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Alnemare AK, Almutairi AB, Almutairi AF, Bin Mahfoz T, Almutairi SB, Alnemare AK, Almjlad RB, Alhumam MN, Alghassab RE. Prevalence of Risk Factors of Chronic Rhinosinusitis With Nasal Polyps Among the Saudi Population. Cureus 2023; 15:e45420. [PMID: 37854730 PMCID: PMC10581594 DOI: 10.7759/cureus.45420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/20/2023] Open
Abstract
Background The burden of chronic rhinosinusitis symptoms experienced by Saudi citizens is considered an important factor in getting an overall insight of the problem in the region, therefore our study aimed to determine the prevalence of risk factors of chronic rhinosinusitis with nasal polyps and correlate the risk factors with various sociodemographic parameters among Saudi population. Methods This study analyzed five-year cross-sectional data from 2017-2021. A total of 386 participants were enrolled and subsequently divided into four groups: aged 18-25 years, 26-35 years, 36-45 years, and > 45 years. A study was conducted utilizing non-probability sampling targeting a population of Saudi nationality living in selected regions of Saudi Arabia. Data was collected through an online questionnaire which had been distributed through social media and had been analyzed accordingly using a statistical package for social sciences. Results In this study, 272 (70.5%) participants were female and 114 (29.5%) were male. A total of 374 (96.9%) participants were Saudis while 12 (3.1%) were non-Saudis. Risk factors were compared by age and gender of study participants. Having polyps in the nose (p-value 0.016) and a family history of polyps (p-value 0.049) showed a significant association with the gender of study participants. The frequency of having nasal polyps was significantly higher among male participants, however, having a family history of nasal polyps was significantly higher among female participants. The educational status of study participants showed a significant association with the use of cortisone (p-value 0.032) and having a broken nose (p-value 0.032). Having a family history of nasal polyps showed a significant (p-value 0.017) association with the socioeconomic status of study participants. Conclusion Nasal polyps are more common in males than females, however, having a family history of nasal polyps was significantly higher among female participants.
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Affiliation(s)
- Ahmad K Alnemare
- Department of Otolaryngology, College of Medicine, Majmaah University, Al-Majmaah, SAU
| | | | | | - Turki Bin Mahfoz
- Department of Otolaryngology, Faculty of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
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Iovănescu G, Pop LL, Vintilă DR, Marin KC, Mogoantă CA, Lăzureanu DC, Borugă VM, Ciucă IM. Nasal polyposis from cystic fibrosis in children - the experience of a single center. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:235-240. [PMID: 37518881 PMCID: PMC10520370 DOI: 10.47162/rjme.64.2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Cystic fibrosis (CF) is the most common monogenic disease, characterized by clinically notable polymorphism. Respiratory disease is the main factor that influences the disease outcome and prognosis of the patient with CF, bacterial infections being responsible for severe exacerbations and rhinosinusitis a difficult complication, besides lung disease. AIM The aim of the paper was to present a case series of CF-associated nasal polyposis and our management experience, providing new data for nasal and sinus complications. PATIENTS, MATERIALS AND METHODS Patients attending the National Cystic Fibrosis Center, Timişoara, Romania, were evaluated for nasal polyposis. Besides clinical examination, endoscopy, and computed tomography (CT) was performed for comprehensive evaluation. Patients with persistent symptoms or with complicated sinusitis underwent surgical approach. RESULTS Fourteen (18.18%) children were diagnosed with nasal polyposis and had surgery, with positive outcomes. One patient received Omalizumab for an associated, uncontrolled asthma with a subsequent substantial effect with the significant polyp reduction and lack of recurrence. CONCLUSIONS Even if extremely difficult to manage, complicated nasal polyposis CF related might have an improved outcome and better life quality.
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Affiliation(s)
- Gheorghe Iovănescu
- Department of ENT, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania;
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Rezende GL, Nakanishi M, Couto SCP, Martins CLFS, Sampaio ALL, Albuquerque LFF, Kückelhaus SAS, Muniz-Junqueira MI. Alterations in innate immune responses of patients with chronic rhinosinusitis related to cystic fibrosis. PLoS One 2022; 17:e0267986. [PMID: 35522627 PMCID: PMC9075614 DOI: 10.1371/journal.pone.0267986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
The role of phagocytes of children with cystic fibrosis (CF) associated with different phenotypes of chronic rhinosinusitis (CRS) is unclear. The aim of this study was to evaluate the phagocytic capacity of blood neutrophils and monocytes and production of superoxide anion by phagocytes in patients with CF with or without chronic rhinosinusitis and with or without nasal polyps (NP). This cross-sectional study was established in 2015–2017 in a tertiary reference center to the CF treatment, Brasilia, Brazil. Sample included 30 children volunteers with CRS related to CF (n = 16) and control subjects (n = 14). Epidemiological and clinical data were compared. Collection of 15 mL of peripheral blood and nasal endoscopy to identify the presence or absence of nasal polyps (NP) were performed. Phagocytosis of Saccharomyces cerevisiae by pathogen-associated molecular pattern receptors and opsonin receptors was assessed. Superoxide anion production was evaluated. The control group showed a higher phagocytic index to monocytes and neutrophils than to the CF or CF+CRS with NP groups [Kruskal-Wallis p = 0.0025] when phagocytosis were evaluated by pathogen-associated molecular pattern receptors (5 yeasts/cell). The phagocytic index of the CF+CRS without NP group was higher than in the CF+CRS with NP group (Kruskal-Wallis p = 0.0168). In the control group, the percentage of phagocytes involved in phagocytosis and superoxide anion production (74.0 ± 9.6%) were higher in all CF groups (p < 0,0001). The innate immune response, represented by phagocytic activity and superoxide anion production by monocytes and neutrophils was more impaired in patients with CF related or not related to CRS than in the control group. However, the phagocytic function of patients without NP showed less impairment.
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Affiliation(s)
- Gustavo L. Rezende
- Hospital de Base, Brasília, Federal District, Brazil
- Laboratory of Cellular Immunology, Pathology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
- Nucleus of Research in Applied Morphology and Immunology, Morphology, Faculty of Medicine, University de Brasília, Brasília, Federal District, Brazil
- * E-mail:
| | - Marcio Nakanishi
- Laboratory of Cellular Immunology, Pathology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
- Department of Otolaryngology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
- D’Or Institute for Research and Education (IDOR), Brasília, Federal District, Brazil
| | - Shirley C. P. Couto
- Laboratory of Cellular Immunology, Pathology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
| | - Carmen L. F. S. Martins
- Laboratory of Cellular Immunology, Pathology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
- Department of Pediatric, Faculty of Medicine, University of Brasilia, Brasilia, Distrito Federal, Brazil
| | - André L. L. Sampaio
- Department of Otolaryngology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
| | - Lucas F. F. Albuquerque
- Nucleus of Research in Applied Morphology and Immunology, Morphology, Faculty of Medicine, University de Brasília, Brasília, Federal District, Brazil
| | - Selma A. S. Kückelhaus
- Laboratory of Cellular Immunology, Pathology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
- Nucleus of Research in Applied Morphology and Immunology, Morphology, Faculty of Medicine, University de Brasília, Brasília, Federal District, Brazil
| | - Maria I. Muniz-Junqueira
- Laboratory of Cellular Immunology, Pathology, Faculty of Medicine, University of Brasilia, Brasília, Federal District, Brazil
- Nucleus of Research in Applied Morphology and Immunology, Morphology, Faculty of Medicine, University de Brasília, Brasília, Federal District, Brazil
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Nguyen TN, Suzuki H, Yoshida Y, Ohkubo JI, Wakasugi T, Kitamura T. Decreased CFTR/PPARγ and increased transglutaminase 2 in nasal polyps. Auris Nasus Larynx 2021; 49:964-972. [PMID: 34728118 DOI: 10.1016/j.anl.2021.10.006] [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: 05/04/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Transglutaminase (TGM)2 and peroxisome proliferator-activated receptor (PPAR)γ are thought to participate in the pathogenesis of nasal polyp formation in cystic fibrosis (CF). We herein investigated expressions of cystic fibrosis transmembrane conductance regulator (CFTR), TGM2, PPARγ and isopeptide bonds, a reaction product of TGM, in non-CF nasal polyps. METHODS Nasal polyps and inferior turbinates were collected from chronic rhinosinusitis patients without CF during transnasal endoscopic sinonasal surgery. Expressions of CFTR, TGM2, isopeptide bonds and PPARγ were examined by fluorescence immunohistochemistry and quantitative RT-PCR. Expression of CFTR was also analyzed by Western blot. RESULTS Immunohistochemical fluorescence of the nasal polyp was significantly lower for CFTR and PPARγ, and significantly higher for TGM2 and isopeptide bonds than that of the turbinate mucosa. Lower expression of CFTR in the nasal polyp than in the turbinate mucosa was also observed in Western blot. Expression of PPARG mRNA was significantly lower in the nasal polyp than in the turbinate mucosa, whereas expressions of CFTR mRNA or TGM2 mRNA did not differ between the two tissues. Immunohistochemical fluorescence for CFTR showed significant negative correlation with that for TGM2 and isopeptide bonds, and significant positive correlation with that for PPARγ. The fluorescence for TGM2 was positively correlated with that for isopeptide bonds and negatively correlated with that for PPARγ. The fluorescence for isopeptide bonds tended to be negatively correlated with that for PPARγ. CONCLUSIONS These results suggest a possible role of the CFTR-TGM2-PPARγ cascade in the pathogenesis of nasal polyp formation in non-CF patients as in CF patients.
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Affiliation(s)
- Thi Nga Nguyen
- Department of Otorhinolaryngology-Head and Neck Surgery and Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan; Faculty of Public Health, Vinh Medical University, Vinh City, Vietnam
| | - Hideaki Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery and Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Yasuhiro Yoshida
- Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Jun-Ichi Ohkubo
- Department of Otorhinolaryngology-Head and Neck Surgery and Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tetsuro Wakasugi
- Department of Otorhinolaryngology-Head and Neck Surgery and Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takuro Kitamura
- Department of Otorhinolaryngology-Head and Neck Surgery and Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Nguyen TN, Do BH, Kitamura T, Ohkubo JI, Wakasugi T, Ohbuchi T, Suzuki H. Expression of Cl - channels/transporters in nasal polyps. Eur Arch Otorhinolaryngol 2020; 277:2263-2270. [PMID: 32333139 DOI: 10.1007/s00405-020-05981-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/11/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Nasal polyp formation is a common sequela of prolonged chronic rhinosinusitis, but the mechanism underlying this disease state is still controversial. We compared the expressions of Cl- channels/transporters in nasal polyps with those in inferior turbinates to explore whether a deficiency in Cl- transport may participate in the pathophysiology of nasal polyp formation as in patients with cystic fibrosis. METHODS Nasal polyps and inferior turbinates were collected from 12 chronic rhinosinusitis patients with hypertrophic rhinitis and/or nasal polyps. Expressions of cystic fibrosis transmembrane conductance regulator (CFTR), pendrin, Na+-K+-2Cl- cotransporter 1 (NKCC1), SLC26A3, TMEM16A and anion exchanger 2 (AE2) were examined by fluorescence immunohistochemistry using Alexa Fluor 488. RESULTS CFTR was weakly expressed on the epithelial surface of the turbinate mucosa whereas the nasal polyps showed almost no fluorescence. Pendrin was mainly expressed on the epithelial surface in both tissues. The fluorescence was moderate in the nasal polyps and strong in the turbinate mucosa. For NKCC1, moderate fluorescence was observed throughout the entire epithelial layer of the nasal polyps, but the turbinate mucosa exhibited almost no fluorescence. On the other hand, no fluorescence for SLC26A3, TMEM16A or AE2 was seen in either tissue. CONCLUSION These results suggest that CFTR, pendrin and NKCC1 may participate in the pathogenesis of nasal mucosal edema and play roles in the mechanism of nasal polyp formation.
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Affiliation(s)
- Thi Nga Nguyen
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Ba Hung Do
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Takuro Kitamura
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Jun-Ichi Ohkubo
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Tetsuro Wakasugi
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Toyoaki Ohbuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Hideaki Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
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Critical Evaluation of Sinonasal Disease in 64 Adults with Primary Ciliary Dyskinesia. J Clin Med 2019; 8:jcm8050619. [PMID: 31067752 PMCID: PMC6571605 DOI: 10.3390/jcm8050619] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/23/2019] [Accepted: 05/01/2019] [Indexed: 11/25/2022] Open
Abstract
To date, no study precisely described ear, nose and throat (ENT) disease in adults with primary ciliary dyskinesia (PCD) and its relationship with ciliary function/ultrastructure. A retrospective study of standardized ENT data (exam, audiogram, sinus Computed tomography (CT), and bacteriology) was conducted in 64 adults with confirmed PCD who were followed in two ENT reference centers. Rhinorrhoea and hearing loss were the main symptoms. Symptom scores were higher in older patients. Nasal endoscopy was abnormal in all patients except one, showing nasal polyps in one-third of the patients and stagnant nasal mucus secretions in 87.5% of the patients. Sinus CT opacities were mainly incomplete and showed one-third of the patients with sinus hypoplasia and/or agenesis. Middle meatus mainly grew Haemophilus influenzae, Streptoccocus pneumoniae and Pseudomonas aeruginosa. Otitis media with effusion (OME), which is constant in childhood, was diagnosed in less than one-quarter of the patients. In two-thirds of the patients, audiogram showed hearing loss that was sensorineural in half of the patients. ENT disease severity was not correlated with ciliary function and ultrastructure, but the presence of OME was significantly associated with a forced expiratory volume (FEV1) < 70%. Rhinosinusitis is the most common clinical feature of PCD in adults, while OME is less frequent. The presence of active OME in adults with PCD could be a severity marker of lung function and lead to closer monitoring.
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Update on sinus disease in children with cystic fibrosis: advances in treatment modalities, microbiology, and health-related quality-of-life instruments. Curr Opin Otolaryngol Head Neck Surg 2018; 26:417-420. [DOI: 10.1097/moo.0000000000000495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Yu H, Ju J, Liu J, Li D. Aberrant expression of miR-663 and transforming growth factor-β1 in nasal polyposis in children. Exp Ther Med 2018; 15:4550-4556. [PMID: 29849780 DOI: 10.3892/etm.2018.5927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 04/11/2017] [Indexed: 12/22/2022] Open
Abstract
The aim of the present study was to investigate the expression of microRNA (miR)-663 and its regulatory effects on the pathogenesis of nasal polyposis in children. Nasal polyp tissue, as well as serum and peripheral blood eosinophils were collected from 35 children diagnosed with nasal polypectomy between August 2013 and August 2015. As a control, the inferior nasal concha, serum and peripheral blood eosinophils were collected from 46 patients with nasal septal deviation complicated by inferior turbinate hypertrophy or patients with simple inferior turbinate hypertrophy who had undergone surgical removal of the inferior nasal concha. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to measure the expression of miR-663 and transforming growth factor-β1 (TGF-β1) in the nasal polyp tissue, serum and peripheral blood eosinophils of patients with nasal polyposis and controls. Western blotting was used to measure the expression of TGF-β1 protein in nasal tissue and eosinophils and an enzyme-linked immunosorbent assay was used to measure serum level of TGF-β1 protein. A dual luciferase reporter assay was used to determine whether TGF-β1 was a target gene of miR-663. Compared with the control group, levels of TGF-β1 mRNA and protein were significantly increased in all three types of specimens from pediatric patients with nasal polyposis (P<0.05). miR-663 expression was significantly decreased in nasal polyp tissue and peripheral blood eosinophils (P<0.05). The dual luciferase reporter assay confirmed that TGF-β1 was a target gene of miR-663. The current study suggests that the upregulation of TGF-β1 may be associated with the downregulation of miR-663 in nasal polyposis in children. miR-663 may have regulatory effects on the pathogenesis of nasal polyposis by regulating TGF-β1 and may be developed as a genetic marker of nasal polyposis in children.
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Affiliation(s)
- Hailing Yu
- Department of Otolaryngology, The Women and Children's Hospital of Qingdao, Qingdao, Shandong 266033, P.R. China
| | - Jianbao Ju
- Department of Otolaryngology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266033, P.R. China
| | - Jingdong Liu
- Department of Medicine, The Women and Children's Hospital of Qingdao, Qingdao, Shandong 266033, P.R. China
| | - Da Li
- Department of Otolaryngology, The Women and Children's Hospital of Qingdao, Qingdao, Shandong 266033, P.R. China
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