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Makary CA, Azar A, Gudis D, Crawford A, Hannikainen P, Kim J, Joe S, Kimple AJ, Lam K, Lee JT, Luong AU, Marcus S, McArdle E, Mullings W, Peppers BP, Lewandrowski C, Lin SY, Ramadan HH, Rose AS, Ryan L, Toskala E, Baroody FM. Evaluation and treatment of rhinosinusitis with primary antibody deficiency in children: Evidence-based review with recommendations. Int Forum Allergy Rhinol 2024; 14:1776-1801. [PMID: 39404739 DOI: 10.1002/alr.23468] [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: 07/30/2024] [Revised: 08/29/2024] [Accepted: 09/24/2024] [Indexed: 11/02/2024]
Abstract
BACKGROUND There is clear evidence that prevalence of primary antibody deficiency (PAD) is higher in children with chronic rhinosinusitis (CRS) than in the general population. The purpose of this multi-institutional and multidisciplinary evidence-based review with recommendations (EBRR) is to thoroughly review the literature on rhinosinusitis with PAD, summarize the existing evidence, and provide recommendations on the evaluation and management of rhinosinusitis in children with PAD. METHODS The PubMed, Embase, and Cochrane databases were systematically reviewed from inception through December 2023. Studies on the evaluation and management of rhinosinusitis in PAD patients were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on the evaluation and management principles for PAD were generated. RESULTS A total of 50 studies were included in this evidence-based review. These studies were evaluated on the incidence of PAD in rhinosinusitis patients, the incidence of rhinosinusitis in PAD patients, and on the different treatment modalities used and their outcome. The aggregate quality of evidence varied across the reviewed domains. CONCLUSION Based on the currently available evidence, the incidence of PAD in children with recalcitrant CRS can be significantly elevated. Despite the presence of multiple studies addressing rhinosinusitis and PAD, the level of evidence supporting different treatment options continues to be lacking. Optimal management requires a multidisciplinary approach through collaboration with clinical immunology. There is need for higher level studies that compare different treatments in children with PAD and rhinosinusitis.
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Affiliation(s)
- Chadi A Makary
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Antoine Azar
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Anna Crawford
- Health Sciences Library, Morgantown, West Virginia, USA
| | - Paavali Hannikainen
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, Illinois, USA
| | - Jean Kim
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Stephanie Joe
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois, Chicago, Illinois, USA
| | - Adam J Kimple
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kent Lam
- Department of Otolaryngology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jivianne T Lee
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Amber U Luong
- Department of Otorhinolaryngology, McGovern Medical School of the University of Texas Health Science Center, Houston, Texas, USA
| | - Sonya Marcus
- Division of Otolaryngology-Head and Neck Surgery, Stony Brook University, Stony Brook, New York, USA
| | - Erica McArdle
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Warren Mullings
- Ear Nose and Throat Department, Kingston Public Hospital, Kingston, Jamaica
| | - Brian P Peppers
- Division of Adult and Pediatric Allergy and Immunology, Department of Pediatrics, West Virginia University, Morgantown, West Virginia, USA
| | - Callum Lewandrowski
- Division of Adult and Pediatric Allergy and Immunology, Department of Pediatrics, West Virginia University, Morgantown, West Virginia, USA
| | - Sandra Y Lin
- Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Hassan H Ramadan
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Austin S Rose
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lindsey Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, Florida, USA
| | - Elina Toskala
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Fuad M Baroody
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine, The Comer Children's Hospital, Chicago, Illinois, USA
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Makary CA, Luong AU, Azar A, Kim J, Ahmed OG, Chaaban MR, Damask CC, Hannikainen P, Joe S, Lam K, Peppers BP, Peters AT, Toskala E, Lin SY. Evaluation and treatment of rhinosinusitis with primary antibody deficiency in adults: Evidence-based review with recommendations. Int Forum Allergy Rhinol 2023; 13:2205-2230. [PMID: 37300852 DOI: 10.1002/alr.23206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/06/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is clear evidence that the prevalence of primary antibody deficiency (PAD) is higher in patients with recurrent and chronic rhinosinusitis (CRS) than in the general population. The purpose of this multi-institutional and multidisciplinary evidence-based review with recommendations (EBRR) is to thoroughly review the literature on rhinosinusitis with PAD, summarize the existing evidence, and provide recommendations on the evaluation and management of rhinosinusitis in patients with PAD. METHODS The PubMed, EMBASE, and Cochrane databases were systematically reviewed from inception through August 2022. Studies on the evaluation and management of rhinosinusitis in PAD patients were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on the evaluation and management principles for PAD were generated. RESULTS A total of 42 studies were included in this evidence-based review. These studies were evaluated on incidence of PAD in rhinosinusitis patients, incidence of rhinosinusitis in PAD patients, and on the different treatment modalities used and their outcome. The aggregate quality of evidence was varied across reviewed domains. CONCLUSION Based on the currently available evidence, PAD can occur in up to 50% of patients with recalcitrant CRS. Despite the presence of multiple studies addressing rhinosinusitis and PAD, the level of evidence supporting different treatment options continues to be lacking. Optimal management requires a multidisciplinary approach through collaboration with clinical immunology. There is need for higher-level studies that compare different treatments in patients with PAD and rhinosinusitis.
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Affiliation(s)
- Chadi A Makary
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Amber U Luong
- Department of Otorhinolaryngology, McGovern, Medical School of the University of Texas Health Science at Houston, Houston, Texas, USA
| | - Antoine Azar
- Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jean Kim
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Omar G Ahmed
- Department of Otolaryngology-Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Mohamad R Chaaban
- Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA
| | - Cecilia C Damask
- Department of Otolaryngology, University of Central Florida, Lake Mary, Florida, USA
| | - Paavali Hannikainen
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Stephanie Joe
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Illinois, USA
| | - Kent Lam
- Department of Otolaryngology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Brian P Peppers
- Division of Adult and Pediatric Allergy and Immunology, Department of Pediatrics, West Virginia University, Morgantown, West Virginia, USA
| | - Anju T Peters
- Division of Allergy Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Elina Toskala
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sandra Y Lin
- Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Ivanova N, Sotirova Y, Gavrailov G, Nikolova K, Andonova V. Advances in the Prophylaxis of Respiratory Infections by the Nasal and the Oromucosal Route: Relevance to the Fight with the SARS-CoV-2 Pandemic. Pharmaceutics 2022; 14:530. [PMID: 35335905 PMCID: PMC8953301 DOI: 10.3390/pharmaceutics14030530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/19/2022] [Accepted: 02/23/2022] [Indexed: 11/22/2022] Open
Abstract
In this time of COVID-19 pandemic, the strategies for prevention of the infection are a primary concern. Looking more globally on the subject and acknowledging the high degree of misuse of protective face masks from the population, we focused this review on alternative pharmaceutical developments eligible for self-defense against respiratory infections. In particular, the attention herein is directed to the nasal and oromucosal formulations intended to boost the local immunity, neutralize or mechanically "trap" the pathogens at the site of entry (nose or mouth). The current work presents a critical review of the contemporary methods of immune- and chemoprophylaxis and their suitability and applicability in topical mucosal dosage forms for SARS-CoV-2 prophylaxis.
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Affiliation(s)
- Nadezhda Ivanova
- Department of Pharmaceutical Technologies, Faculty of Pharmacy, Medical University of Varna, 55 Marin Drinov Str., 9000 Varna, Bulgaria; (Y.S.); (G.G.); (V.A.)
| | - Yoana Sotirova
- Department of Pharmaceutical Technologies, Faculty of Pharmacy, Medical University of Varna, 55 Marin Drinov Str., 9000 Varna, Bulgaria; (Y.S.); (G.G.); (V.A.)
| | - Georgi Gavrailov
- Department of Pharmaceutical Technologies, Faculty of Pharmacy, Medical University of Varna, 55 Marin Drinov Str., 9000 Varna, Bulgaria; (Y.S.); (G.G.); (V.A.)
| | - Krastena Nikolova
- Department of Physics and Biophysics, Faculty of Pharmacy, Medical University of Varna, 55 Marin Drinov Str., 9000 Varna, Bulgaria;
| | - Velichka Andonova
- Department of Pharmaceutical Technologies, Faculty of Pharmacy, Medical University of Varna, 55 Marin Drinov Str., 9000 Varna, Bulgaria; (Y.S.); (G.G.); (V.A.)
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