpää
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere, Finland
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Zhang M, Peng X, Liang X, Wang W, Yang Y, Xu F, Lu X, Geng D, Li M. MicroRNA-145-5p Regulates the Epithelial-Mesenchymal Transition in Nasal Polyps by Targeting Smad3. Clin Exp Otorhinolaryngol 2024; 17:122-136. [PMID: 38360523 DOI: 10.21053/ceo.2023.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/15/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES The annual prevalence of chronic rhinosinusitis (CRS) is increasing, and the lack of effective treatments imposes a substantial burden on both patients and society. The formation of nasal polyps in patients with CRS is closely related to tissue remodeling, which is largely driven by the epithelial-mesenchymal transition (EMT). MicroRNA (miRNA) plays a pivotal role in the pathogenesis of numerous diseases through the miRNA-mRNA regulatory network; however, the specific mechanism of the miRNAs involved in the formation of nasal polyps remains unclear. METHODS The expression of EMT markers and Smad3 were detected using western blots, quantitative real-time polymerase chain reaction, and immunohistochemical and immunofluorescence staining. Differentially expressed genes in nasal polyps and normal tissues were screened through the Gene Expression Omnibus database. To predict the target genes of miR-145-5p, three different miRNA target prediction databases were used. The migratory ability of cells was evaluated using cell migration assay and wound healing assays. RESULTS miR-145-5p was associated with the EMT process and was significantly downregulated in nasal polyp tissues. In vitro experiments revealed that the downregulation of miR-145-5p promoted EMT. Conversely, increasing miR-145-5p levels reversed the EMT induced by transforming growth factor-β1. Bioinformatics analysis suggested that miR-145-5p targets Smad3. Subsequent experiments confirmed that miR-145-5p inhibits Smad3 expression. CONCLUSION Overall, miR-145-5p is a promising target to inhibit nasal polyp formation, and the findings of this study provide a theoretical basis for nanoparticle-mediated miR-145-5p delivery for the treatment of nasal polyps.
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Affiliation(s)
- Mengyu Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaole Peng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaolong Liang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wentao Wang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuqing Yang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fan Xu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaomin Lu
- Department of Oncology, Affiliated Haian Hospital of Nantong University, Nantong, China
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Manyi Li
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Sato R, Kumai T, Yuasa R, Wakisaka R, Komatsuda H, Yamaki H, Ishida Y, Wada T, Takahara M. Common Characteristics of Sinonasal Inflammation Associated with IgG4-Related Disease and Other Chronic Inflammatory Diseases: A Retrospective Observational Study. ORL J Otorhinolaryngol Relat Spec 2024; 86:95-100. [PMID: 38663371 DOI: 10.1159/000538365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/26/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disease characterized by elevated serum IgG4, tissue infiltration of IgG4-positive cells, and fibrosis. Although a number of IgG4-RD patients show sinonasal involvement, there is little known about sinonasal inflammation associated with IgG4-RD. This study aimed to describe the clinicopathological features of sinonasal inflammation associated with IgG4-RD and to compare with other inflammatory diseases, such as eosinophilic chronic rhinosinusitis (ECRS) and granulomatosis with polyangiitis (GPA). METHODS A retrospective analysis of clinicopathological features of patients with sinonasal lesions and high serum IgG4 was performed. Patient data were reviewed to determine whether they fulfilled the diagnostic criteria for other inflammatory diseases. RESULTS Six of 7 patients were diagnosed with IgG4-RD, while 1 patient was diagnosed with GPA. In the 6 patients with IgG4-RD, intranasal findings showed nasal polyps in 3 patients (50%) and nasal crusting in the 3 patients (50%). Computed tomography showed ethmoid sinus involvement in 5 patients (83%). Five of the 6 patients (83%) were diagnosed with IgG4-RD based on nasal biopsy, whereas 1 patient (17%) was diagnosed based on lacrimal gland biopsy. Four patients fulfilled the Japanese epidemiological survey of refractory ECRS (JESREC) criteria. However, none of the patients showed eosinophil infiltration. Although the patient with GPA showed high levels of serum IgG4 and tissue infiltration of IgG4-positive cells in the nasal biopsy, the patient showed common clinical features of GPA. CONCLUSION Patients with sinonasal inflammation associated with IgG4-RD had similar clinical characteristics with ECRS and GPA. Histopathological findings of the nasal biopsy from clinically diagnosed GPA was consistent with that of IgG4-RD. Sinonasal inflammation associated with IgG4-RD should be diagnosed based not only on tissue infiltration of IgG4-positive cells but in conjunction with clinical findings such as local nasal characteristics, involvement of other organs, and serum antineutrophil cytoplasmic antibody levels. IgG4-RD should be ruled out in patients with eosinophilia without histopathological eosinophil infiltration.
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Affiliation(s)
- Ryosuke Sato
- Department of Otolaryngology, Head and Neck Surgery, Kitami Red Cross Hospital, Kitami, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Takumi Kumai
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
- Department of Innovative Head and Neck Cancer Research and Treatment, Asahikawa Medical University, Asahikawa, Japan
| | - Ryota Yuasa
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Risa Wakisaka
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Hiroki Komatsuda
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Hidekiyo Yamaki
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Yoshiya Ishida
- Department of Otolaryngology, Head and Neck Surgery, Kitami Red Cross Hospital, Kitami, Japan
| | - Tetsuji Wada
- Department of Otolaryngology, Head and Neck Surgery, Kitami Red Cross Hospital, Kitami, Japan
| | - Miki Takahara
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
- Department of Innovative Head and Neck Cancer Research and Treatment, Asahikawa Medical University, Asahikawa, Japan
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Kawakita K, Kouzaki H, Murao T, Kubo Y, Nishiguchi T, Nakamura K, Arai H, Matsumoto K, Tojima I, Shimizu S, Shimizu T. Role of basal cells in nasal polyp epithelium in the pathophysiology of eosinophilic chronic rhinosinusitis (eCRS). Allergol Int 2024:S1323-8930(24)00045-5. [PMID: 38670810 DOI: 10.1016/j.alit.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/10/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Basal cell hyperplasia is commonly observed in nasal polyp epithelium of eosinophilic chronic rhinosinusitis (eCRS). We examined the function and mechanisms of basal cell hyperplasia in the pathophysiology of eCRS. METHODS We found that normal human bronchial epithelial (NHBE) cells obtained basal cell characteristics when cultured with PneumaCult™-Ex Plus Medium. Most of the cells passaged three times expressed basal cell surface markers CD49f and CD271 by flow cytometry, and basal cell nuclear marker p63 by immunohistochemical staining. We named these NHBE cells with basal cell characteristics cultured Basal-like cells (cBC), and NHBE cells cultured with BEGM™ cultured Epithelial cells (cEC). The characteristics of cBC and cEC were examined and compared by RNA sequencing, RT-PCR, ELISA, and cell proliferation studies. RESULTS RNA sequencing revealed that cBC showed higher gene expression of thymic stromal lymphopoietin (TSLP), IL-8, TLR3, and TLR4, and lower expression of PAR-2 compared with cEC. The mRNA expression of TSLP, IL-8, TLR3, and TLR4 was significantly increased in cBC, and that of PAR-2 was significantly increased in cEC by RT-PCR. Poly(I:C)-induced TSLP production and LPS-induced IL-8 production were significantly increased in cBC. IL-4 and IL-13 stimulated the proliferation of cBC. Finally, the frequency of p63-positive basal cells was increased in nasal polyp epithelium of eCRS, and Ki67-positive proliferating cells were increased in p63-positive basal cells. CONCLUSIONS Type 2 cytokines IL-4 and IL-13 induce basal cell hyperplasia, and basal cells exacerbate type 2 inflammation by producing TSLP in nasal polyp of eCRS.
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Affiliation(s)
- Kento Kawakita
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Hideaki Kouzaki
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan.
| | - Takuya Murao
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Yoshihito Kubo
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Tatsuji Nishiguchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Keigo Nakamura
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Hiroyuki Arai
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Koji Matsumoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Ichiro Tojima
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Shino Shimizu
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Takeshi Shimizu
- Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan
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Suzaki I, Maruyama Y, Kamimura S, Hirano K, Nunomura S, Izuhara K, Kobayashi H. Residual nasal polyp tissue following dupilumab therapy is associated with periostin-associated fibrosis. Eur Arch Otorhinolaryngol 2024; 281:1807-1817. [PMID: 37979011 DOI: 10.1007/s00405-023-08336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Dupilumab, an anti-interleukin-4 receptor alpha monoclonal antibody, is a new treatment for severe uncontrolled chronic rhinosinusitis with nasal polyps. However, data on the effect of dupilumab on histological changes in nasal polyp tissue are lacking. We aimed to investigate the effect of dupilumab on real-life clinical conditions and nasal polyp tissues from patients with eosinophilic chronic rhinosinusitis (ECRS), which is a refractory subtype. METHODS We conducted an open-label, prospective, observational, single-centre study on 63 patients with refractory ECRS on the basis of the criteria of the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis Study. These patients had a history of surgery and received dupilumab for 24 weeks. Patient-reported sinonasal symptoms, T&T olfactometry and nasal polyp scores were prospectively evaluated. In 23 patients with residual nasal polyps following dupilumab treatment, changes in systemic and local periostin expression, and total collagen deposition in nasal polyp tissues were investigated before and after dupilumab administration. RESULTS Dupilumab rapidly improved sinonasal symptoms and reduced the nasal polyp score 24 weeks after initiation. 40 (63.5%) patients had resolution of nasal polyps, but the reduction was limited in the remaining 23 (36.5%) patients. Periostin expression in serum and nasal lavage fluid was decreased, whereas periostin and the total collagen deposition area in subepithelial tissues in residual nasal polyps were enhanced after dupilumab administration. CONCLUSION Dupilumab improves sinonasal symptoms and reduces the nasal polyp score in refractory ECRS. Periostin-associated tissue fibrosis may be involved in the differential effect of dupilumab on nasal polyp reduction.
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Affiliation(s)
- Isao Suzaki
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-Ku, Tokyo, 142-8666, Japan.
| | - Yuki Maruyama
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-Ku, Tokyo, 142-8666, Japan
| | - Sawa Kamimura
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-Ku, Tokyo, 142-8666, Japan
| | - Kojiro Hirano
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-Ku, Tokyo, 142-8666, Japan
| | - Satoshi Nunomura
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Hitome Kobayashi
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-Ku, Tokyo, 142-8666, Japan
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Okano M, Kanai K, Oka A. Pathogenesis-based application of biologics for chronic rhinosinusitis: Current and future perspectives. Auris Nasus Larynx 2024; 51:371-378. [PMID: 37743131 DOI: 10.1016/j.anl.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023]
Abstract
Chronic rhinosinusitis (CRS) is heterogeneous and contains diverse pathogenesis including type 1, type 2, and/or type 3 inflammation. For severe type 2 CRS especially CRS with nasal polyps (CRSwNP), biologics that target inflammatory molecules have recently been applied along with further changes in the treatment algorithm for CRS. Currently, a completed phase 3 clinical trial for biologics for severe CRSwNP with inadequate response to surgery and/or intranasal corticosteroids, including omalizumab (anti-IgE), mepolizumab (anti-IL-5), benralizumab (anti-IL-5Rα), and dupilumab (anti-IL-4Rα), have all shown efficacy. Similar phase 3 clinical trials for tezepelumab (anti-TSLP) and etokimab (anti-IL-33) are now underway and completed, respectively. Further studies need to evaluate how to optimally and cost-effectively use biologics for CRS and determine if any biomarkers are indicative of which biologics should be administered. A definition of complete and/or clinical remission of CRS is also needed to determine when to reduce or discontinue biologics. In addition, more precise basic research on CRS, such as endotyping and genotyping, will need to be undertaken in order to determine novel targets for biologics.
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Affiliation(s)
- Mitsuhiro Okano
- Department of Otorhinolaryngology, International University School of Medicine, Narita, Japan.
| | - Kengo Kanai
- Department of Otorhinolaryngology, International University School of Medicine, Narita, Japan
| | - Aiko Oka
- Department of Otorhinolaryngology, International University School of Medicine, Narita, Japan
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Li S, Zhang Z, Wang L, Yan X, Jiang Y, Yu L. Diagnostic significance of peripheral blood indices for eosinophilic chronic rhinosinusitis in Chinese adults. Eur Arch Otorhinolaryngol 2024; 281:1337-1345. [PMID: 37938374 DOI: 10.1007/s00405-023-08324-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVE Eosinophilic chronic rhinosinusitis (eCRS) is a refractory subtype of CRS. This study aimed to compare the differences in clinical features and peripheral blood indices between eCRS and non-eCRS Chinese patients and identify the predictive factors for eCRS. METHODS In this study, a total of 1352 patients with CRS were enrolled and divided into eCRS and non-eCRS groups based on the degree of eosinophilic infiltration in histopathology, and their demographic and clinical characteristics, as well as peripheral blood indices, were compared. Logistic regression analysis was used to identify the factors associated with eCRS, and the optimal cut-off values of predictors were determined using subject working curves. RESULTS As compared to those in the non-eCRS group patients, the proportion of males, age, proportion of smokers, peripheral blood eosinophil count, and erythrocyte count were significantly higher, while the peripheral blood neutrophil count, platelet count, neutrophil/lymphocyte count ratio (NLR), platelet/lymphocyte count ratio (PLR), and neutrophil × platelet/lymphocyte count ratio (SII index) were significantly lower in the eCRS group patients. Logistic regression analysis showed that age, peripheral blood neutrophil count, eosinophil count, and platelet count were independent predictors of eCRS, and eosinophil count > 2.05 × 108/L could be used as a diagnostic marker for eCRS with a sensitivity and specificity of 87.1% and 78.3%, respectively. CONCLUSIONS There were significant differences in the clinical features of eCRS and non-eCRS patients. Peripheral blood eosinophil count could early and more accurately predict eCRS.
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Affiliation(s)
- Shunke Li
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Laoshan District, Qingdao, 266003, China
| | - Zengxiao Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Laoshan District, Qingdao, 266003, China
| | - Lin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Laoshan District, Qingdao, 266003, China
| | - Xudong Yan
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Laoshan District, Qingdao, 266003, China
| | - Yan Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Laoshan District, Qingdao, 266003, China.
| | - Longgang Yu
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Laoshan District, Qingdao, 266003, China.
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12
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Bai J, Tan BK, Kato A. Endotypic heterogeneity and pathogenesis in chronic rhinosinusitis. Curr Opin Allergy Clin Immunol 2024; 24:1-8. [PMID: 37966157 PMCID: PMC10873077 DOI: 10.1097/aci.0000000000000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
PURPOSE OF REVIEW This review aims to provide updates in realms of endotypic heterogeneity, pathogenesis at the molecular level, potential of biomarkers, and cutting-edge scope of biologics in CRS. RECENT FINDINGS High-dimensional analyses, such as transcriptomes, and machine learning, have significantly enhanced CRS endotyping, uncovering diverse pathogenetic mechanisms contributing to its heterogeneity. The dynamic process of epithelial remodeling in CRS pathogenesis has gained more clarity and support as exemplified by IL-13 and oncostatin M (OSM) that are shown intricately linked to epithelial barrier dysfunction. Moreover, anti-dsDNA autoantibody, BAFF, periostin, and cystatin SN show promise as potentials biomarkers, offering diagnostic and prognostic value for CRS. SUMMARY The identification of inflammatory molecules involved in endotype specific signaling pathways provides insights into the underlying mechanisms and verifiable biomarkers for diagnosis and prediction of disease severity. More comprehensive clinical studies should be conducted to facilitate biologics from bench to bedside in treating CRS.
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Affiliation(s)
- Junqin Bai
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Bruce K. Tan
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Atsushi Kato
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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13
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Saito T, Okazaki K, Fushimi K, Tsuzuki K. Usefulness of post-operative endoscopic score for optimal treatment selection in recurrent eosinophilic chronic rhinosinusitis. J Laryngol Otol 2024; 138:162-168. [PMID: 37222127 DOI: 10.1017/s0022215123000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This study retrospectively analysed post-operative endoscopic scores to determine the optimal post-operative treatment in patients with eosinophilic chronic rhinosinusitis undergoing functional endoscopic sinus surgery. METHODS In total, 339 adults who underwent initial bilateral functional endoscopic sinus surgery for eosinophilic chronic rhinosinusitis were enrolled. Patients were divided into group A, which required no additional post-operative treatment; group B, which required local/systemic steroids post-operatively; and group C, which further required dupilumab and/or revision surgery. RESULTS Sixty-five per cent of patients could be treated with initial functional endoscopic sinus surgery (group A). Post-operative steroids were required in 35 per cent of patients with a post-operative endoscopic score of 30 per cent (group B). Further advanced treatments with dupilumab and/or revision functional endoscopic sinus surgery were required in 10 per cent of patients with a post-operative endoscopic score of 65 per cent (group C). CONCLUSION The post functional endoscopic sinus surgery endoscopic score can be used as an index to determine treatment at the time of eosinophilic chronic rhinosinusitis recurrence.
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Affiliation(s)
- Takahiro Saito
- Department of Otorhinolaryngology - Head and Neck Surgery, Hyogo Medical University, Nishinomiya, Japan
| | - Ken Okazaki
- Department of Otorhinolaryngology - Head and Neck Surgery, Hyogo Medical University, Nishinomiya, Japan
| | - Katsuya Fushimi
- Department of Otorhinolaryngology - Head and Neck Surgery, Hyogo Medical University, Nishinomiya, Japan
| | - Kenzo Tsuzuki
- Department of Otorhinolaryngology - Head and Neck Surgery, Hyogo Medical University, Nishinomiya, Japan
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14
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Akiyama K, Samukawa Y, Hoshikawa H. Assessment of eosinophilic rhinosinusitis cases that required secondary treatment (biologics or reoperation) during long-term postoperative courses. Auris Nasus Larynx 2024; 51:167-173. [PMID: 37635037 DOI: 10.1016/j.anl.2023.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Endoscopic sinus surgery (ESS) is selected as the primary treatment for eosinophilic chronic rhinosinusitis (ECRS). Biologics or reoperation are sometimes required as secondary treatment after ESS. The present study examined the long-term postoperative courses of ECRS cases treated according to the current treatment concept, the frequency of secondary treatment, and its predictive factors. METHODS Ninety-four patients with ECRS who underwent ESS and received continuous management for 1-5 years were retrospectively investigated. Patient characteristics, long-term changes in endoscopic scores and the results of olfactory function tests, and secondary treatment were evaluated. RESULTS Five patients underwent reoperation and 11 received dupilumab during the follow-up period (35.9±19.2 months). Sixteen patients (17%) required secondary treatment due to the deterioration of sinus conditions. These patients were significantly younger, had higher comorbidity rates of allergic rhinitis and bronchial asthma, and a higher preoperative CT score than those who did not require secondary treatment. Three months after surgery, CT scores, endoscopic scores (E-scores), and the self-administered odor questionnaire (SAOQ) were significantly worse in patients who required secondary treatment. A multivariate regression analysis identified age, preoperative CT scores, and 3-month E-scores as predictive factors for secondary treatment. Three-month E-scores showed higher sensitivity and specificity, and the odds ratio was 11.3 when the cut-off value was set at 10. CONCLUSION The early identification of patients for whom ESS may fail is important and additional treatments need to be provided at the appropriate timing where needed. Patients with the following factors need to be carefully followed up: a young age, high preoperative CT score, and high early postoperative E-score.
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Affiliation(s)
- Kosuke Akiyama
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kita-gun, Miki-cho, Ikenobe 1750-1, Kagawa 761-0793, Japan.
| | - Yasushi Samukawa
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kita-gun, Miki-cho, Ikenobe 1750-1, Kagawa 761-0793, Japan
| | - Hiroshi Hoshikawa
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kita-gun, Miki-cho, Ikenobe 1750-1, Kagawa 761-0793, Japan
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15
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Liu Y, Wu X, Song P, Liu L, Zhong X, He Q, Zhang Z. Increased S. aureus colonization and reduced antimicrobial peptide expression in erythrodermic psoriasis. Int Immunopharmacol 2024; 127:111343. [PMID: 38096593 DOI: 10.1016/j.intimp.2023.111343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Erythrodermic psoriasis (EP) is a severe and rare condition characterized by prominent erythema and scaling over 75 % of the body surface area. Unlike psoriasis vulgaris (PV), EP carries high risk of systemic involvement, including superficial skin infections and sepsis, particularly those caused by Staphylococcus aureus. OBJECTIVE To explore the microecological characteristics of EP and detect the levels of antimicrobial peptides (AMPs) in both skin and serum of EP patients. METHODS In this study, skin microbiomes of 10 EP patients were analyzed through 16S rRNA gene sequencing. The expressions of AMPs, Interleukin-4/13 (IL-4/13), Interleukin-17 (IL-17) and Interferon-γ (IFN-γ) in skin were detected via immunohistochemical staining and serum levels of AMP were evaluated by ELISA. We also enrolled 10 AD and 10 PV patients as controls. RESULTS EP patients retained rich microbial diversity, dominated by S. aureus. The AMPs of hBD2, LL-37, and RNase7 in EP keratinocytes were significantly lower than those in PV, but higher than those in AD. The expression levels of IL-4, IL-13 and IFN-γ in lesions are similar between EP and AD, but quite different from PV. What's more, the serum AMP levels in EP were similar to those in PV while significantly lower than in AD. CONCLUSION We found EP patients have a rich microbial diversity dominated by S. aureus in lesions, while lower serum and skin AMPs expressions, which may account for the increased incidence of S. aureus cutaneous infections and sepsis in EP patients.
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Affiliation(s)
- Yuhua Liu
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Guangdong Province, PR China
| | - Xiaoyan Wu
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Guangdong Province, PR China
| | - Pengfei Song
- Department of Dermatology, The Eighth Affiliated Hospital of Sun Yat-sen University, Guangdong Province, PR China
| | - Leying Liu
- Department of Dermatology, The Eighth Affiliated Hospital of Sun Yat-sen University, Guangdong Province, PR China
| | - Xinyu Zhong
- Department of Dermatology, The Eighth Affiliated Hospital of Sun Yat-sen University, Guangdong Province, PR China
| | - Qin He
- Department of Dermatology, The Eighth Affiliated Hospital of Sun Yat-sen University, Guangdong Province, PR China
| | - Zhenying Zhang
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Guangdong Province, PR China; Department of Dermatology, The Eighth Affiliated Hospital of Sun Yat-sen University, Guangdong Province, PR China.
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Kim J, Kwak S, Lee J, Park IH, Lee SH, Shin JM, Kim TH. Eosinophilic Chronic Rhinosinusitis and Pathogenic Role of Protease. Int J Mol Sci 2023; 24:17372. [PMID: 38139201 PMCID: PMC10744023 DOI: 10.3390/ijms242417372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/01/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is an inflammation of the nasal and paranasal sinus mucosa, and eosinophilic CRS (eCRS) is a subtype characterized by significant eosinophil infiltration and immune response by T-helper-2 cells. The pathogenesis of eCRS is heterogeneous and involves various environmental and host factors. Proteases from external sources, such as mites, fungi, and bacteria, have been implicated in inducing type 2 inflammatory reactions. The balance between these proteases and endogenous protease inhibitors (EPIs) is considered important, and their imbalance can potentially lead to type 2 inflammatory reactions, such as eCRS. In this review, we discuss various mechanisms by which exogenous proteases influence eCRS and highlight the emerging role of endogenous protease inhibitors in eCRS pathogenesis.
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Affiliation(s)
- Jaehyeong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (J.K.); (S.K.); (J.L.); (I.-H.P.); (S.H.L.); (J.M.S.)
- Mucosal Immunology Institute, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Sooun Kwak
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (J.K.); (S.K.); (J.L.); (I.-H.P.); (S.H.L.); (J.M.S.)
| | - Juhyun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (J.K.); (S.K.); (J.L.); (I.-H.P.); (S.H.L.); (J.M.S.)
| | - Il-Ho Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (J.K.); (S.K.); (J.L.); (I.-H.P.); (S.H.L.); (J.M.S.)
| | - Seung Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (J.K.); (S.K.); (J.L.); (I.-H.P.); (S.H.L.); (J.M.S.)
| | - Jae Min Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (J.K.); (S.K.); (J.L.); (I.-H.P.); (S.H.L.); (J.M.S.)
- Mucosal Immunology Institute, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Tae Hoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (J.K.); (S.K.); (J.L.); (I.-H.P.); (S.H.L.); (J.M.S.)
- Mucosal Immunology Institute, College of Medicine, Korea University, Seoul 02841, Republic of Korea
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Ishikawa C, Takeno S, Okamoto Y, Kawasumi T, Kakimoto T, Takemoto K, Nishida M, Ishino T, Hamamoto T, Ueda T, Tanaka A. Oncostatin M's Involvement in the Pathogenesis of Chronic Rhinosinusitis: Focus on Type 1 and 2 Inflammation. Biomedicines 2023; 11:3224. [PMID: 38137445 PMCID: PMC10740885 DOI: 10.3390/biomedicines11123224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVES The cytokine oncostatin M (OSM) elicits pathogenic effects involving disruption of the epithelial barrier function as a part of immunological response networks. It is unclear how these integrated cytokine signals influence inflammation and other physiological processes in the pathology of chronic rhinosinusitis (CRS). We investigated the expression and distribution of OSM and OSM receptor (OSMR) in CRS patients' sinonasal specimens, and we compared the results with a panel of inflammatory cytokine levels and clinical features. PATIENTS AND METHODS We classified CRS patients as eosinophilic (ECRS, n = 36) or non-eosinophilic (non-ECRS, n = 35) based on the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis phenotypic criteria and compared their cases with those of 20 control subjects. We also examined OSM's stimulatory effects on cytokine receptor expression levels using the human bronchial epithelium cell line BEAS-2B. RESULTS RT-PCR showed that the OSM mRNA levels were significantly increased in the CRS patients' ethmoid sinus mucosa. The OSM mRNA levels were positively correlated with those of TNF-α, IL-1β, IL-13, and OSMR-β. In BEAS-2B cells, OSM treatment induced significant increases in the OSMRβ, IL-1R1, and IL-13Ra mRNA levels. CONCLUSIONS OSM is involved in the pathogenesis of CRS in both type 1 and type 2 inflammation, suggesting the OSM signaling pathway as a potential therapeutic target for modulating epithelial stromal interactions.
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Affiliation(s)
- Chie Ishikawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Sachio Takeno
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Yukako Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Tomohiro Kawasumi
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Takashi Kakimoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Kota Takemoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Manabu Nishida
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Takashi Ishino
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Takao Hamamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Tsutomu Ueda
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (C.I.); (Y.O.); (T.K.); (T.K.); (K.T.); (M.N.); (T.I.); (T.H.); (T.U.)
| | - Akio Tanaka
- Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan;
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Kidoguchi M, Imoto Y, Noguchi E, Nakamura T, Morii W, Adachi N, Ii R, Koyama K, Aoki S, Miyashita K, Hosokawa Y, Omura K, Tanaka Y, Tanaka K, Hida Y, Ninomiya T, Kato Y, Sakashita M, Takabayashi T, Fujieda S. Middle meatus microbiome in patients with eosinophilic chronic rhinosinusitis in a Japanese population. J Allergy Clin Immunol 2023; 152:1669-1676.e3. [PMID: 37768238 DOI: 10.1016/j.jaci.2023.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common chronic inflammatory disease and is subdivided into eosinophilic and noneosinophilic forms. There are few reports investigating the nasal microbiome and its pathological functions in patients with CRS. OBJECTIVE We sought to analyze factors contributing to variations of the nasal microbiome in CRS, and on the basis of these factors, to elucidate whether the bacterial metabolites were related to the pathogenesis. METHODS Nasal swabs were collected, and the V3 to V4 variable region of the 16S ribosomal RNA gene was amplified and sequenced. Factors contributing to variations of the nasal microbiome in patients with CRS were compared. The most influential factor was whether CRS was eosinophilic, and we compared α- and β-diversity, bacterial species, and predictive bacterial functions between the 2 patient groups. In addition, the metabolites of the key bacteria were extracted, and we evaluated the predicted bacterial functions in airway epithelial cells. RESULTS In total, 110 patients with CRS and 33 control subjects were enrolled. On the basis of the factors of variation, it was found that patients with eosinophilic CRS (n = 65) had different microbiomes with weighted UniFrac β-diversity and lower α-diversity compared with those with noneosinophilic CRS (n = 45). A higher abundance of Fusobacterium nucleatum and an increased LPS pathway were observed in patients with noneosinophilic CRS compared with those with eosinophilic CRS. In airway epithelial cells, LPS derived from F nucleatum suppressed the expression levels of ALOX15 induced by TH2 cytokines. CONCLUSIONS The differences in the nasal microbiome may play a key role in the pathophysiology of CRS.
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Affiliation(s)
- Masanori Kidoguchi
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui; Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Yoshimasa Imoto
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Emiko Noguchi
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki.
| | - Takako Nakamura
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Wataru Morii
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Naoto Adachi
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui; Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Rieko Ii
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Keisuke Koyama
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Satoshi Aoki
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Keisuke Miyashita
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yu Hosokawa
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kazuhiro Omura
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kaori Tanaka
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Gifu
| | - Yukio Hida
- Division of Clinical Laboratory, University of Fukui Hospital, Fukui
| | - Takahiro Ninomiya
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Yukinori Kato
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Masafumi Sakashita
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Tetsuji Takabayashi
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Shigeharu Fujieda
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
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19
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Kan X, Guan R, Hao J, Zhao C, Sun Y. Integrative analysis of immune-related signature profiles in eosinophilic chronic rhinosinusitis with nasal polyposis. FEBS Open Bio 2023; 13:2273-2289. [PMID: 37867480 PMCID: PMC10699107 DOI: 10.1002/2211-5463.13720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/25/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023] Open
Abstract
Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) is a subtype of chronic rhinosinusitis (CRS) that is associated with the nasal cavity and sinus polyps, elevated levels of eosinophils, and dysregulated immune responses to environmental triggers. The underlying cause of ECRSwNP is not well understood, and few studies have focused on the unique features of this subtype of CRS. Our study integrated proteomic and transcriptomic data with multi-omic bioinformatics analyses. We collected nasal polyps from three ECRSwNP patients and three control patients and identified 360 differentially expressed (DE) proteins, including 119 upregulated and 241 downregulated proteins. Functional analyses revealed several significant associations with ECRSwNP, including focal adhesion, hypertrophic cardiomyopathy, and extracellular matrix (ECM)-receptor interactions. Additionally, a protein-protein interaction (PPI) network revealed seven hub proteins that may play crucial roles in the development of ECRSwNP. We also compared the proteomic data with publicly available transcriptomic data and identified a total of 1077 DE genes. Pathways enriched by the DE genes involved angiogenesis, positive regulation of cell motility, and immune responses. Furthermore, we investigated immune cell infiltration and identified biomarkers associated with eosinophil and M2 macrophage infiltration using CIBERSORT and Weighted Gene Correlation Network Analysis (WGCNA). Our results provide a more complete picture of the immune-related mechanisms underlying ECRSwNP, which could contribute to the development of more precise treatment strategies for this condition.
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Affiliation(s)
- Xuan Kan
- Department of Otorhinolaryngology, Head and Neck SurgeryThe Second Affiliated Hospital, Harbin Medical UniversityChina
| | - Ruidi Guan
- Department of Otorhinolaryngology, Head and Neck SurgeryThe Second Affiliated Hospital, Harbin Medical UniversityChina
| | - Jianwei Hao
- Department of Otorhinolaryngology, Head and Neck SurgeryThe Second Affiliated Hospital, Harbin Medical UniversityChina
| | - Chunyuan Zhao
- Department of Otorhinolaryngology, Head and Neck SurgeryThe Second Affiliated Hospital, Harbin Medical UniversityChina
| | - Yanan Sun
- Department of Otorhinolaryngology, Head and Neck SurgeryThe Second Affiliated Hospital, Harbin Medical UniversityChina
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20
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Lin YT, Lin CF, Liao CK, Yeh TH. Comprehensive evaluation of type 2 endotype and clinical features in patients with chronic rhinosinusitis with nasal polyps in Taiwan: a cross-sectional study. Eur Arch Otorhinolaryngol 2023; 280:5379-5389. [PMID: 37439928 DOI: 10.1007/s00405-023-08118-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE Endotype-driven treatment has been introduced in the management of chronic rhinosinusitis with nasal polyps (CRSwNP), and an understanding of the associations between phenotypes and endotypes of CRSwNP will be beneficial in identifying responders. We aimed to determine the correlations between clinical manifestations and type 2 inflammatory mediators of sinonasal tissues. METHODS Adult patients undergoing endoscopic sinus surgery for bilateral CRSwNP were prospectively enrolled. Tissue eosinophilia and type 2 mediator expression in tissue homogenates were assessed and correlated with clinical features, including symptoms, comorbidities, blood eosinophil counts, specific allergen immunoglobulin (IgE) testing, computed tomography (CT) scan findings, and Sino-Nasal Outcome Test-22 scores. RESULTS A total of 93 subjects were recruited in our study. Fifty-nine (63.4%) cases were identified as the eosinophilic endotype, demonstrating with higher rates of comorbidity of asthma, blood eosinophilia and a high ethmoid-maxillary ratio on CT images. To correlate of phenotypes with the inflammatory mediator profile, multivariate analyses revealed the associations of IgE expression in nasal polyp tissues with allergen sensitization (p = 0.042), CT ethmoid-maxillary ratio (p = 0.001) and tissue eosinophil counts (p = 0.022); the association of interleukin (IL-5) expression with the blood eosinophil percentage (p = 0.020); and the association of IL-13 expression with white blood cell count (p = 0.002) and central compartment-type inflammation (p < 0.001). CONCLUSION We demonstrated associations of IgE and IL-5 expression with clinical features of eosinophilic-type inflammation and a significantly elevated level of IL-13 in patients with central-compartment-type CRSwNP. These observations may be useful when considering the use of type 2 biologic treatment and require further validation studies.
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Affiliation(s)
- Yi-Tsen Lin
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Chih-Feng Lin
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Chun-Kang Liao
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
- Department of Otolaryngology, National Taiwan University Yunlin Branch, Yunlin, Taiwan
| | - Te-Huei Yeh
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
- College of Medicine, National Taiwan University, Taipei, Taiwan.
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21
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Xie X, Xuan L, Zhao Y, Wang X, Zhang L. Diverse Endotypes of Chronic Rhinosinusitis and Clinical Implications. Clin Rev Allergy Immunol 2023; 65:420-432. [PMID: 38175322 DOI: 10.1007/s12016-023-08976-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
Chronic rhinosinusitis (CRS) is a highly heterogeneous disease characterized by inflammation in the nasal and sinus mucosa. The CRS phenotypes, based on the presence or absence of nasal polyps, are known as CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). However, this classification has limitations in fully capturing the mechanisms and clinical manifestations of CRS. To address the heterogeneity of CRS, there has been a growing focus on classifying the condition into distinct endotypes. Endotype classification involves grouping patients based on specific molecular, immunological, and clinical characteristics, allowing for more personalized and targeted treatment approaches.This review delves into the current state of endotype classifications for CRS. It explores the role of geographic factors, microbiome, and subphenotype in shaping different endotypes. Additionally, the review examines how various clinical features are associated with specific endotypes, providing valuable insights into tailoring treatment options for better outcomes and transitions between different endotypes.Overall, this review offers a comprehensive and up-to-date perspective on the intricate realm of CRS endotype classifications. By unraveling the molecular and clinical intricacies, this review lays the foundation for more precise, effective, and individualized treatment strategies in the management of CRS.
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Affiliation(s)
- Xiran Xie
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China
| | - Lijia Xuan
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China
- Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China
| | - Yajuan Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China
- Department of Otolaryngology, Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing, 101300, China
| | - Xiangdong Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China.
- Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China.
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China.
- Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China.
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22
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Kobayashi Y, Chu HH, Bui DV, Yun Y, Nguyen LM, Mitani A, Suzuki K, Asako M, Kanda A, Iwai H. The Neutralization of the Eosinophil Peroxidase Antibody Accelerates Eosinophilic Mucin Decomposition. Cells 2023; 12:2746. [PMID: 38067174 PMCID: PMC10706369 DOI: 10.3390/cells12232746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Eosinophilic airway inflammation, complicated by bronchial asthma and eosinophilic chronic rhinosinusitis (ECRS), is difficult to treat. The disease may become refractory when eosinophilic mucin associated with eosinophil peroxidase (EPX) and autoantibodies fills in the paranasal sinus and small airway. This study investigated the functional role of an anti-EPX antibody in eosinophilic mucin of ECRS in eosinophilic airway inflammation. Eosinophilic mucin was obtained from patients with ECRS. The effects of the anti-EPX antibody on dsDNA release from eosinophils and eosinophilic mucin decomposition were evaluated. Immunofluorescence or enzyme-linked immunosorbent assays were performed to detect the anti-EPX antibody and its supernatant and serum levels in eosinophilic mucin, respectively. The serum levels of the anti-EPX antibody were positively correlated with sinus computed tomography score and fractionated exhaled nitrogen oxide. Patients with refractory ECRS had higher serum levels of the anti-EPX antibody than those without. However, dupilumab treatment decreased the serum levels of the anti-EPX antibody. Immunoglobulins (Igs) in the immunoprecipitate of mucin supernatants enhanced dsDNA release from eosinophils, whereas the neutralization of Igs against EPX stopped dsDNA release. Furthermore, EPX antibody neutralization accelerated mucin decomposition and restored corticosteroid sensitivity. Taken together, the anti-EPX antibody may be involved in the formulation of eosinophilic mucin and be used as a clinical marker and therapeutic target for intractable eosinophilic airway inflammation.
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Affiliation(s)
- Yoshiki Kobayashi
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Hanh Hong Chu
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Dan Van Bui
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Yasutaka Yun
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Linh Manh Nguyen
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Akitoshi Mitani
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Kensuke Suzuki
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Mikiya Asako
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Akira Kanda
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Hiroshi Iwai
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
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23
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Oda T, Iwamoto H, Takeno S, Kawasumi T, Takemoto K, Nishida M, Chikuie N, Horibe Y, Yamaguchi K, Sakamoto S, Higaki N, Taruya T, Horimasu Y, Masuda T, Hamamoto T, Nakashima T, Ishino T, Ueda T, Fujitaka K, Hamada H, Hattori N. Exhaled Nitric Oxide and Olfactory Dysfunction in Patients with Asthma: Association with Chronic Rhinosinusitis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1776. [PMID: 37893494 PMCID: PMC10608782 DOI: 10.3390/medicina59101776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023]
Abstract
Objectives: Olfactory dysfunction is a clinical sign that is important to detect with coexistent upper airway comorbidities in patients with asthma. This study aimed to investigate the etiology of olfactory dysfunction in patients with asthma and the relationship between fractional exhaled nitric oxide (FeNO) levels. Materials and Methods: This study included 47 asthma patients who were evaluated for olfactory dysfunction at Hiroshima University Hospital between 2012 and 2020. The etiologies of olfactory dysfunction were evaluated, and they were classified according to the FeNO levels of patients with asthma. Results: Olfactory dysfunction was observed in 30 patients with asthma, with chronic rhinosinusitis (77%) being the most prevalent etiology. Eosinophilic chronic rhinosinusitis (ECRS) was the most prevalent etiology of olfactory dysfunction in asthma patients with high FeNO levels (≥25 ppb), while non-eosinophilic chronic rhinosinusitis (NCRS) was the most prevalent etiology in asthma patients with low FeNO levels (<25 ppb). Additionally, the prevalence of ECRS was significantly higher in asthma patients with olfactory dysfunction and high FeNO levels (74%) than in those with either high FeNO levels or olfactory dysfunction and those with low FeNO levels and no olfactory dysfunction (12% and 9%, respectively). Conclusions: We found that ECRS was the predominant cause of olfactory dysfunction in patients with high FeNO levels, while NCRS was more common in those with low FeNO levels. The present study showed that both ECRS and NCRS are common etiologies of olfactory dysfunction in patients with asthma. Additionally, this study supports the link between upper and lower airway inflammation in patients with asthma complicated with olfactory dysfunction.
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Affiliation(s)
- Takashi Oda
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Hiroshi Iwamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Sachio Takeno
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Tomohiro Kawasumi
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Kota Takemoto
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Manabu Nishida
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Nobuyuki Chikuie
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Yuichiro Horibe
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Kakuhiro Yamaguchi
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Shinjiro Sakamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Naoko Higaki
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Takayuki Taruya
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Yasushi Horimasu
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Takeshi Masuda
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Takao Hamamoto
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Taku Nakashima
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Takashi Ishino
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Tsutomu Ueda
- Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (T.O.); (T.K.); (K.T.); (M.N.); (N.C.); (Y.H.); (T.T.); (T.H.); (T.I.); (T.U.)
| | - Kazunori Fujitaka
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
| | - Hironobu Hamada
- Department of Physical Analysis and Therapeutic Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan;
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (H.I.); (K.Y.); (S.S.); (N.H.); (Y.H.); (T.M.); (T.N.); (K.F.); (N.H.)
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24
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Miyamura K, Mori E, Nakashima D, Miura M, Chiba S, Otori N. Relationship of Lesion Location to Postoperative Steroid Use in Eosinophilic Chronic Rhinosinusitis. Laryngoscope 2023; 133:2511-2516. [PMID: 36692200 DOI: 10.1002/lary.30586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/30/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Eosinophilic chronic rhinosinusitis (ECRS) is known to recur after surgery. The treatment choice for recurrent ECRS, such as oral steroids or biological agents, must be chosen carefully, and identifying the lesion location may be useful. This study aimed to evaluate the postoperative course of ECRS patients and assess the relationship between endoscopic lesion location and postoperative oral steroid use. METHODS Patients with chronic rhinosinusitis who underwent bilateral endoscopic sinus surgery from April 2018 to March 2020 were divided into two groups based on the presence or absence of oral steroid use after surgery. The primary endpoint was the lesion location on endoscopic findings during surgery: middle turbinate, middle meatus, superior turbinate, superior meatus, nasal septum, and sphenoethmoidal recess. Subjective symptoms, blood tests, and computerized tomography (CT) findings (Lund-Mackay score) were evaluated as secondary endpoints. RESULTS Among 264 patients, 88 were diagnosed histologically with ECRS (mean 48.98 ± 1.40 years, 67 males/21 females). Twenty-three patients were steroid-using, 65 were steroid-free, and six stopped attending their appointments. Patients with sphenoethmoidal recess lesions were significantly more likely to require steroids (p = 0.019). There was a significant association between steroid use and younger age (p = 0.041), olfactory dysfunction (p = 0.021), and all sinuses (Frontal sinus: p < 0.001, Anterior ethmoid sinus: p = 0.002, Posterior ethmoid sinus: p = 0.011, Maxillary sinus: p = 0.018, Sphenoid sinus: p = 0.034, Total score: p < 0.001). CONCLUSION A sphenoethmoidal recess lesion was a risk factor for requiring postoperative steroids. Young age, olfactory dysfunction, and preoperative severe CT findings were also significant risk factors. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2511-2516, 2023.
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Affiliation(s)
- K Miyamura
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - D Nakashima
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - M Miura
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - S Chiba
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - N Otori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
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25
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Gong X, Han Z, Fan H, Wu Y, He Y, Fu Y, Zhu T, Li H. The interplay of inflammation and remodeling in the pathogenesis of chronic rhinosinusitis: current understanding and future directions. Front Immunol 2023; 14:1238673. [PMID: 37771597 PMCID: PMC10523020 DOI: 10.3389/fimmu.2023.1238673] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Chronic rhinosinusitis (CRS), a common clinical condition characterized by persistent mucosal inflammation and tissue remodeling, has a complex pathogenesis that is intricately linked to innate and adaptive immunity. A number of studies have demonstrated that a variety of immune cells and cytokines that play a vital role in mediating inflammation in CRS are also involved in remodeling of the nasal mucosa and the cells as well as different cytokines involved in remodeling in CRS are also able to exert some influence on inflammation, even though the exact relationship between inflammation and remodeling in CRS has not yet been fully elucidated. In this review, the potential role of immune cells and cytokines in regulating inflammation and remodeling of CRS mucosa has been described, starting with the immune cells and cytokines that act together in inflammation and remodeling. The goal is to aid researchers in understanding intimate connection between inflammation and remodeling of CRS and to offer novel ideas for future research.
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Affiliation(s)
- Xinru Gong
- Health and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhoutong Han
- Health and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hongli Fan
- Health and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuqi Wu
- Health and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuanqiong He
- Health and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yijie Fu
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Tianmin Zhu
- Health and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hui Li
- School of Preclinical Medicine, Chengdu University, Chengdu, China
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Pantazidou G, Papaioannou I, Skoulakis C, Petinaki E, Hajiioannou J. Vitamin D Levels in Chronic Rhinosinusitis in Patients With or Without Nasal Polyposis: A Systematic Review. Cureus 2023; 15:e46275. [PMID: 37908960 PMCID: PMC10615355 DOI: 10.7759/cureus.46275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 11/02/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a large group of heterogeneous diseases characterized by extensive inflammation of the nasal mucosa and sinuses. Vitamin D (VD), as an immunoregulatory hormone, may play an important role in the pathophysiology of CRS. The purpose of this study is to review the existing literature that correlates VD levels with CRS with or without nasal polyps. A systematic manual search was conducted in the PubMed and Google Scholar databases up to July 2023. Articles from PubMed and the first 100 articles from Google Scholar were recorded for our research. Keywords used were the following: vitamin D, chronic rhinosinusitis, and nasal polyps. Among the 134 articles retrieved, only 18 were eligible. The other 116 studies were excluded as they related VD levels with other conditions (e.g., allergic rhinitis) and for other reasons. However, we identified two more eligible records through the manual research of the above-mentioned 132 studies, and finally, 20 records were included in the current review. The review concerned case-control studies, prospective, retrospective, and cross-sectional studies. Based on our review, we concluded that CRS patients are correlated with the lowest VD levels, accompanied by increased severity of the disease, especially in those with nasal polyposis. Patients can benefit from appropriate VD supplementation, and serum VD levels should be included in the laboratory assessment of CRS. However, due to the heterogeneity of the individuals involved, more well-designed clinical trials as well as randomized clinical trials should be conducted for further validation of the above findings in the general population in the future.
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Affiliation(s)
- Georgia Pantazidou
- Otolaryngology - Head and Neck Surgery, General Hospital of Patras, Patras, GRC
| | | | | | - Efthimia Petinaki
- Biopathology - Clinical Microbiology, University Hospital of Larisa, Larisa, GRC
| | - Jiannis Hajiioannou
- Otolaryngology - Head and Neck Surgery, University Hospital of Larisa, Larisa, GRC
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Smith KA, Gill AS, Pollard CE, Sumsion JS, Saffari H, Ashby S, Witt BL, Shipman PA, Gabrielsen DA, Yim MT, Levy JM, Oakley GM, Orlandi RR, Gleich GJ, Alt JA, Pulsipher A. An eosinophil peroxidase activity assay accurately predicts eosinophilic chronic rhinosinusitis. J Allergy Clin Immunol 2023; 152:400-407. [PMID: 37148919 PMCID: PMC10524284 DOI: 10.1016/j.jaci.2023.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND A definitive diagnosis of eosinophilic chronic rhinosinusitis (eCRS) requires invasive surgical tissue sampling and histologic enumeration of intact eosinophils. Eosinophil peroxidase (EPX) is an accurate biomarker of sinonasal tissue eosinophilia in CRS regardless of polyp status. A less invasive and rapid method that accurately identifies tissue eosinophilia would be of great benefit to patients. OBJECTIVE We sought to evaluate a new clinical tool that uses a nasal swab and colorimetric EPX activity assay to predict a diagnosis of eCRS. METHODS A prospective, observational cohort study was conducted using nasal swabs and sinonasal tissue biopsies obtained from patients with CRS electing endoscopic sinus surgery. Patients were classified as non-eCRS (n = 19) and eCRS (n = 35) on the basis of pathologically determined eosinophil counts of less than 10 or greater than or equal to 10 eosinophils/HPF, respectively. Swab-deposited EPX activity was measured and compared with tissue eosinophil counts, EPX levels, and CRS-specific disease metrics. RESULTS EPX activity was significantly increased in patients with eCRS than in patients without eCRS (P < .0001). With a relative absorbance unit cutoff value of greater than or equal to 0.80, the assay demonstrated high sensitivity (85.7%) and moderate specificity (79.0%) for confirming eCRS. Spearman correlations between EPX activity and tissue eosinophil counts (rs = 0.424), EPX levels (rs = 0.503), and Lund-Kennedy endoscopy scores (rs = 0.440) in eCRS were significant (P < .05). CONCLUSIONS This investigation evaluates a nasal swab sampling method and EPX activity assay that accurately confirms eCRS. This method could potentially address the unmet need to identify sinonasal tissue eosinophilia at the point-of-care, as well as to longitudinally monitor eosinophil activity and treatment response.
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Affiliation(s)
- Kristine A Smith
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Amarbir S Gill
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Chelsea E Pollard
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jorgen S Sumsion
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Hedieh Saffari
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Shaelene Ashby
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Benjamin L Witt
- Cytopathology Section, University of Utah School of Medicine, Salt Lake City, Utah
| | - Paige A Shipman
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - David A Gabrielsen
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Michael T Yim
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah; Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Shreveport, Shreveport, La
| | - Joshua M Levy
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Ga
| | - Gretchen M Oakley
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Richard R Orlandi
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Gerald J Gleich
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jeremiah A Alt
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah; Department of Molecular Pharmaceutics, University of Utah College of Pharmacy, Salt Lake City, Utah; Utah Center for Nanomedicine, University of Utah, Salt Lake City, Utah.
| | - Abigail Pulsipher
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, University of Utah School of Medicine, Salt Lake City, Utah; Department of Molecular Pharmaceutics, University of Utah College of Pharmacy, Salt Lake City, Utah; Utah Center for Nanomedicine, University of Utah, Salt Lake City, Utah.
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Kong W, Wu Q, Zhang H, Zhang Y, Yang Q. Novel insights into central compartment atopic disease - a literature review. Expert Rev Clin Immunol 2023; 19:847-856. [PMID: 36924000 DOI: 10.1080/1744666x.2023.2192480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
INTRODUCTION Central compartment atopic disease (CCAD) is a newly recognized variant subtype of chronic rhinosinusitis (CRS). Although CCAD has been reported to be correlated with allergy, there is still a considerable gap in our knowledge regarding CCAD. AREAS COVERED We have conducted a thorough analysis of the literature on CCAD. This review provides current understanding and therapeutic strategies of CCAD. In this article, we will review the clinical presentations and parameters, allergy-related etiology, endotypes, and recommended management of CCAD. EXPERT OPINION CCAD is considered as an aeroallergen-driven type 2/eosinophilic inflammatory pattern. Although CCAD can be diagnosed by endoscopy and radiology, as well as allergen test, pathogenesis and management strategies leave much to be desired, and further studies are needed.
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Affiliation(s)
- Weifeng Kong
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qingwu Wu
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - He Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yana Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qintai Yang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Izuhara K, Fujieda S, Ohta N. The functional role and the clinical application of periostin in chronic rhinosinusitis. Expert Rev Clin Immunol 2023; 19:857-866. [PMID: 36946365 DOI: 10.1080/1744666x.2023.2192928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/15/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Chronic rhinosinusitis (CRS) comprises several heterogenous groups, now classified based on endotype more often than on phenotype. A number of studies aimed at finding a useful biomarker for type 2 CRS suggest that periostin is a promising surrogate. AREAS COVERED A comprehensive overview of the clinical significance of tissue periostin expression and serum periostin in CRS patients is provided. The effects of comorbid asthma on serum periostin and samples other than serum in which periostin can be detected in CRS patients are also discussed. Moreover, the functional roles of periostin in CRS pathogenesis are summarized. EXPERT OPINION The position of periostin as a signature biomarker of type 2 CRS has been well established, enabling us to classify CRS patients by endotyping. Serum periostin is useful not only for endotyping CRS patients, but also for estimating disease severity, comorbidity, prognosis, and response to treatment, and in particular, predicting recurrence after surgery. However, it remains to be addressed how we apply serum periostin to using biologics for CRS patients. Further studies aimed at showing periostin to be a therapeutic target for CRS are awaited.
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Affiliation(s)
- Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Shigeharu Fujieda
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Nobuo Ohta
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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Zhou A, Shi C, Fan Y, Zheng Y, Wang J, Liu Z, Xie H, Liu J, Jiao Q. Involvement of CD40-CD40L and ICOS-ICOSL in the development of chronic rhinosinusitis by targeting eosinophils. Front Immunol 2023; 14:1171308. [PMID: 37325657 PMCID: PMC10267736 DOI: 10.3389/fimmu.2023.1171308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/20/2023] [Indexed: 06/17/2023] Open
Abstract
Background Chronic rhinosinusitis (CRS), whose prevalence and pathogenesis are age-related, is characterized by nasal tissue eosinophil infiltration. CD40-CD40 ligand (CD40L) pathway involves in the eosinophil-mediated inflammation, and inducible co-stimulator (ICOS)-ICOS ligand (ICOSL) signal can strengthen CD40-CD40L interaction. Whether CD40-CD40L and ICOS-ICOSL have a role in the development of CRS remains unknown. Objectives The aim of this study is to investigate the association of CD40-CD40L and ICOS-ICOSL expression with CRS and underlying mechanisms. Methods Immunohistology detected the expression of CD40, CD40L, ICOS, and ICOSL. Immunofluorescence was performed to evaluate the co-localizations of CD40 or ICOSL with eosinophils. Correlations between CD40-CD40L and ICOS-ICOSL as well as clinical parameters were analyzed. Flow cytometry was used to explore the activation of eosinophils by CD69 expression and the CD40 and ICOSL expression on eosinophils. Results Compared with the non-eCRS subset, ECRS (eosinophilic CRS) subset showed significantly increased CD40, ICOS, and ICOSL expression. The CD40, CD40L, ICOS, and ICOSL expressions were all positively correlated with eosinophil infiltration in nasal tissues. CD40 and ICOSL were mainly expressed on eosinophils. ICOS expression was significantly correlated with the expression of CD40-CD40L, whereas ICOSL expression was correlated with CD40 expression. ICOS-ICOSL expression positively correlated with blood eosinophils count and disease severity. rhCD40L and rhICOS significantly enhanced the activation of eosinophils from patients with ECRS. Tumor necrosis factor-α (TNF-α) and interleukin-5 (IL-5) obviously upregulated CD40 expression on eosinophils, which was significantly inhibited by the p38 mitogen-activated protein kinase (MAPK) inhibitor. Conclusions Increased CD40-CD40L and ICOS-ICOSL expressions in nasal tissues are linked to eosinophils infiltration and disease severity of CRS. CD40-CD40L and ICOS-ICOSL signals enhance eosinophils activation of ECRS. TNF-α and IL-5 regulate eosinophils function by increasing CD40 expression partly via p38 MAPK activation in patients with CRS.
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Affiliation(s)
- Aina Zhou
- Department of Ear, Nose, and Throat, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chenxi Shi
- Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuhui Fan
- Department of Ear, Nose, and Throat, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yushuang Zheng
- Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jue Wang
- Department of Ear, Nose, and Throat, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhichen Liu
- Department of Ear, Nose, and Throat, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huanxia Xie
- Department of Ear, Nose, and Throat, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jisheng Liu
- Department of Ear, Nose, and Throat, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qingqing Jiao
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Suzaki I, Tanaka A, Yanai R, Maruyama Y, Kamimura S, Hirano K, Kobayashi H. Eosinophilic granulomatosis with polyangiitis developed after dupilumab administration in patients with eosinophilic chronic rhinosinusitis and asthma: a case report. BMC Pulm Med 2023; 23:130. [PMID: 37076824 PMCID: PMC10114392 DOI: 10.1186/s12890-023-02415-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Eosinophilic granulomatosis with polyangiitis (EGPA) is a form of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis characterized by eosinophil-rich granulomatous inflammation and small-to-medium vessel vasculitis associated with asthma, rhinosinusitis, and eosinophilia. EGPA is often difficult to distinguish from severe asthma and eosinophilic chronic rhinosinusitis (ECRS) in cases when there are no findings that suggest vasculitis. Dupilumab, an anti-IL-4Rα monoclonal antibody, is expected to be effective in eosinophilic airway inflammatory diseases, such as refractory asthma and chronic rhinosinusitis (CRS). Although transient eosinophilia and eosinophilic pneumoniae have been reported in patients with refractory asthma and CRS associated with dupilumab, few studies have examined the development of EGPA. CASE PRESENTATION We report a case of a 61-year-old woman treated with dupilumab for refractory ECRS and eosinophilic otitis media (EOM) complicated by severe asthma. Although she had a previous history of eosinophilic pneumoniae and myeloperoxidase (MPO) ANCA positivity, there were no apparent findings of vasculitis before the initiation of dupilumab. After the second administration of dupilumab, several adverse events developed, including worsening of ECRS, EOM and asthma, and neuropathy. A blood test showed an eosoinophilia and re-elevation of MPO-ANCA levels after the administration of dupilumab. Therefore, dupilumab was discontinued owing to the development of EGPA, and prednisolone and azathioprine administration was initiated for a remission induction therapy. CONCLUSION To the best of our knowledge, this is the first case report that suggests that dupilumab may directly trigger the manifestation of vasculitis in patients who were previously MPO-ANCA-positive. Although the precise mechanism of how dupilumab could trigger the development of EGPA requires further elucidation, measuring MPO-ANCA in patients with multiple eosinophilic disorders before the initiation of dupilumab might be helpful when considering the possibility of a latent EGPA. When administering dupilumab to patients with a previous history of MPO-ANCA positivity, clinicians must carefully monitor and collaborate with other specialists in the pertinent fields of study for appropriate usage.
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Affiliation(s)
- Isao Suzaki
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan.
| | - Akihiko Tanaka
- Department of Medicine, Division of Respiratory Medicine and Allergology, School of Medicine, Showa University, Tokyo, Japan
| | - Ryo Yanai
- Department of Medicine, Division of Rheumatology, School of Medicine, Showa University, Tokyo, Japan
| | - Yuki Maruyama
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Sawa Kamimura
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kojiro Hirano
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Hitome Kobayashi
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
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Yoshikawa M, Sunaga Y, Koshiba R, Inukai M, Takeuchi M. Real‐world burden and treatment of chronic rhinosinusitis in Japan: A retrospective claims database analysis. Laryngoscope Investig Otolaryngol 2023; 8:346-356. [PMID: 37090876 PMCID: PMC10116956 DOI: 10.1002/lio2.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/24/2023] [Accepted: 02/12/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives Chronic rhinosinusitis (CRS) is a heterogeneous disease, which can be subdivided into CRS with (CRSwNP) or without (CRSsNP) nasal polyps. An intractable form of CRSwNP that is associated with an eosinophil-dominant inflammatory cell infiltration (eosinophilic CRS) has become more prevalent in Japan. There is currently limited information on the burden of CRS in Japan and treatment approaches used in real-world practice. Methods This retrospective, observational, comparative cohort study used information from the Japanese JMDC insurance claims database (study period April 1, 2015, to March 31, 2020). A CRS cohort was identified and matched with a control group without CRS. The primary objective was to clarify disease burden and treatment approaches by comparing comorbidities, healthcare resource utilization (HRU), and drug prescriptions in the CRS and non-CRS groups. Results In total, 23,256 individuals with CRS (1762 with CRSwNP and 21,494 with CRSsNP) were matched with 23,256 controls. The mean age was 45 years and the majority of individuals were male (57%). Individuals with CRS had a higher disease burden than controls, with more frequent comorbidities (particularly, type 2 inflammatory disease [e.g., allergic rhinitis and asthma], and those caused by systemic corticosteroids [SCS]), and higher HRU (including outpatient visits, laboratory examinations and surgical procedures). Further, individuals with CRS were prescribed more medications, both for CRS (including SCS) and non-CRS conditions, than controls. Conclusion In Japan, CRS is associated with a high disease burden, and multiple treatment approaches are used in affected individuals, including long-term SCS, which is generally not recommended. Level of Evidence 3.
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Affiliation(s)
- Mamoru Yoshikawa
- Department of Otorhinolaryngology Toho University Ohashi Medical Center Tokyo Japan
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Cluster analysis of patients with chronic rhinosinusitis and asthma after endoscopic sinus surgery. Ann Allergy Asthma Immunol 2023; 130:325-332.e7. [PMID: 36436785 DOI: 10.1016/j.anai.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patients with chronic rhinosinusitis with nasal polyps and asthma (CRSwAS) are highly heterogenous in severity and prognosis. The clinical phenotypes and inflammatory endotypes of CRSwAS and their association with outcomes of endoscopic sinus surgery (ESS) have not been fully studied yet. OBJECTIVE We aimed to find out the clinical phenotypes of CRSwAS and explore their relationship with ESS outcomes using cluster analysis. METHODS We recruited 103 consecutive adult patients with CRSwAS who had undergone ESS and been followed up for more than 1 year. For cluster analysis, we collected the data from 63 variables pertaining to demographic characteristics, preoperative disease status, surgical techniques, postoperative medical treatment, and outcomes. Eosinophilic CRS was defined as greater than or equal to 10 eosinophils/high-power field, and sinus computed tomography was evaluated by Lund-Mackay sinus computed tomography score (LM score). RESULTS We screened 92 eligible patients and 13 preoperative variables for balanced iterative reducing and clustering using hierarchies cluster analysis. Patients with CRSwAS were divided into 4 clusters with distinct ESS outcomes: (1) cluster 1, characterized by aspirin-exacerbated respiratory disease, eosinophilic CRS, high preoperative LM score, moderate-to-severe asthma, and uncontrolled CRS after ESS; (2) cluster 2, characterized as having female dominance (66.67%), non-aspirin-exacerbated respiratory disease, eosinophilic CRS, high preoperative LM score, moderate-to-severe asthma, and uncontrolled CRS after ESS; (3) cluster 3, characterized as having female dominance (95.83%), noneosinophilic CRS, low preoperative LM score, moderate asthma, and controlled CRS after ESS; and (4) cluster 4, characterized as men-only, smoker, noneosinophilic CRS, low preoperative LM score, mild asthma, and controlled CRS after ESS. CONCLUSION CRSwAS has distinct clusters, each corresponding to unique clinical and inflammatory characteristics and ESS outcomes.
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Wang Y, Lou H, Xian M, Cui J, Piao Y, Wang C, Zhang L, Xian J. Investigation of the Value of T 2 Mapping in the Prediction of Eosinophilic Chronic Rhinosinusitis With Nasal Polyps. J Comput Assist Tomogr 2023; 47:329-336. [PMID: 36723408 PMCID: PMC10045955 DOI: 10.1097/rct.0000000000001411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eosCRSwNP) usually have more extensive sinus disease, severe symptoms, and poorer disease control compared with patients with non-eosCRSwNP. Separating these entities will be crucial for patient management. The purpose of this study is to investigate T 1, T 2 , and apparent diffusion coefficient (ADC) values of the nasal polyps in patients with CRSwNP and evaluate the usefulness of these parameters for differentiating these diseases. METHODS Sinonasal magnetic resonance imaging was performed in 36 patients with eosCRSwNP and 20 patients with non-eosCRSwNP (including T 1 mapping, T 2 mapping, and diffusion-weighted imaging) before surgery. The T 1 , T 2 , and ADC values were calculated and correlated with pathologically assessed inflammatory cells of nasal polyps. RESULTS Significant higher T 2 value, higher eosinophil count, and lower lymphocyte count of the nasal polyps were observed in eosCRSwNP than those in non-eosCRSwNP. There was no significant difference in T 1 or ADC values between the 2 groups. T 2 value was correlated with eosinophil count and lymphocyte count in CRSwNP. The area under the curve of T 2 value for predicting eosCRSwNP was 0.78 with 89.9% sensitivity and 60.0% specificity. CONCLUSION T 2 value is a promising imaging biomarker for predicting eosCRSwNP. It can help to distinguish eosCRSwNP from non-eosCRSwNP.
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Affiliation(s)
| | | | | | - Jing Cui
- From the Departments of Radiology
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Takemoto K, Lomude LS, Takeno S, Kawasumi T, Okamoto Y, Hamamoto T, Ishino T, Ando Y, Ishikawa C, Ueda T. Functional Alteration and Differential Expression of the Bitter Taste Receptor T2R38 in Human Paranasal Sinus in Patients with Chronic Rhinosinusitis. Int J Mol Sci 2023; 24:4499. [PMID: 36901926 PMCID: PMC10002785 DOI: 10.3390/ijms24054499] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/31/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023] Open
Abstract
The bitter taste receptors (T2Rs) expressed in human sinonasal mucosae are known to elicit innate immune responses involving the release of nitric oxide (NO). We investigated the expression and distribution of two T2Rs, T2R14 and T2R38, in patients with chronic rhinosinusitis (CRS) and correlated the results with fractional exhaled NO (FeNO) levels and genotype of the T2R38 gene (TAS2R38). Using the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) phenotypic criteria, we identified CRS patients as either eosinophilic (ECRS, n = 36) or non-eosinophilic (non-ECRS, n = 56) patients and compared these groups with 51 non-CRS subjects. Mucosal specimens from the ethmoid sinus, nasal polyps, and inferior turbinate were collected from all subjects, together with blood samples, for RT-PCR analysis, immunostaining, and single nucleotide polymorphism (SNP) typing. We observed significant downregulation of T2R38 mRNA levels in the ethmoid mucosa of non-ECRS patients and in the nasal polyps of ECRS patients. No significant differences in T2R14 or T2R38 mRNA levels were found among the inferior turbinate mucosae of the three groups. Positive T2R38 immunoreactivity was localized mainly in epithelial ciliated cells, whereas secretary goblet cells generally showed lack of staining. The patients in the non-ECRS group showed significantly lower oral and nasal FeNO levels compared with the control group. There was a trend towards higher CRS prevalence in the PAV/AVI and AVI/AVI genotype groups as compared to the PAV/PAV group. Our findings reveal complex but important roles of T2R38 function in ciliated cells associated with specific CRS phenotypes, suggesting the T2R38 pathway as a potential therapeutic target for promotion of endogenous defense mechanisms.
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Affiliation(s)
| | | | - Sachio Takeno
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan
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He Y, Fu Y, Wu Y, Zhu T, Li H. Pathogenesis and treatment of chronic rhinosinusitis from the perspective of sinonasal epithelial dysfunction. Front Med (Lausanne) 2023; 10:1139240. [PMID: 37138733 PMCID: PMC10149833 DOI: 10.3389/fmed.2023.1139240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/13/2023] [Indexed: 05/05/2023] Open
Abstract
Background Chronic rhinosinusitis (CRS) is a clinical syndrome primarily characterized by long-term mucosal inflammation of the nasal cavity and sinuses. The pathogenesis of CRS is still unclear due to its high heterogeneity. A number of studies have recently focused on the sinonasal epithelium. Thus, there has been a quantum leap in awareness of the role of the sinonasal epithelium, which is now understood as an active functional organ rather than simply an inert mechanical barrier. Undoubtedly, epithelial dysfunction plays a vital role in the onset and development of CRS. Objective In this article, we discuss the potential contribution of sinonasal epithelium dysfunction to CRS pathogenesis and explore a few current and developing therapeutic options targeting the sinonasal epithelium. Results Impaired mucociliary clearance (MCC) and an abnormal sinonasal epithelial barrier are usually considered to be the main causative factors in CRS. Epithelial-derived bioactive substances, such as cytokines, exosomes, and complements, play a vital role in the regulation of innate and adaptive immunity and contribute to the pathophysiological alterations of CRS. The phenomena of epithelial-mesenchymal transition (EMT), mucosal remodeling, and autophagy observed in CRS offer some novel insights into the pathogenesis of this disease. In addition, existing treatment options targeting disorder of sinonasal epithelium can help to relieve the main symptoms associated with CRS to some extent. Conclusion The presence of a normal epithelium is fundamental for maintaining homeostasis in the nasal and paranasal sinuses. Here, we describe various aspects of the sinonasal epithelium and highlight the contributions of epithelial dysfunction to CRS pathogenesis. Our review provides sound evidence of the need for in-depth study of the pathophysiological alterations of this disease and for the development of novel epithelium-targeting alternative treatments.
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Affiliation(s)
- Yuanqiong He
- School of Heath Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yijie Fu
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Yuqi Wu
- School of Heath Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianmin Zhu
- School of Heath Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hui Li
- School of Preclinical Medicine, Chengdu University, Chengdu, China
- *Correspondence: Hui Li
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Numano Y, Nomura K, Hemmi T, Ikeda R, Kakuta R, Sugawara M. The Factors Related to the Time for Sinus Debridement after Functional Endoscopic Sinus Surgery - A Retrospective Study. Ann Maxillofac Surg 2023; 13:49-52. [PMID: 37711532 PMCID: PMC10499281 DOI: 10.4103/ams.ams_6_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 05/16/2023] [Accepted: 07/03/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Post-operative care after functional endoscopic sinus surgery (FESS) is essential for managing the long-term success of chronic rhinosinusitis. Post-operative sinus debridement promotes proper wound healing, but the procedure can be accompanied by discomfort and pain. Hence, we analysed the clinical factors related to sinus debridement time after FESS. Materials and Methods We evaluated retrospectively the clinical factors affecting the time taken for post-operative sinus debridement on the first visit after the discharge. We reviewed 101 patients who underwent FESS at our hospital by the same surgeon and extracted patient information. The time for post-operative sinus debridement at the first outpatient clinic was measured. Results The days of putting the cotton ball in the operated nostril were negatively associated with sinus debridement time (coefficient - -16.4 ± 5.7 seconds/day, P = 0.005). In contrast, current or history of asthma, amount of bleeding during the surgery, number of opened sinuses by the operation or the number of eosinophils in resected tissues under a microscope at ×400 was not associated. Discussion We recommend the use of a cotton ball in the nostril after FESS because it shortens the sinus debridement time. Placing cotton balls in the nostril helps to maintain a humid wound environment and reduce crusting, leading to easier sinus debridement and better wound healing.
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Affiliation(s)
- Yuki Numano
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Miyagi, Japan
| | - Tomotaka Hemmi
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Miyagi, Japan
| | - Ryoukichi Ikeda
- Department of Otolaryngology, Head and Neck Surgery, Iwate Medical University Hospital, Iwate, Japan
| | - Risako Kakuta
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Mitsuru Sugawara
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Miyagi, Japan
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Okano M, Fujieda S, Gotoh M, Kurono Y, Matsubara A, Ohta N, Kamijo A, Yamada T, Nakamaru Y, Asako M, Sakurai D, Terada T, Yonekura S, Sakashita M, Okubo K. Executive summary: Japanese guidelines for allergic rhinitis 2020. Allergol Int 2023; 72:41-53. [PMID: 36509676 DOI: 10.1016/j.alit.2022.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022] Open
Abstract
The Practical Guideline for the Management of Allergic Rhinitis, the fist guideline for allergic rhinitis in Japan, was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 9th edition was published in 2020 and is widely used today. The most recent collection of evidence from the literature was supplemented to the revised guideline to incorporate evidence-based medicine. The revised guideline includes updated epidemiology of allergic rhinitis in Japan, a figure representing the mechanisms of allergic rhinitis in both the onset and sensitization phases with the introduction of regulatory T cells and type 2 innate lymphoid cells, practical assessment for diagnosis, new pharmacotherapy agents such as anti-IgE mAb and a new drug delivery system for antihistamines, sublingual immunotherapy for children, dual sublingual immunotherapy for house dust mites and Japanese cedar pollen extract, new classification for surgery for allergic rhinitis, and treatment and prescriptions for older adults. An evidence-based step-by-step strategy for treatment is also described.
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Affiliation(s)
- Mitsuhiro Okano
- Department of Otorhinolaryngology, International University of Health and Welfare School of Medicine, Narita, Japan.
| | - Shigeharu Fujieda
- Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Minoru Gotoh
- Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan
| | - Yuichi Kurono
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Atsushi Matsubara
- Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Nobuo Ohta
- Department of Otorhinolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | - Takechiyo Yamada
- Department of Otorhinolaryngology, Head and Neck Surgery, Akita University, Graduate School of Medicine, Akita, Japan
| | - Yuji Nakamaru
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Mikiya Asako
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Daiju Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Tetsuya Terada
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shuji Yonekura
- Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masafumi Sakashita
- Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Kimihiro Okubo
- Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan
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Oka SI, Kanai K, Oka A, Kitamura H, Furutate S, Oyamada S, Takahashi M, Iwasaki S, Koike T, Mochizuki T, Okano M. A case of intractable chronic rhinosinusitis without nasal polyps leading remission after treatment switching from anti-IL-5 to anti-IL-4Rα monoclonal antibody. OTOLARYNGOLOGY CASE REPORTS 2023. [DOI: 10.1016/j.xocr.2023.100512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Matucci A, Nencini F, Maggiore G, Chiccoli F, Accinno M, Vivarelli E, Bruno C, Locatello LG, Palomba A, Nucci E, Mecheri V, Perlato M, Rossi O, Parronchi P, Maggi E, Gallo O, Vultaggio A. High proportion of inflammatory CD62L low eosinophils in blood and nasal polyps of severe asthma patients. Clin Exp Allergy 2023; 53:78-87. [PMID: 35490414 DOI: 10.1111/cea.14153] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/04/2022] [Accepted: 04/26/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND In mice models, eosinophils have been divided into different subpopulations with distinct phenotypes and functions, based on CD62L and CD101 patterns of membrane expression. Limited data are available in humans. OBJECTIVE To investigate eosinophils subpopulations in peripheral blood (PB) and nasal polyp tissue (NP) from severe eosinophilic asthma (SEA) patients plus concomitant chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS We recruited 23 SEA patients (14 with CRSwNP); as controls, we enrolled 15 non-severe asthma patients, 15 allergic rhinitis patients without asthma and 15 healthy donors. Eosinophils were isolated from PB and NP and analysed by FACS. Eotaxin-3 and eotaxin-1 mRNA expression in NP tissue was also evaluated. RESULTS A significantly higher percentage of circulating CD62Llow cells was observed in SEA, as compared with controls, expressing higher levels of CCR3, CD69 and lower levels of CD125 (IL-5R), CRTH2, CD86 and CD28 in comparison with CD62Lbright cells. In NP, eosinophils showed a high proportion of CD62Llow phenotype, significantly greater than that observed in PB. Surface expression of IL-3R, IL-5R, CD69 and CD86 was significantly higher in CD62Llow eosinophils from NP than in those from blood. Moreover, eotaxin-3 mRNA expression positively correlated with the percentage of CD62Llow cells in NP. CONCLUSION Two different eosinophil subphenotypes can be identified in blood and NP of SEA patients, with a preferential accumulation of CD62Llow inflammatory cells in NP.
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Affiliation(s)
- Andrea Matucci
- Immunoallergology Unit, Careggi University Hospital, Florence, Italy
| | - Francesca Nencini
- Immunoallergology Unit, Careggi University Hospital, Florence, Italy
| | - Giandomenico Maggiore
- Otolaryngology Clinic, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Fabio Chiccoli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Matteo Accinno
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Chiara Bruno
- Otolaryngology Clinic, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Luca Giovanni Locatello
- Otolaryngology Clinic, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Annarita Palomba
- Department of Pathology, Careggi University Hospital, Florence, Italy
| | - Elena Nucci
- Department of Pathology, Careggi University Hospital, Florence, Italy
| | - Valentina Mecheri
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Margherita Perlato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Oliviero Rossi
- Immunoallergology Unit, Careggi University Hospital, Florence, Italy
| | - Paola Parronchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Enrico Maggi
- Translational Immunology Unit, Immunology Area, Bambino Gesù Children's Hospital, I.R.C.C.S, Rome, Italy
| | - Oreste Gallo
- Otolaryngology Clinic, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
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Sato T, Ikeda H, Murakami K, Murakami K, Shirane S, Ohta N. Periostin is an aggravating factor and predictive biomarker of eosinophilic chronic rhinosinusitis. Allergol Int 2023; 72:161-168. [PMID: 36109310 DOI: 10.1016/j.alit.2022.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Patients with eosinophilic chronic rhinosinusitis (ECRS) respond poorly to many treatment modalities. Overproduction of periostin in the nasal mucosa is reported to contribute to polyp formation. This study examined periostin levels in patients with ECRS in comparison with levels in patients with non-ECRS. METHODS Fifty-nine patients with chronic rhinosinusitis were grouped into those with ECRS and those with non-ECRS. We compared the relationships between peripheral blood eosinophil level, serum periostin level, histopathological findings, clinical and laboratory findings, nose findings, diagnostic score of the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis Study, and postoperative recurrence of nasal polyps in each group. RESULTS In the ECRS group, a positive correlation was found between peripheral blood eosinophil level and serum periostin level (rs = 0.49, P < 0.01: Spearman's rank correlation coefficient). ROC curve analysis was used to evaluate the serum periostin level that could predict postoperative recurrence of nasal polyps in the ECRS group: the area under the curve (AUC) was 0.95, sensitivity was 92%, and specificity was 100%; the serum periostin cutoff value for postoperative recurrence of nasal polyps was 130 ng/ml. In ROC curve analysis to evaluate peripheral blood eosinophil level, the AUC was 0.73, sensitivity was 69.2%, and specificity was 85.0%; the cutoff value was 8.8%. CONCLUSIONS periostin was implicated in the pathophysiology of ECRS. Periostin shown to be a more useful biomarker than eosinophils in ECRS. Periostin was shown to likely be an important biomarker for pathological severity of ECRS and postoperative recurrence of nasal polyps.
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Affiliation(s)
- Teruyuki Sato
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
| | - Hiroki Ikeda
- Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Keigo Murakami
- Division of Pathology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kazuhiro Murakami
- Division of Pathology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Shion Shirane
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Nobuo Ohta
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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CCL4 Regulates Eosinophil Activation in Eosinophilic Airway Inflammation. Int J Mol Sci 2022; 23:ijms232416149. [PMID: 36555793 PMCID: PMC9782438 DOI: 10.3390/ijms232416149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Eosinophilic chronic rhinosinusitis (ECRS) is a refractory airway disease accompanied by eosinophilic inflammation, the mechanisms of which are unknown. We recently found that CCL4/MIP-1β-a specific ligand for CCR5 receptors-was implicated in eosinophil recruitment into the inflammatory site and was substantially released from activated eosinophils. Moreover, it was found in nasal polyps from patients with ECRS, primarily in epithelial cells. In the present study, the role of epithelial cell-derived CCL4 in eosinophil activation was investigated. First, CCL4 expression in nasal polyps from patients with ECRS as well as its role of CCL4 in eosinophilic airway inflammation were investigated in an in vivo model. Furthermore, the role of CCL4 in CD69 expression-a marker of activated eosinophils-as well as the signaling pathways involved in CCL4-mediated eosinophil activation were investigated. Notably, CCL4 expression, but not CCL5, CCL11, or CCL26, was found to be significantly increased in nasal polyps from patients with ECRS associated with eosinophil infiltration as well as in BEAS-2B cells co-incubated with eosinophils. In an OVA-induced allergic mouse model, CCL4 increased eosinophil accumulation in the nasal mucosa and the bronchoalveolar lavage (BALF). Moreover, we found that CD69 expression was upregulated in CCL4-stimulated eosinophils; similarly, phosphorylation of several kinases, including platelet-derived growth factor receptor (PDGFR)β, SRC kinase family (Lck, Src, and Yes), and extracellular signal-regulated kinase (ERK), was upregulated. Further, CCR5, PDGFRβ, and/or Src kinase inhibition partially restored CCL4-induced CD69 upregulation. Thus, CCL4, which is derived from airway epithelial cells, plays a role in the accumulation and activation of eosinophils at inflammatory sites. These findings may provide a novel therapeutic target for eosinophilic airway inflammation, such as ECRS.
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A decreased prevalence of group 2 innate lymphoid cells in blood is associated with good postoperative outcomes in patients with chronic rhinosinusitis. Auris Nasus Larynx 2022:S0385-8146(22)00224-3. [DOI: 10.1016/j.anl.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/06/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
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Zhipu N, Zitao H, Jichao S, Cuida M. Research advances in roles of microRNAs in nasal polyp. Front Genet 2022; 13:1043888. [PMID: 36506304 PMCID: PMC9732428 DOI: 10.3389/fgene.2022.1043888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
MicroRNAs (miRNAs), a subset of endogenous RNAs highly conservative with short chains, play key regulatory role in the biological relevant events of the cells. Exosomes are extracellular vesicles like the plasma membrane components being able to deliver information molecules such as miRNA between cells and to regulate the fate of the target cells. The progression of chronic rhinosinusitis with nasal polyps (CRSwNP) is closely associated with significant alterations of miRNA levels in both cells and exosomes. RNA-binding proteins (RBPs) have been acknowledged to play important roles in intracellular miRNA transport to exosomes, and specific membrane proteins such as caveolin-1 critically involved in HNRNPA1 -mediated transport of miRNA to exosomes. Aberrant alteration in endogenous miRNA levels significantly contributes to the process of airway remodeling in the nasal tissue and to the occurrence and progression of inflammatory responses in CRSwNP. Exogenous miRNAs delivered via exosomes has also been shown to play an important role in activating macrophages or in regulating vascular permeability in the CRSwNP.This paper highlights the mechanism of RBP-mediated delivery of miRNAs to exosomes and the important contribution of endogenous miRNAs to the development of CRSwNP in response to inflammation and airway remodeling. Finally, we discuss the future research directions for regulation of the miRNAs to CRSwNP.Delivery of exogenous miRNAs by exosomes alters the endogenous miRNAs content in nasal mucosal epithelial cells or in associated inflammatory cells in the CRSwNP, and altered endogenous miRNAs affects the inflammatory response and airway remodeling, which then regulates the occurrence and progression of CRSwNP.RBPs and associated membrane proteins such as caveolin-1 may play a crucial role in the entry of exogenous miRNA into exosomes.
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Affiliation(s)
- Niu Zhipu
- Clinical Medicine, China-Japan Union Hospital of Jilin University Norman Bethune Third School of Jilin University, Changchun, China
| | - Huo Zitao
- Clinical Medicine, China-Japan Union Hospital of Jilin University Norman Bethune Third School of Jilin University, Changchun, China
| | - Sha Jichao
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University Norman Bethune Third School of Jilin University, Changchun, China,*Correspondence: Sha Jichao, ; Meng Cuida,
| | - Meng Cuida
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University Norman Bethune Third School of Jilin University, Changchun, China,*Correspondence: Sha Jichao, ; Meng Cuida,
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Chen W, He S, Xie X, Yang X, Duan C, Ye P, Li X, Lawrence MG, Borish L, Feng X. Over-expression of CRTH2 indicates eosinophilic inflammation and poor prognosis in recurrent nasal polyps. Front Immunol 2022; 13:1046426. [DOI: 10.3389/fimmu.2022.1046426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
BackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is often characterized by recurrent nasal polyp (NP) growth following surgical removal, but the mechanisms are still not clear. This study aimed to investigate the expression of chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2) receptor on NP and the role it plays in eosinophil inflammation and polyp recurrence.MethodsForty-one CRSwNPs patients and seventeen controls were enrolled in this study. mRNA was extracted from nasal tissues and evaluated for expression of CRTH2. Immunofluorescence staining was performed to confirm the distribution and expression of CRTH2 protein. CRTH2 expression on peripheral blood eosinophils was quantified by flow cytometry. The eosinophil count and clinical implications were also evaluated and their correlations with CRTH2 expression were analyzed.ResultsNasal polyps displayed increased expression of CRTH2 in mRNA level compared with control samples, with the highest expression observed in recurrent NP. Immunofluorescence confirmed over-expression of CRTH2 in recurrent NP and this was independent of the concurrent presence of asthma. CRTH2 expression was positively correlated with tissue eosinophil number (Spearman’s ρ=0.69, P<0.001) and the postoperative sino-nasal outcome test-22 (SNOT-22) score (Spearman’s ρ=0.67, P<0.001). Receiver operating characteristic (ROC) curves revealed CRTH2 was more predictive for NP recurrence compared to either eosinophil number and concomitant asthma, with an area under the ROC curve of 0.9107.ConclusionThe over-expression of CRTH2 in recurrent nasal polyps correlates with greater eosinophilic inflammation and poor prognosis which is independent of concomitant asthma.
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靳 晶, 许 昱. [Research progress of biomarkers in nasal secretions in endotypes diagnosis and clinical application of chronic rhinosinusitis]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:888-892. [PMID: 36347587 PMCID: PMC10127556 DOI: 10.13201/j.issn.2096-7993.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Indexed: 06/16/2023]
Abstract
With the development of studies on the endotypes of chronic rhinosinusitis (CRS) and the biomarkers of nasal secretions, the studies of CRS endotypes based on nasal secretion have become more abundant. This paper summarizes the endotypes classification of CRS, the collection methods of nasal secretion and the nasal secretion biomarkers related to the endotypes of CRS, in order to provide a reference for establishing the corresponding endotypes of CRS based on the nasal secretion biomarkers.
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Affiliation(s)
- 晶 靳
- 武汉大学人民医院耳鼻咽喉头颈外科(武汉,430060)Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - 昱 许
- 武汉大学人民医院耳鼻咽喉头颈外科(武汉,430060)Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China
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Zahran AM, El-Badaway O, Elsayh IK, Osman MM. Delineation of T cell subsets in chronic rhinosinusitis with nasal polyps. ACTA OTORHINOLARYNGOLOGICA ITALICA 2022; 42:441-449. [DOI: 10.14639/0392-100x-n2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/02/2022] [Indexed: 12/24/2022]
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Kato E, Tsutsumiuchi T, Muramoto A, Tokunaga T, Fujieda S, Kobayashi M. The Percentage of PNAd-Expressing Vessels is Correlated with Disease Severity in Eosinophilic Chronic Rhinosinusitis. Am J Rhinol Allergy 2022; 37:43-50. [PMID: 36172642 DOI: 10.1177/19458924221129903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Eosinophilic chronic rhinosinusitis (ECRS) is a chronic inflammatory condition of the paranasal sinuses characterized by intractable nasal polyps with prominent eosinophil infiltration. These eosinophils are presumably recruited from peripheral blood via vessels expressing peripheral lymph node addressin (PNAd), a set of glycoproteins decorated with 6-sulfo sialyl Lewis x (sLex) glycans that serve as L-selectin ligands. Based on the severity classification algorithm proposed by the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) study group, ECRS is divided into mild, moderate and severe groups; however, as yet there are few reports comparing the clinicopathological differences among these groups. OBJECTIVE Our goal was to elucidate clinicopathological differences among the three different severities of ECRS with special reference to eosinophils and PNAd-expressing vessels. METHODS We performed quantitative immunohistochemical analysis of PNAd-expressing vessels using surgical specimens of nasal polyps from patients exhibiting varying severity of ECRS (n = 35) and from individuals with non-ECRS (n = 10). To this end, we immunostained tissue sections with anti-PNAd and anti-CD34 monoclonal antibodies, and then determined the number of vessels immunolabeled with each antibody. RESULTS The number of eosinophils infiltrating nasal polyps was correlated with ECRS severity. We also found that the PNAd + /CD34 + vessel ratio, namely, the percentage of PNAd-expressing vessels among all vessels, was positively correlated not only with ECRS severity but also with the number of eosinophils infiltrating nasal polyps formed in ECRS. CONCLUSION These results strongly suggest that PNAd-expressing vessels play at least a partial role in eosinophil recruitment to nasal polyps and consequent severity of ECRS.
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Affiliation(s)
- Eiichi Kato
- Department of Tumor Pathology, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan.,Department of Otorhinolaryngology and Head & Neck Surgery, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan
| | - Toshiki Tsutsumiuchi
- Department of Tumor Pathology, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan.,Department of Otorhinolaryngology and Head & Neck Surgery, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan
| | - Akifumi Muramoto
- Department of Tumor Pathology, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan
| | - Takahiro Tokunaga
- Department of Otorhinolaryngology and Head & Neck Surgery, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan
| | - Shigeharu Fujieda
- Department of Otorhinolaryngology and Head & Neck Surgery, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan
| | - Motohiro Kobayashi
- Department of Tumor Pathology, Faculty of Medical Sciences, 26423University of Fukui, Eiheiji, Japan
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Goto M, Nishimoto K, Jougasaki Y, Matsuzaki T, Nomoto M. Respiratory epithelial adenomatoid hamartomas of the sinonasal tract: A histopathological analysis of 50 patients. Pathol Int 2022; 72:541-549. [DOI: 10.1111/pin.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Masamichi Goto
- Department of Pathology National Hospital Organization Kagoshima Medical Center Kagoshima Japan
| | - Kengo Nishimoto
- Department of Otorhinolaryngology National Hospital Organization Kagoshima Medical Center Kagoshima Japan
| | - Yasuyo Jougasaki
- Department of Pathology National Hospital Organization Kagoshima Medical Center Kagoshima Japan
| | - Tsutomu Matsuzaki
- Department of Otorhinolaryngology National Hospital Organization Kagoshima Medical Center Kagoshima Japan
| | - Mitsuharu Nomoto
- Department of Pathology National Hospital Organization Kagoshima Medical Center Kagoshima Japan
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50
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Ogata A, Hayashi K, Kitano T, Onozaki K, Itoh S, Hida S. Staphylococcal γ-hemolysins induce IL-4 production in murine basophils. Biochem Biophys Res Commun 2022; 632:107-112. [DOI: 10.1016/j.bbrc.2022.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/18/2022] [Indexed: 11/02/2022]
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