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Gelardi M, Giancaspro R, Ronca G, Quaranta VN, Daloiso A, Bocciolini C, Notargiacomo M, Lingua C, Pecoraro P, Iannuzzi L, Cassano M. Correlation between chronic rhinosinusitis with nasal polyposis (CRSwNP) severity and asthma control. Am J Otolaryngol 2023; 44:103701. [PMID: 36473259 DOI: 10.1016/j.amjoto.2022.103701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Matteo Gelardi
- Department of Otolaryngology, University of Foggia, Italy
| | | | - Gianluca Ronca
- Department of Otolaryngology, University of Foggia, Italy
| | - Vitaliano Nicola Quaranta
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University "Aldo Moro" of Bari, Bari, Italy
| | | | - Corso Bocciolini
- UOC of Otolaryngology, Hospital Maggiore of Bologna, Bologna, Italy
| | | | | | - Pietro Pecoraro
- ENT External Agreement, National Health Service, ASP 6 Palermo Sicily Region (Italy)
| | - Lucia Iannuzzi
- ENT Clinic, Department of Biomedical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
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Liu Z, Hong J, Huang X, Wu D. Olfactory cleft mucus galectin-10 predicts olfactory loss in chronic rhinosinusitis. Ann Allergy Asthma Immunol 2023; 130:317-324.e1. [PMID: 35870756 DOI: 10.1016/j.anai.2022.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/03/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Eosinophils have been reported to be involved in the pathogenesis of olfactory fluctuation in chronic rhinosinusitis (CRS). Galectin-10 is more frequently associated with type 2 inflammation and potentially a sign of intense eosinophil activation. OBJECTIVE To explore olfactory cleft mucus and olfactory mucosa galectin-10 level and its association with olfactory dysfunction (OD) in CRS. METHODS We prospectively enrolled 50 patients with CRS and 15 healthy controls. Olfactory cleft mucus and superior turbinate biopsy specimens were collected to analyze galectin-10 levels and quantify tissue eosinophils. Psychophysical olfactory testing, olfactory cleft endoscopy scale, and olfactory cleft computed tomography scores were obtained. The predictability of galectin-10 levels for OD in patients with CRS was analyzed by multivariable logistic regression analysis. RESULTS Both olfactory cleft mucus and olfactory mucosa galectin-10 levels in patients with CRS with OD were significantly higher than those in patients with CRS without OD (all P < .001). Mucus galectin-10 levels were positively correlated with tissue eosinophils (r = 0.541, P = 0.002), olfactory cleft endoscopy scale (r = 0.498, P = 0.006), and olfactory cleft computed tomography scores (r = 0.432, P = 0.019) in patients with CRS. Mucus galectin-10 levels were negatively correlated threshold, discrimination, and identification (r = -0.589, P = 0.001), olfactory threshold (r = -0.522, P = 0.003), olfactory discrimination (r = -0.488, P = 0.007), and olfactory identification (r = -0.466, P = 0.011) scores. After adjusting for patient demographics and comorbidities, mucus galectin-10 levels were significantly associated with OD in patients with CRS (odds ratio, 1.299; P = .008). Mucus galectin-10 levels greater than 8.975 ng/mL were the best predictor of OD in CRS. CONCLUSION Olfactory cleft mucus galectin-10 is highly associated with OD in CRS.
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Affiliation(s)
- Zheng Liu
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Junsheng Hong
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaoxi Huang
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Dawei Wu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, People's Republic of China.
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Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement. J Pers Med 2022; 12:jpm12050846. [PMID: 35629268 PMCID: PMC9143504 DOI: 10.3390/jpm12050846] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/18/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is a sino-nasal chronic inflammatory disease, occurring in 5–15% of the general population. CRS with nasal polyps (CRSwNP) is present in up to 30% of the CRS population. One-third of CRSwNP patients suffer from disease that is uncontrolled by current standards of care. Biologics are an emerging treatment option for patients with severe uncontrolled CRSwNP, but their positioning in the treatment algorithm is under discussion. Effective endotyping of CRSwNP patients who could benefit from biologics treatment is required, as suggested by international guidelines. Other issues affecting management include comorbidities, such as allergy, non-steroidal anti-inflammatory drug–exacerbated respiratory disease, and asthma. Therefore, the choice of treatment in CRSwNP patients depends on many factors. A multidisciplinary approach may improve CRSwNP management in patients with comorbidities, but currently there is no shared management model. We summarize the outcomes of a Delphi process involving a multidisciplinary panel of otolaryngologists, pulmonologists, and allergist-immunologists involved in the management of CRSwNP, who attempted to reach consensus on key statements relating to the diagnosis, endotyping, classification and management (including the place of biologics) of CRSwNP patients.
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Gelardi M, Bocciolini C, Notargiacomo M, Schiavetti I, Lingua C, Pecoraro P, Iannuzzi L, Quaranta VA, Giancaspro R, Ronca G, Cassano M, Ciprandi G. Chronic rhinosinusitis with nasal polyps: how to identify eligible patients for biologics in clinical practice. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:75-81. [PMID: 35292789 PMCID: PMC9058935 DOI: 10.14639/0392-100x-n1699] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/07/2021] [Indexed: 11/23/2022]
Abstract
Objective This study compared three severity measures for chronic rhinosinusitis with nasal polyps (CRSwNP). The outcome was to identify patients who are eligible for biological therapy. Methods 330 adult patients with CRSwNP were examined. Nasal polyp score (NPS), sinonasal outcome test (SNOT-22) and clinical-cytological grading (CCG) were compared. Clinical history, past surgery and asthma control test were also considered. Results Only 45 (13.6%) patients had a contextual positivity to the three severity measures. The concordance among tests was slight/fair. Patients with severe disease (all tests positive) had more impaired parameters. The mixed cytotype (OR = 4.07), nasal obstruction (OR = 10.06), post-nasal drip (OR = 1.98), embarrassment (OR = 2.53) and difficulty falling asleep (OR = 1.92) were significantly associated with severe CRSwNP. Conclusions To identify candidates for biological therapy, the contextual use of NPS, SNOT-22 and CCG is preferable. In this way, global assessment of CRSwNP, including morphology, inflammation, comorbidity, symptoms and quality of life is possible.
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Affiliation(s)
- Matteo Gelardi
- Department of Otolaryngology, University of Foggia, Italy
| | | | | | - Irene Schiavetti
- Epidemiology, Biostatistics and Committe, Department of Direction, Istituto Giannina Gaslini, Genoa, Italy
| | | | | | - Lucia Iannuzzi
- ENT Clinic, Department of Biomedical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | | | | | - Gianluca Ronca
- Department of Otolaryngology, University of Foggia, Italy
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Gelardi M, Ciprandi G, Cassano M. Nasal cytology detects biofilms. Med Pharm Rep 2021; 94:267-268. [PMID: 34013201 PMCID: PMC8118218 DOI: 10.15386/mpr-1990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/07/2021] [Accepted: 03/17/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Matteo Gelardi
- Department of Otolaryngology, University of Foggia, Foggia, Italy
| | | | - Michele Cassano
- Department of Otolaryngology, University of Foggia, Foggia, Italy
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Smell impairment in patients with chronic rhinosinusitis: a real-life study. Eur Arch Otorhinolaryngol 2021; 279:773-777. [PMID: 33942122 DOI: 10.1007/s00405-021-06848-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/22/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Chronic rhinosinusitis with nasal polyps (CRSwNP) is a frequently occurring condition involving type 2 inflammation. It has a global prevalence of approximately 4% and has a major effect on the quality of life of those affected by it. CRSwNP is a complex condition for otorhinolaryngologists to manage, since its precise pathogenic basis has not been established, treatment is challenging and the condition often recurs. It is common to find abnormalities in smelling in those with CRSwNP. MATERIALS AND METHODS This cross-sectional study enrolled patients suffering from CRS. Three groups were compared: 1812 patients with CRS, 571 with CRSwNP, and 120 with CRSwNP treated by FESS. The Sniffin' Sticks® olfactory test was used to measure olfactory function in all patients. RESULTS Olfactory dysfunction was a common symptom in patients with CRS, ranging in frequency from 56 to 74%. In patients with CRSwNP, impairment of sense of smell affected 64% of subjects (42% with anosmia, 10% with hyposmia, and 12% with cacosmia). After surgery, there was a significant improvement in the ability to smell normally. CONCLUSION The present study confirms that impairment of smell is a common symptom in patients with chronic rhinosinusitis, mainly in subjects with nasal polyps. FESS reduces the prevalence of olfactory dysfunction.
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Mullol J, Mariño F, Valls M, Alobid I, Marin C. Reply. J Allergy Clin Immunol 2020; 146:463-464. [PMID: 32593492 PMCID: PMC7314450 DOI: 10.1016/j.jaci.2020.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of Biomedical Research in Respiratory Diseases (CIBERES), Barcelona, Spain.
| | - Franklin Mariño
- Center of Biomedical Research in Respiratory Diseases (CIBERES), Barcelona, Spain; Rhinology and Skull Base Surgery Unit, ENT Department, Ramon y Cajal University Hospital, Madrid, Spain
| | - Meritxell Valls
- Center of Biomedical Research in Respiratory Diseases (CIBERES), Barcelona, Spain; Hospital Son Espases, Palma de Mallorca, Spain
| | - Isam Alobid
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of Biomedical Research in Respiratory Diseases (CIBERES), Barcelona, Spain
| | - Concepció Marin
- Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of Biomedical Research in Respiratory Diseases (CIBERES), Barcelona, Spain
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