1
|
Brescia G, Fabbris C, Calvanese L, Bandolin L, Pedruzzi B, Di Pasquale Fiasca VM, Marciani S, Mularoni F, Degli Esposti Pallotti F, Negrisolo M, Spinato G, Frigo AC, Marioni G. Blood Basophils Relevance in Chronic Rhinosinusitis with Aspirin-Exacerbated Respiratory Disease. Diagnostics (Basel) 2023; 13:diagnostics13111920. [PMID: 37296772 DOI: 10.3390/diagnostics13111920] [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: 03/28/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023] Open
Abstract
Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and intolerance to cyclooxygenase-1 inhibitors. Interest is emerging in studying the role of circulating inflammatory cells in CRSwNP pathogenesis and its course, as well as their potential use for a patient-tailored approach. By releasing IL-4, basophils play a crucial role in activating the Th2-mediated response. The main aim of this study was to, first, investigate the level of the pre-operative blood basophils' values, blood basophil/lymphocyte ratio (bBLR) and blood eosinophil-to-basophil ratio (bEBR) as predictors of recurrent polyps after endoscopic sinus surgery (ESS) in AERD patients. The secondary aim was to compare the blood basophil-related variables of the AERD series (study group) with those of a control group of 95 consecutive cases of histologically non-eosinophilic CRSwNP. The AERD group showed a higher recurrence rate than the control group (p < 0.0001). The pre-operative blood basophil count and pre-operative bEBR were higher in AERD patients than in the control group (p = 0.0364 and p = 0.0006, respectively). The results of this study support the hypothesis that polyps removal may contribute to reducing the inflammation and activation of basophils.
Collapse
Affiliation(s)
- Giuseppe Brescia
- ENT Unit, Department of Surgery, Ospedali Riuniti Padova Sud, 35043 Padova, Italy
| | - Cristoforo Fabbris
- ENT Unit, Department of Surgery, Ospedali Riuniti Padova Sud, 35043 Padova, Italy
- Department of Medicine DIMED, Padova University, 35100 Padova, Italy
| | - Leonardo Calvanese
- ENT Unit, Department of Surgery, Ospedali Riuniti Padova Sud, 35043 Padova, Italy
| | - Luigia Bandolin
- ENT Unit, Department of Surgery, Ospedali Riuniti Padova Sud, 35043 Padova, Italy
| | - Barbara Pedruzzi
- ENT Unit, Department of Surgery, Ospedali Riuniti Padova Sud, 35043 Padova, Italy
| | | | - Silvia Marciani
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University, 35100 Padova, Italy
| | - Francesca Mularoni
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University, 35100 Padova, Italy
| | | | - Michael Negrisolo
- Department of Neuroscience DNS, Padova University, 35100 Padova, Italy
| | - Giacomo Spinato
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University, 35100 Padova, Italy
| | - Anna Chiara Frigo
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, Padova University, 35100 Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, Padova University, 31100 Treviso, Italy
| |
Collapse
|
2
|
Taniguchi M, Heffler E, Olze H, White A, Côrte-Real J, Olsson P, Lazarewicz S. The Role of Omalizumab in NSAID-Exacerbated Respiratory Disease: A Narrative Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2570-2578. [PMID: 35764285 DOI: 10.1016/j.jaip.2022.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
Nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) is a condition characterized by the triad of chronic rhinosinusitis with nasal polyps, bronchial asthma, and hypersensitivity to nonsteroidal anti-inflammatory drugs. This article explores the current knowledge on the various pathological mechanism(s) of N-ERD-such as arachidonic acid metabolism, cysteinyl leukotrienes, prostaglandins, platelets, IgE, mast cells, eosinophils, basophils, and innate immune system-and the role of omalizumab in its management. The authors dive deep into the role of IgE in N-ERD and its potential as a therapeutic target. IgE plays a significant role in mediating allergic reactions, is intricately linked with mast cells, interacts with multiple immunopathological pathways involved in N-ERD, and tends to be elevated in patients with N-ERD. Multiple real-world studies, observational studies, and case series, as well as 2 phase III trials, have demonstrated the effectiveness of omalizumab in the management of N-ERD. For a disease with such a well-documented history, the pathophysiology of N-ERD and the most effective ways to manage it remain a mystery. With this background, the authors ask-is IgE a missing piece of the N-ERD puzzle, thus explaining the efficacy of omalizumab in the treatment of the disease?
Collapse
Affiliation(s)
- Masami Taniguchi
- Center for Immunology and Allergology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan; Center for Clinical Research, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Heidi Olze
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Charité Universitätsmedizin, Berlin, Germany
| | | | | | | | | |
Collapse
|
3
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the complex cellular interactions of aspirin-exacerbated respiratory disease (AERD) and how these interactions promote pathogenic mechanisms of AERD. RECENT FINDINGS In addition to characteristic changes in eicosanoid levels, recent studies have identified increases in alarmin cytokines (IL-33, thymic stromal lymphopoietin) as well as activated innate lymphoid and plasma cell populations in samples from AERD patients. SUMMARY Patients with AERD typically demonstrate high levels of proinflammatory eicosanoids including cysteinyl leukotrienes (CysLTs) and prostaglandin D2 (PGD2) and hyporesponsiveness to prostaglandin E2 (PGE2). CysLTs are released by mast cells, eosinophils, and adherent platelets and promote epithelial release of IL-33, which activates mast cells and group 2 innate lymphoid cells (ILC2s) in concert with CysLTs. TSLP induces PGD2 release from mast cells which activates and recruits eosinophils, basophils, Th2 cells, and ILC2s via CRTH2. In turn, ILC2s and other cell types produce Th2 cytokines IL-4, IL-5, and IL-13 that, along with CysLTs and PGD2, promote bronchoconstriction, eosinophilic tissue inflammation, and mucus production.
Collapse
Affiliation(s)
- Jana H. Badrani
- Department of Medicine, University of California-San Diego, La Jolla, CA
| | - Taylor A. Doherty
- Department of Medicine, University of California-San Diego, La Jolla, CA
- Veterans Affairs San Diego Health Care System, La Jolla, CA
| |
Collapse
|
4
|
Taniguchi M, Mitsui C, Hayashi H, Ono E, Kajiwara K, Mita H, Watai K, Kamide Y, Fukutomi Y, Sekiya K, Higashi N. Aspirin-exacerbated respiratory disease (AERD): Current understanding of AERD. Allergol Int 2019; 68:289-295. [PMID: 31235242 DOI: 10.1016/j.alit.2019.05.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022] Open
Abstract
The characteristics in AERD are severe adult-onset asthma, eosinophilic rhinosinusitis with nasal polyposis, and CysLT overproduction. The cause of AERD have remained unclear, however the decrease in the production of PGE2 caused by the reduction in COX-2 activity is considered to main pathological mechanism of AERD. The mast cell activation and the interaction between platelets and granulocytes are lead to the CysLT overproduction and severe eosinophilic inflammation. The ongoing activation of mast cells is important key pathogenesis in not only stable AERD but exacerbated AERD by aspirin and NSAIDs. In recent years, type 2 inflammation caused by ILC2 activation in patients with AERD have been attracting attention. Omalizumab is effective option for AERD via suppression of mast cell activation and CysLT overproduction. Dupilumab improves sinus symptoms especially in patients with AERD. In near future, anti-platelet drug, CRTH2 antagonist, and anti-TSLP antibody may be useful candidates of therapeutic options in patients with AERD.
Collapse
Affiliation(s)
- Masami Taniguchi
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan.
| | - Chihiro Mitsui
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Hiroaki Hayashi
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Emiko Ono
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Keiichi Kajiwara
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Haruhisa Mita
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Kentaro Watai
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Yosuke Kamide
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Yuma Fukutomi
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Kiyoshi Sekiya
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| | - Noritaka Higashi
- National Hospital Organization Sagamihara National Hospital, Clinical Research Center, Kanagawa, Japan
| |
Collapse
|