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Zou C, Ji H, Cui J, Qian B, Chen YC, Zhang Q, He S, Sui Y, Bai Y, Zhong Y, Zhang X, Ni T, Che Z. Preliminary study on AI-assisted diagnosis of bone remodeling in chronic maxillary sinusitis. BMC Med Imaging 2024; 24:140. [PMID: 38858631 PMCID: PMC11165780 DOI: 10.1186/s12880-024-01316-2] [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: 02/21/2023] [Accepted: 05/30/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVE To construct the deep learning convolution neural network (CNN) model and machine learning support vector machine (SVM) model of bone remodeling of chronic maxillary sinusitis (CMS) based on CT image data to improve the accuracy of image diagnosis. METHODS Maxillary sinus CT data of 1000 samples in 500 patients from January 2018 to December 2021 in our hospital was collected. The first part is the establishment and testing of chronic maxillary sinusitis detection model by 461 images. The second part is the establishment and testing of the detection model of chronic maxillary sinusitis with bone remodeling by 802 images. The sensitivity, specificity and accuracy and area under the curve (AUC) value of the test set were recorded, respectively. RESULTS Preliminary application results of CT based AI in the diagnosis of chronic maxillary sinusitis and bone remodeling. The sensitivity, specificity and accuracy of the test set of 93 samples of CMS, were 0.9796, 0.8636 and 0.9247, respectively. Simultaneously, the value of AUC was 0.94. And the sensitivity, specificity and accuracy of the test set of 161 samples of CMS with bone remodeling were 0.7353, 0.9685 and 0.9193, respectively. Simultaneously, the value of AUC was 0.89. CONCLUSION It is feasible to use artificial intelligence research methods such as deep learning and machine learning to automatically identify CMS and bone remodeling in MSCT images of paranasal sinuses, which is helpful to standardize imaging diagnosis and meet the needs of clinical application.
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Affiliation(s)
- Caiyun Zou
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China
| | - Hongbo Ji
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China
| | - Jie Cui
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China
| | - Bo Qian
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Qingxiang Zhang
- Department of Otolaryngology Head and Neck Surgery, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, PR China
| | - Shuangba He
- Department of Otolaryngology Head and Neck Surgery, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, PR China
| | - Yang Sui
- School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, PR China
| | - Yang Bai
- School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, PR China
| | - Yeming Zhong
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China
| | - Xu Zhang
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China
| | - Ting Ni
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China
| | - Zigang Che
- Department of Radiology, Nanjing Tongren Hospital, School of Medicine, Southeast University, No. 2007, Ji Yin Avenue, Jiang Ning District, Nanjing, 211102, PR China.
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Fang KM, Chiu YL, Hong RW, Cheng PC, Cheng PW, Liao LJ. The Interleukin-15 and Interleukin-8 Axis as a Novel Mechanism for Recurrent Chronic Rhinosinusitis with Nasal Polyps. Biomedicines 2024; 12:980. [PMID: 38790942 PMCID: PMC11117578 DOI: 10.3390/biomedicines12050980] [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: 04/09/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
The prevention of postoperative recurrence after endoscopic sinus surgery (ESS) relies on targeting specific pathological mechanisms according to individuals' immunological profiles. However, essential biomarkers and biological characteristics of difficult-to-treat chronic rhinosinusitis (CRS) patients are not well-defined. The aim of this study was to explore the immunologic profiles of subgroups of CRS patients and determine the specific cytokines responsible for recalcitrant or recurrent CRS with nasal polyposis (rCRSwNP). We used 30 cytokine antibody arrays to determine the key cytokines related to recurrent polypogenesis. Enzyme-linked immunosorbent assay (ELISA) experiments were conducted to assess the levels of these key cytokines in 78 patients. Polymorphonuclear leukocytes (PMNs) isolated from nasal polyps were challenged with specific cytokines to examine the levels of enhanced interleukin (IL)-8 production. Finally, we used immunohistochemistry (IHC) staining to check for the presence and distribution of the biomarkers within nasal polyps. A cytokine antibody array revealed that IL-8, IL-13, IL-15, and IL-20 were significantly higher in the recalcitrant CRSwNP group. Subsequent ELISA screening showed a stepwise increase in tissue IL-8 levels in the CHR, CRSsNP, and CRSwNP groups. PMNs isolated from nine CRSwNP cases all demonstrated enhanced IL-8 production after IL-15 treatment. IHC staining was labeled concurrent IL-8 and IL-15 expression in areas of prominent neutrophil infiltration. Our results suggest that IL-15 within the sinonasal mucosa plays a crucial role in promoting IL-8 secretion by infiltrating PMNs in recalcitrant nasal polyps. In addition, we propose a novel therapeutic strategy targeting the anti-IL-15/IL-8 axis to treat CRS with nasal polyposis.
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Affiliation(s)
- Kai-Min Fang
- Department of Nursing, Oriental Institute of Technology, College of Healthcare and Management, New Taipei City 220, Taiwan;
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
| | - Yen-Ling Chiu
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (Y.-L.C.); (R.-W.H.)
| | - Ruo-Wei Hong
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (Y.-L.C.); (R.-W.H.)
| | - Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
- Department of Electrical Engineering, Yuan Ze University, Taoyuan 320, Taiwan
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Gokani SA, Espehana A, Pratas AC, Luke L, Sharma E, Mattock J, Gavrilovic J, Clark A, Wileman T, Philpott CM. Systematic Review of Protein Biomarkers in Adult Patients With Chronic Rhinosinusitis. Am J Rhinol Allergy 2023; 37:705-729. [PMID: 37491901 PMCID: PMC10548774 DOI: 10.1177/19458924231190568] [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] [Indexed: 07/27/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by differing inflammatory endotypes. The identification of suitable biomarkers could enable personalized approaches to treatment selection. OBJECTIVE This study aimed to identify and summarize clinical studies of biomarkers in adults with CRS in order to inform future research into CRS endotypes. METHODS We conducted systematic searches of MEDLINE and Web of Science from inception to January 30, 2022 and included all clinical studies of adult CRS patients and healthy controls measuring biomarkers using enzyme-linked immunosorbent assays or Luminex immunoassays. Outcomes included the name and tissue type of identified biomarkers and expression patterns within CRS phenotypes. Study quality was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. A narrative synthesis was performed. RESULTS We identified 78 relevant studies involving up to 9394 patients, predominantly with CRS with nasal polyposis. Studies identified 80 biomarkers from nasal tissue, 25 from nasal secretions, 14 from nasal lavage fluid, 24 from serum, and one from urine. The majority of biomarkers found to distinguish CRS phenotypes were identified in nasal tissue, especially in nasal polyps. Serum biomarkers were more commonly found to differentiate CRS from controls. The most frequently measured biomarker was IL-5, followed by IL-13 and IL-4. Serum IgE, IL-17, pentraxin-3 and nasal phospho-janus kinase 2, IL-5, IL-6, IL-17A, granulocyte-colony stimulating factor, and interferon gamma were identified as correlated with disease severity. CONCLUSION We have identified numerous potential biomarkers to differentiate a range of CRS phenotypes. Future studies should focus on the prognostic role of nasal tissue biomarkers or expand on the more limited studies of nasal secretions and nasal lavage fluid.We registered this study in PROSPERO (CRD42022302787).
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Affiliation(s)
- Shyam A. Gokani
- Norwich Medical School, University of East Anglia, Norwich, UK
- James Paget University Hospital, Gorleston, UK
| | | | - Ana C. Pratas
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Louis Luke
- James Paget University Hospital, Gorleston, UK
| | - Ekta Sharma
- University College London Hospital, London, UK
| | | | - Jelena Gavrilovic
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - Allan Clark
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom Wileman
- Norwich Medical School, University of East Anglia, Norwich, UK
- Quadram Institute Bioscience, Norwich, UK
| | - Carl M. Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- James Paget University Hospital, Gorleston, UK
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Che Z, Zhang Q, Zhao P, Lv H, Ding H, Li J, Wang H, Zhang P, Ji H, Zou C, Wang Z. Computed Tomography Evaluation of Unilateral Chronic Maxillary Sinusitis With Osteitis. EAR, NOSE & THROAT JOURNAL 2021; 102:NP237-NP244. [PMID: 33752463 DOI: 10.1177/0145561321993936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Computed tomography (CT) is the preferred noninvasive method for the evaluation of osteitis in chronic sinusitis. Some scholars believe that the bone changes associated with chronic sinusitis always show high attenuation (high density) and are positively correlated with the severity of the disease. However, sinus bone remodeling is a complex process that may cause high or low attenuation. There have been few reports on the spread of osteitis. Therefore, additional research on sinus CT is necessary. OBJECTIVE To observe bony changes in chronic maxillary sinusitis (CMS) by CT and reveal the mechanism. METHODS A retrospective study was conducted in 45 patients with unilateral CMS with bony changes in the sinus walls. The patients' clinical data and CT results were analyzed and compared between the affected and normal sides. We propose the location, involvement, attenuation, and thickness method to evaluate CMS with osteitis. RESULTS Of the 45 patients, 40 (88.9%), 2, 12, and 7 had posterior external, medial, anterior, and superior lesions, respectively. The nasal region, sphenoid bone, palatine bone, and zygomatic arch were involved in 3, 12, 8, and 18 (40%) patients, respectively. Computed tomography indicated high attenuation in 30 (75.0%) and low attenuation in 10 (25.0%) patients; 6 (15.0%) showed new bone marrow cavities. The bone thickness was significantly different between the affected and normal sides in 40 patients (P < .001), including members of both the high- and low-attenuation groups (high-attenuation group: P < .001; low-attenuation group: P < .01). However, there was no significant difference in the thickness of the affected side between the high- and low-attenuation groups (P > .05). CONCLUSIONS Chronic rhinosinusitis with bony changes may occur in the maxillary sinus walls and spread to adjacent bones. Both increased and decreased attenuation may occur in these circumstances. Analyzing the CT features of bone changes in unilateral CMS can improve the accuracy of disease diagnosis.
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Affiliation(s)
- Zigang Che
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.,Department of Radiology, Nanjing Tongren Hospital, Southeast University Medical College, Nanjing, People's Republic of China
| | - Qingxiang Zhang
- Department of Otolaryngology-Head and Neck Surgery, Nanjing Tongren Hospital, Southeast University Medical College, Nanjing, People's Republic of China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Heyu Ding
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hongbo Ji
- Department of Radiology, Nanjing Tongren Hospital, Southeast University Medical College, Nanjing, People's Republic of China
| | - Caiyun Zou
- Department of Radiology, Nanjing Tongren Hospital, Southeast University Medical College, Nanjing, People's Republic of China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
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IL-21 and IL-21-producing T cells are involved in multiple sclerosis severity and progression. Immunol Lett 2019; 216:12-20. [DOI: 10.1016/j.imlet.2019.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/27/2019] [Accepted: 09/16/2019] [Indexed: 12/14/2022]
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Lefrançois P, Chapdelaine H, Côté B, Desrosiers M. A role for auto-immunity in chronic rhinosinusitis? Lessons learned from sub-epidermal bullous disorders of the skin. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2016; 12:38. [PMID: 27499767 PMCID: PMC4975886 DOI: 10.1186/s13223-016-0141-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/13/2016] [Indexed: 12/16/2022]
Abstract
Chronic rhinosinusitis (CRS) is a frequent chronic condition, which has origins in complex interactions between genetic, immunological and microbial factors. The role of auto-immunity in CRS remains unclear, although recent studies have started to emerge in CRS patient refractory to maximal medical management. We discuss the possible auto-immunity link between CRS and other skin diseases, in particular acquired bullous dermatoses, and review the current evidence. We raise additional considerations for auto-immunity from both research and clinical standpoints.
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Affiliation(s)
| | - Hugo Chapdelaine
- Centre Hospitalier de l’Université de Montréal (CHUM), Université de Montréal, Montreal, QC Canada
| | - Benoît Côté
- Centre Hospitalier de l’Université de Montréal (CHUM), Université de Montréal, Montreal, QC Canada
| | - Martin Desrosiers
- Centre Hospitalier de l’Université de Montréal (CHUM), Université de Montréal, Montreal, QC Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Université de Montréal, Montreal, QC Canada
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Abstract
Since rhinosinusitis is an inflammatory disease, cytokines as key regulators of inflammation play a central role in its pathophysiology. In acute rhinosinusitis, several proinflammatory cytokines of different types have been identified. Initial information about the involvement of the inflammasome in rhinosinusitis has been gained, but this area remains open for more detailed research. Although it has been accepted now that chronic rhinosinusitis (CRS) needs to be differentiated into CRS with and without nasal polyps, it has become clear that this distinction is insufficient to clearly define subgroups with uniform pathophysiology and cytokine patterns. While Th1-cytokines are mostly found in CRSsNP and Th2 cytokines in CRSwNP, there is a substantial overlap, and several other cytokines have also been detected. Attempts to identify CRS endotypes based on cytokines are ongoing but not yet generally accepted. Despite the central role of cytokines in rhinosinusitis, no specific cytokine-targeted therapies are currently available, and only very few studies have specifically addressed the effects of such biologicals in rhinosinusitis.
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Affiliation(s)
- Kathrin Scheckenbach
- Department of Otorhinolaryngology, Head & Neck Surgery, Heinrich Heine University, Duesseldorf, Germany.
| | - Martin Wagenmann
- Department of Otorhinolaryngology, Head & Neck Surgery, Heinrich Heine University, Duesseldorf, Germany.
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Suh JD. Editorial: Advances in the Diagnosis and Treatment of Patients with Chronic Rhinosinusitis and Allergy. Am J Rhinol Allergy 2015; 29:1-2. [DOI: 10.2500/ajra.2015.29.4158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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