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Lee JY, Kim DH, Kim SW, Im YH, Park CS, Kim DH, Alkhars Z, Kim SW. Diagnostic criteria for eosinophilic chronic rhinosinusitis: Comparative analysis and novel scoring system. Int Forum Allergy Rhinol 2024. [PMID: 39039646 DOI: 10.1002/alr.23416] [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: 01/10/2024] [Revised: 06/25/2024] [Accepted: 07/05/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Accurate identification of eosinophilic chronic rhinosinusitis is essentialg because its treatment and prognosis substantially differ from other subtypes. METHODS This retrospective observational study included 640 patients who underwent endoscopic sinus surgery for chronic rhinosinusitis in a single tertiary center from January 2021 to December 2022. Receiver operating characteristic curves were generated to compare accuracy, sensitivity, specificity of the novel scoring system, and previous diagnostic criteria (Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis, European Forum for Research and Education in Allergy and Airway Diseases, European Position Paper on Rhinosinusitis and Nasal Polyps, and Sakuma et al.) for predicting eosinophilic chronic rhinosinusitis (ECRS) by tissue eosinophil count ≥70 per high power field. RESULTS Patients were randomly divided into estimation (n = 430) and validation (n = 210) groups. The area under the receiver operating characteristic curve for the novel score was 0.753 (95% confidence interval [CI], 0.670-0.835) in the estimation group, 0.729 (0.629-0.830) in the validation group, and 0.661 (0.584-0.738) in the 20-fold cross-validation with the entire dataset. CONCLUSIONS We propose a novel scoring system that incorporates three key parameters: "novel score = blood eosinophil (%) + total Lund-Mackay score of anterior ethmoid sinuses + 2 if nasal polyp present" greater than 7 can be reliably used for diagnosing ECRS. This system can facilitate decision-making processes regarding the administration of oral steroids and biologics targeting type 2 inflammation prior to surgical intervention.
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Affiliation(s)
- Jae Yoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yeon Hee Im
- Department of Otolaryngology-Head and Neck Surgery, Uijeongbu Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
| | - Chan Soon Park
- Department of Otolaryngology-Head and Neck Surgery, Saint Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea
| | - Dong Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Incheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - Zainab Alkhars
- Department of Otolaryngology-Head and Neck Surgery, Al Jabr Hospital, Ministry of Health, Al Ahsa, Saudi Arabia
| | - Soo Whan Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Wu C, Zhan X. Sleep and psychological disorders seriously affect the quality of life of chronic rhinosinusitis patients. Eur Arch Otorhinolaryngol 2024; 281:3615-3623. [PMID: 38341822 DOI: 10.1007/s00405-024-08505-3] [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: 11/15/2023] [Accepted: 01/24/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE Chronic rhinosinusitis (CRS) is a common disease that affects patients' quality of life (QoL). We aim to explore which symptoms bothered the patient most. METHODS This is a cross-sectional study of CRS patients 2 years after endoscopic sinus surgery (ESS). The main observation indicators were SNOT-22 and visual analog scale (VAS) scores. The patients were grouped according to clinical control standard of EPOS 2020. Patients' symptom scores and postoperative medication were used for analysis. RESULTS A total of 276 patients were included, among them, uncontrolled patients accounted for 23.9%, sense of taste/smell, fatigue, lacking of a good night's sleep, reduced concentration and reduced productivity were the most serious symptoms that troubled them. VAS and SNOT-22 scores were significantly different among all groups (P = 0.000), and had clinical significance for the diagnosis of clinical uncontrolled patients (both P < 0.0001). Furthermore, the duration of corticosteroids use and nasal saline irrigation in uncontrolled patients was significantly longer than that in other patients (P < 0.05). CONCLUSION There are significant differences in the QoL of CRS patients with different clinical control, sleep and psychological disorders are main symptoms that affect the QoL of CRS patients, and more targeted management of sleep/psychological issues may be needed especially for uncontrolled patients.
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Affiliation(s)
- Chan Wu
- Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Xiaojun Zhan
- Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing, 100045, China.
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3
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Tang B, Tu J, Zhang M, Zhang Z, Yu J, Shen L, Luo Q, Ye J. Diagnostic value and underlying mechanism of nasal nitric oxide in eosinophilic chronic rhinosinusitis with nasal polyps. Mol Immunol 2023; 159:1-14. [PMID: 37224640 DOI: 10.1016/j.molimm.2023.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE Nitric oxide (NO) is an important messenger molecule widely present in the human body. However, the role of nasal NO (nNO) in eosinophilic chronic rhinosinusitis with nasal polyps (Eos CRSwNP) remain unclear. This study aimed to investigate the diagnostic value and underlying mechanism of nNO in Eos CRSwNP. METHODS The medical records of 84 non-Eos CRSwNP patients, 55 Eos CRSwNP patients, and 37 control subjects were retrospectively reviewed. The diagnostic value of nNO for Eos CRSwNP was assessed. The expression of inducible nitric oxide synthase (iNOS), endothelial nitric oxide synthase (eNOS), and tight junctions (TJs) components claudin-1, occludin, and ZO-1 was detected in the nasal polyps. Primary human nasal epithelial cells (HNECs) were co-treated with eNOS inhibitor (L-NAME) or Akt inhibitor (MK-2206), interleukin (IL)-13, and dexamethasone (Dex). The level of NO and the expression of TJs and Akt/eNOS pathways were examined. RESULTS The nNO levels of the CRSwNP group were significantly lower than those of the control group. Compared with the non-Eos CRSwNP group, the Eos CRSwNP group showed higher nNO level. The combination of nNO level, eosinophilic percentage, and posterior ethmoid score had a better predictive value for Eos CRSwNP (AUC = 0.855). The expression of iNOS, eNOS, and p-eNOS was higher in the CRSwNP groups than in the control group, and p-eNOS expression was higher in the Eos CRSwNP group than in the non-Eos CRSwNP group. The expression of TJs was lower in the Eos CRSwNP group than in the non-Eos CRSwNP and control group. IL-13 decreased TJ expression in HNECs, while Dex promoted Akt and eNOS phosphorylation, NO production and TJ expression. Furthermore, these effects of Dex were inhibited by L-NAME and MK-2206 in HNECs. CONCLUSION nNO may have a high diagnostic value in Eos CRSwNP, and Akt/eNOS pathway may promote the generation of NO to protect TJs. NO may have a potentially important role in the diagnosis and treatment of Eos CRSwNP.
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Affiliation(s)
- Binxiang Tang
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Junhao Tu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China; Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Meiping Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Zhiqiang Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Jieqing Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China; Institute of Jiangxi Otorhinolaryngology Head & Neck Suegery, Nanchang, Jiangxi Province, China
| | - Li Shen
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Qing Luo
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Jing Ye
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China; Institute of Jiangxi Otorhinolaryngology Head & Neck Suegery, Nanchang, Jiangxi Province, China.
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Seah JJ, Thong M, Wang DY. The Diagnostic and Prognostic Role of Biomarkers in Chronic Rhinosinusitis. Diagnostics (Basel) 2023; 13:diagnostics13040715. [PMID: 36832203 PMCID: PMC9955000 DOI: 10.3390/diagnostics13040715] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Chronic rhinosinusitis (CRS) refers to an inflammatory disease of the sinonasal mucosa, with a significant economic burden and impact on quality of life. The diagnosis of CRS is conventionally made on careful history and physical examination, including nasoendoscopic assessment which requires technical expertise. There has been increasing interest in using biomarkers in the non-invasive diagnosis and prognostication of CRS, tailored to the disease inflammatory endotype. Potential biomarkers currently being studied can be isolated from peripheral blood, exhaled nasal gases or nasal secretions, as well as sinonasal tissue. In particular, various biomarkers have revolutionized the way in which CRS is managed, revealing new inflammatory pathways where novel therapeutic drugs are employed to curb the inflammatory process, which may be different from one patient to the next. Biomarkers that have been extensively studied in CRS, such as eosinophil count, IgE, and IL-5, have been associated with a TH2 inflammatory endotype which correlates with an eosinophilic CRSwNP phenotype that predicts a poorer prognosis, tends to recur after conventional surgical treatment, but responds to glucocorticoid treatment. Newer biomarkers that demonstrate potential, such as nasal nitric oxide, can support a diagnosis of CRS with or without nasal polyps, especially when invasive tests such as nasoendoscopy are unavailable. Other biomarkers such as periostin can be used to monitor disease course after treatment of CRS. With a personalized treatment plan, the management of CRS can be individualized, optimizing treatment efficiency and reducing adverse outcomes. As such, this review aims to compile and summarize the existing literature regarding the utility of biomarkers in CRS in terms of diagnosis and prognostication, and also makes recommendations for further studies to fill current knowledge gaps.
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Affiliation(s)
- Jun Jie Seah
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Mark Thong
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, National University Health System, Singapore 119228, Singapore
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Correspondence:
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Zielińska-Bliźniewska H, Paprocka-Zjawiona M, Merecz-Sadowska A, Zajdel R, Bliźniewska-Kowalska K, Malinowska K. Serum IL-5, POSTN and IL-33 levels in chronic rhinosinusitis with nasal polyposis correlate with clinical severity. BMC Immunol 2022; 23:33. [PMID: 35752781 PMCID: PMC9233770 DOI: 10.1186/s12865-022-00507-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a group of heterogeneous diseases characterized by epithelial inflammation and tissue eosinophilic infiltration. IL-5, POSTN, and IL-33 are important factors that act as chemoattractants for eosinophils, and a tissue-remodeling protein positively correlated with eosinophils in blood and mediators of eosinophilic infiltration. The aim of the study was to determine the expression of IL-5, POSTN and IL-33, at the gene and protein levels, in eosinophilic CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP), and to correlate this expression with clinical severity. MATERIALS AND METHODS The study included 40 CRSwNP patients and 53 CRSsNP patients and 40 control subjects. The expression of IL-5, POSTN and IL-33 mRNA was determined in sinonasal mucosal samples and in nasal polyp tissue by real-time PCR. Protein levels in the serum of CRSwNP patients were measured by ELISA. Computed tomography was evaluated according to Lund-Mackay scores, and visual analog scale scores were assessed. RESULTS NP tissue demonstrated significantly higher IL-5 and POSTN mRNA expression than the sinonasal tissue in the CRSsNP and CRSwNP groups. CRS groups demonstrated elevated IL-33 mRNA expression in comparison to controls irrespective of the presence of NP. No correlation was found between IL-5, POSTN and IL-33 mRNA expression and disease severity. CRSwNP group demonstrated significantly higher serum IL-5, POSTN and IL-33 protein levels than controls, and this corresponds to disease severity. CONCLUSION Serum IL-5, POSTN and IL-33 levels may be important markers for classification of eosinophilic CRSwNP patients, along with disease severity.
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Affiliation(s)
| | - Milena Paprocka-Zjawiona
- Department of Allergology and Respiratory Rehabilitation, Medical University of Lodz, 90-725, Lodz, Poland
| | - Anna Merecz-Sadowska
- Department of Computer Science in Economics, University of Lodz, 90-214, Lodz, Poland.
| | - Radosław Zajdel
- Department of Computer Science in Economics, University of Lodz, 90-214, Lodz, Poland
| | | | - Katarzyna Malinowska
- Department of Allergology and Respiratory Rehabilitation, Medical University of Lodz, 90-725, Lodz, Poland
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Kim DH, Kim SW, Basurrah MA, Hwang SH. Clinical and laboratory features for various criteria of eosinophilic chronic rhinosinusitis: a systematic review and meta-analysis. Clin Exp Otorhinolaryngol 2022; 15:230-246. [PMID: 35413170 PMCID: PMC9441508 DOI: 10.21053/ceo.2022.00052] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/11/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives: To evaluate the differences in clinical and laboratory features between eosinophilic chronic rhinosinusitis (ECRS) and non-ECRS and to compare the diagnostic criteria for ECRS.Methods: We compared clinical features and/or laboratory findings classified as ECRS and non-ECRS according to various diagnostic criteria (histological and clinical criteria). In addition, we analyzed studies to compare endoscopic findings, symptom scores, laboratory findings, and computed tomography (CT) findings between ECRS and non-ECRS. Results: Our search included 55 studies with 6,143 patients. As a result of comparing clinical features and/or laboratory criteria with histological criteria, there were no significant differences regarding nasal symptom scores and CT scores according to criteria. Serum eosinophil levels showed differences according to criteria, however, ECRS were higher serum eosinophil levels than non-ECRS in all criteria. In the case of olfactory dysfunction, JESREC and tissue eosinophilia (
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Vaitkus J, Vitkauskiene A, Matuseviciute V, Naudziunas A, Siupsinskiene N, Vaitkus S. Local inflammatory marker production in Lithuanian patients with chronic rhinosinusitis with nasal polyps. J Immunotoxicol 2021; 17:202-206. [PMID: 33307887 DOI: 10.1080/1547691x.2020.1850938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
There are two clinical subtypes of chronic rhinosinusitis (CRS): chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP). The aim of the study here was to determine the levels of invasive inflammatory markers in nasal mucosa samples taken from CRSwNP patients during the surgery and to identify markers that could serve as targets for potential clinical and therapeutic interventions. The study was carried out in 59 patients with proven CRSwNP and a control group consisting of 52 healthy individuals. Concentrations of the inflammatory markers of interest were determined using a LuminexR Assay multiplex kit. The data obtained indicated that levels of inflammatory cytokines interleukin (IL)-2, -4, -5, -7, -12, -17 and -22 were all significantly higher in the nasal polyps (NP) than those in the mucosa of control participants. No differences were seen between the study groups for IL -6, -10, -13, -21 and interferon (IFN)-γ. OR (Odds Ratio) analyses confirmed that elevations in mucosal levels of IL-2, -4, -5, -7, -12, -17, and -22 were likely immune markers of CRSwNP. In conclusion, the present study demonstrated that IL-2, -4, -12 and -22 may be important in the etiopathogenesis of CRSwNP; as markers, each show moderate sensitivity, but high specificity in the Lithuanian population. IL-17 had good sensitivity, but low specificity in the CRSwNP patients.
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Affiliation(s)
- Justinas Vaitkus
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilte Matuseviciute
- Medicine Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Albinas Naudziunas
- Departament of Internal Medicine, Medicine Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Saulius Vaitkus
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Lai Y, Hu L, Yang L, Hu X, Song X, Yang J, Li H, Chen K, Li H, Wang D. Interaction Between Serum/Glucocorticoid-Regulated Kinase 1 and Interleukin-6 in Chronic Rhinosinusitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:776-790. [PMID: 34486261 PMCID: PMC8419640 DOI: 10.4168/aair.2021.13.5.776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/05/2021] [Accepted: 03/15/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE Serum/glucocorticoid-regulated kinase 1 (SGK1) has recently emerged as a critical regulator of inflammatory diseases. In this study, we examined SGK1 expression and its possible pathogenic roles in chronic rhinosinusitis (CRS). METHODS Immunohistochemistry, western blotting, Bio-Plex assay, enzyme-linked immunosorbent assays, and quantitative real-time polymerase chain reaction were performed to assess protein and gene expression levels. The mRNA expression levels of SGK1 and interleukin-6 (IL-6) were extracted from a CRS database to perform correlation analysis. Stable cell lines with SGK1 overexpression (16HBE) and knockdown (A549) were constructed to investigate the interaction between SGK1 and IL-6 in vitro. RESULTS SGK1 exhibited strong cytoplasmic and nuclear staining in the epithelial layers and the lamina propria of nasal polyps (NPs) and in the mucosal tissues of CRS without nasal polyps (CRSsNP). The mRNA and protein expression levels of SGK1 and IL-6 were significantly increased in NPs and CRSsNP tissues, compared to control tissues. SGK1 phosphorylation was significantly greater in NPs than in CRSsNP tissues (P < 0.01). The mRNA levels of SGK1 and IL-6 were significantly correlated (P < 0.001, r = 0.649). Exposure to IL-6 significantly increased SGK1 expression in cultured dispersed NP cells, 16HBE cells, and A549 cells. IL-6 expression was significantly down-regulated in SGK1-overexpressing 16HBE cells (P < 0.01) and significantly up-regulated in SGK1-knockdown A549 cells (P < 0.05). Administration of GSK650394, a SGK1 inhibitor, significantly increased IL-6 self-induced mRNA expression in cultured dispersed NP cells and 16HBE cells. CONCLUSIONS The interaction between SGK1 and IL-6 may play an anti-inflammatory role in IL-6-induced inflammation in the pathogenesis of CRS.
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Affiliation(s)
- Yuting Lai
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Li Hu
- Department of Clinical Laboratory, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Lu Yang
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xianting Hu
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xiaole Song
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Jingyi Yang
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Hongbin Li
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Kun Chen
- Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huabin Li
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China.
| | - Dehui Wang
- Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China.
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Kawasumi T, Takeno S, Ishikawa C, Takahara D, Taruya T, Takemoto K, Hamamoto T, Ishino T, Ueda T. The Functional Diversity of Nitric Oxide Synthase Isoforms in Human Nose and Paranasal Sinuses: Contrasting Pathophysiological Aspects in Nasal Allergy and Chronic Rhinosinusitis. Int J Mol Sci 2021; 22:7561. [PMID: 34299181 PMCID: PMC8304068 DOI: 10.3390/ijms22147561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022] Open
Abstract
The human paranasal sinuses are the major source of intrinsic nitric oxide (NO) production in the human airway. NO plays several roles in the maintenance of physiological homeostasis and the regulation of airway inflammation through the expression of three NO synthase (NOS) isoforms. Measuring NO levels can contribute to the diagnosis and assessment of allergic rhinitis (AR) and chronic rhinosinusitis (CRS). In symptomatic AR patients, pro-inflammatory cytokines upregulate the expression of inducible NOS (iNOS) in the inferior turbinate. Excessive amounts of NO cause oxidative damage to cellular components, leading to the deposition of cytotoxic substances. CRS phenotype and endotype classifications have provided insights into modern treatment strategies. Analyses of the production of sinus NO and its metabolites revealed pathobiological diversity that can be exploited for useful biomarkers. Measuring nasal NO based on different NOS activities is a potent tool for specific interventions targeting molecular pathways underlying CRS endotype-specific inflammation. We provide a comprehensive review of the functional diversity of NOS isoforms in the human sinonasal system in relation to these two major nasal disorders' pathologies. The regulatory mechanisms of NOS expression associated with the substrate bioavailability indicate the involvement of both type 1 and type 2 immune responses.
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Affiliation(s)
| | - Sachio Takeno
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan; (T.K.); (C.I.); (D.T.); (T.T.); (K.T.); (T.H.); (T.I.); (T.U.)
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Ma M, Liu L, Jin W, Chen H, Zhou T, Tong B. Study on the effects of desloratadine citrate disodium on the postoperative complications and inflammatory response in patients with chronic sinusitis undergoing endoscopic sinus surgery. Am J Transl Res 2021; 13:1840-1846. [PMID: 33841709 PMCID: PMC8014428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the effects of desloratadine citrate disodium on the postoperative complications and inflammatory markers in patients with chronic sinusitis undergoing endoscopic sinus surgery. METHODS From June 2019 to December 2020, the patients with chronic sinusitis who received treatment in our hospital were selected and divided into the control group (CG) and experimental group (EG). In both groups, patients were given endoscopic sinus surgery. On this basis, patients were treated with desloratadine citrate disodium in the EG. The total effective rate of the operation and the incidence of complications were compared between the two groups, and the VAS scores of clinical symptoms were compared between the two groups after treatment. Meanwhile, the changes of serum TIgE, ECP and inflammatory factors were compared between the two groups, and the nasal mucociliary clearing function was compared between the two groups before and after treatment. RESULTS After treatment, the total effective rate was 94.9% in the EG, which was significantly higher than that in the CG (82.2%). The levels of serum interleukin-6 (IL-6), interleukin-8 (IL-8), high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) in the EG were significantly lower than those in the CG, and the levels of serum TIgE and ECP were also significantly lower than those in the CG. After treatment for 3 months, the mucociliary clearance rate and mucociliary clearance rate in the EG were significantly higher than those in the CG, while the saccharin clearance time was significantly shorter than that in the CG. The incidence of complications in the EG was significantly lower than that in the CG (all P < 0.05). CONCLUSION Desloratadine citrate disodium combined with endoscopic sinus surgery can improve the clinical efficacy, reduce the level of inflammatory factors and effectively reduce the incidence of complications in patients with chronic sinusitis.
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Affiliation(s)
- Ming Ma
- Department of Otolaryngology, The First Affiliated Hospital of Anhui Medical UniversityHefei 238000, Anhui Province, China
| | - Longsheng Liu
- Department of Otolaryngology, Chaohu Hospital of Anhui Medical UniversityChaohu 238000, Anhui Province, China
| | - Wei Jin
- Department of Otolaryngology, Chaohu Hospital of Anhui Medical UniversityChaohu 238000, Anhui Province, China
| | - Hong Chen
- Department of Otolaryngology, Chaohu Hospital of Anhui Medical UniversityChaohu 238000, Anhui Province, China
| | - Tao Zhou
- Department of Otolaryngology, Chaohu Hospital of Anhui Medical UniversityChaohu 238000, Anhui Province, China
| | - Busheng Tong
- Department of Otolaryngology, The First Affiliated Hospital of Anhui Medical UniversityHefei 238000, Anhui Province, China
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Fujieda S, Matsune S, Takeno S, Asako M, Takeuchi M, Fujita H, Takahashi Y, Amin N, Deniz Y, Rowe P, Mannent L. The Effect of Dupilumab on Intractable Chronic Rhinosinusitis with Nasal Polyps in Japan. Laryngoscope 2020; 131:E1770-E1777. [PMID: 33226139 PMCID: PMC8247406 DOI: 10.1002/lary.29230] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/09/2020] [Accepted: 10/21/2020] [Indexed: 12/19/2022]
Abstract
Objectives/Hypothesis Dupilumab, which blocks the shared receptor component for interleukin‐4 and interleukin‐13, reduced polyp size, sinus opacification, and symptom severity, and was well tolerated in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) in the SINUS‐52 study (NCT02898454). We assessed dupilumab in patients enrolled at Japanese centers. Methods Patients on a background of mometasone furoate nasal spray, received dupilumab 300 mg every 2 weeks (q2w) for 52 weeks (Arm A); dupilumab 300 mg q2w for 24 weeks, followed by every 4 weeks (q4w) for 28 weeks (Arm B); or placebo (Arm C). Co‐primary endpoints were week 24 nasal polyp score (NPS), nasal congestion (NC) score, and sinus Lund–Mackay CT (LMK‐CT) scores. Symptoms, sense of smell, health‐related quality of life, and safety were assessed during the 52‐week treatment period. Results Of 49 patients enrolled in Japan, 45 completed the study. Week 24 least squares (LS) mean improvement versus placebo were as follows: NPS (Arm A: −3.1, P < .0001; Arm B: −2.1, P = .0011); NC score (Arm A: −1.2, P < .0001; Arm B: −0.9, P < .0001); and LMK‐CT (Arm A: −5.1, P = .0005; Arm B: −2.8, P = .0425). The most common treatment‐emergent adverse event in dupilumab and placebo‐treated patients was nasopharyngitis. Conclusion Dupilumab provided rapid, significant, and clinically meaningful improvements for patients with CRSwNP in Japan. Dupilumab was well tolerated, and safety and efficacy were consistent with the overall study population. Level of Evidence 2 Laryngoscope, 131:E1770–E1777, 2021
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Affiliation(s)
| | - Shoji Matsune
- Nippon Medical School, Musashi Kosugi Hospital, Kanagawa, Japan
| | - Sachio Takeno
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | | | | | - Nikhil Amin
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, U.S.A
| | - Yamo Deniz
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, U.S.A
| | - Paul Rowe
- Sanofi, Bridgewater, New Jersey, U.S.A
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Ren W, Wang Z, Wang J, Wu Z, Ren Q, Yu A, Ruan Y. IL-5 overexpression attenuates aortic dissection by reducing inflammation and smooth muscle cell apoptosis. Life Sci 2019; 241:117144. [PMID: 31830482 DOI: 10.1016/j.lfs.2019.117144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/18/2019] [Accepted: 12/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND As an inflammation-related cytokine, interleukin (IL)-5 has been reported to be involved in the development of cardiovascular diseases, such as chronic heart failure and atherosclerosis. However, the role of IL-5 in acute aortic dissection (AAD) has barely been explored. METHODS Aortic tissue samples from normal donors and patients with AAD were collected, and the expression and localization of IL-5 in aortic tissue were analyzed. In addition, a mouse AAD model was established by administering angiotensin II (Ang II) to β-aminopropionitrile (BAPN)-treated mice. Morphological examinations and histopathologic analyses were performed to evaluate the effects of IL-5 overexpression on the occurrence of AAD. RESULTS IL-5 expression was significantly decreased in aorta samples from AAD patients compared to those from donors, and macrophages were the main source of IL-5. In addition, IL-5 expression was decreased in plasma and aortic tissue samples from AAD mice. IL-5 overexpression markedly attenuated the occurrence of AAD in mice and produced corresponding decreases in the inflammatory response and cell apoptosis. In cocultures of macrophages and smooth muscle cells (SMCs), IL-5 overexpression in the macrophages significantly reduced Ang II-induced SMC apoptosis. CONCLUSION IL-5 overexpression suppresses the development of AAD by reducing inflammation and SMC apoptosis. These results suggest that IL-5 is a potential therapeutic target in AAD.
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Affiliation(s)
- Wei Ren
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060,China
| | - Zhiwei Wang
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060,China.
| | - Jiahui Wang
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Zhiyong Wu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060,China
| | - Quan Ren
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Anfeng Yu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060,China
| | - Yongle Ruan
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060,China
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Zhu J, Zhang W, Shen G, Yu X, Guo J, Zhong T. Lund exhaust on hemodynamic parameters and inflammatory mediators in patients undergoing cardiac valve replacement under cardiopulmonary bypass. Exp Ther Med 2018; 16:1747-1752. [PMID: 30186397 PMCID: PMC6122371 DOI: 10.3892/etm.2018.6354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/21/2018] [Indexed: 11/07/2022] Open
Abstract
The effect of Lund exhaust technique on hemodynamics and inflammatory mediators in patients undergoing cardiac valve replacement under cardiopulmonary bypass was evaluated. A total of 60 patients with heart disease undergoing elective heart valve replacement under elective cardiopulmonary bypass were randomly divided into Lund exhaust group (group A) and control group (group B), with 30 patients in each group. Group A underwent Lund exhaust during cardiopulmonary bypass, while group B was identical to group A except for not using the Lund exhaust technique during cardiopulmonary bypass. The hemodynamic parameters at different time-points showed that the indexes of MAP, PASP, CO, CI, PCWP, CVP and SVR in T1, T2, T3 and T4 moments between group A and group B were statistically significant (p<0.05). There was no statistical significance in IL-6, IL-8, IL-10, TNF-α and TIMP-1 between group A and group B patients at the T0 moment (p>0.05). The levels of IL-6, IL-8, IL-10, TNF-α and TIMP-1 in group B patients at T1, T2, T3 and T4 moments were statistically significant compared with those in group A (p<0.05). The IL-6, IL-8, TNF-α indexes of group B patients were statistically significant at the T5 moment compared with those in group A (p<0.05). The IL-10 and TIMP-1 of two groups were not statistically significant at the T5 moment. The operating time, CPB time, aortic clamp time, intraoperative blood loss, postoperative tube time, ICU stay time, hospital stay time and pulmonary infection of patients in group A were significantly less than those in group B. In conclusion, Lund exhaust technology can significantly reduce the fluctuation of hemodynamics, decrease the expression of inflammatory factors, improve lung function, and is conducive to the rehabilitation of patients.
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Affiliation(s)
- Jihong Zhu
- Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Weimin Zhang
- Heart Center, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Guoying Shen
- Out-patient Department, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Xin Yu
- Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Jige Guo
- Heart Center, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Taidi Zhong
- Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
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Ekinci A, Özcan M. Levels of Th1 and Th2 Cytokines in Patients with Nasal Polyps. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2018. [DOI: 10.5799/jcei.433807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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