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Abdelnaseer U, El Sayed Salem A, Shawky BH, Yousef A. Assessment of Nasal Obstruction Symptoms and Pulmonary Function Following Functional Endoscopic Sinus Surgery (FESS) in Chronic Rhinosinusitis with Nasal Polyps. Indian J Otolaryngol Head Neck Surg 2023; 75:3235-3241. [PMID: 37974679 PMCID: PMC10646092 DOI: 10.1007/s12070-023-03898-9] [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: 01/08/2023] [Accepted: 05/25/2023] [Indexed: 11/19/2023] Open
Abstract
The upper and lower airways are typically subjected to identical inflammatory stimuli and comprise a single organ that is functionally connected. 40 patients with chronic rhinosinusitis with nasal polyps who had failed medical treatment and undergone FESS participated in our study. Prior to surgery and three months after surgery, nasal obstruction symptoms were measured using the NOSE score system and pulmonary function tests were evaluated using spirometry. The mean Nose Score was 70 before surgery but dropped to 4 afterward, with a p value < 0.001 showing a statistically significant improvement in the nasal symptoms following FESS. The mean pre-operative FVC, FEV1, and FEV1/FVC% values were 3.19, 2.53, and 78.81%, respectively, while the mean post-operative values were 3.14, 2.5, and 79.01%. Following FESS, there wasn't a statistically significant change in lung function tests. Our study showed that percentage of change of total NOSE score has a statistically significant Negative correlation with percentage of change of pulmonary function tests parameters. This study demonstrates the positive effects of FESS on nasal polyposis patients' quality of life and nasal obstruction symptoms without having any negative impacts on the lower airways.
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Affiliation(s)
- Usama Abdelnaseer
- Otolaryngology Department, Kasr Al-Aini, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman El Sayed Salem
- Pulmonology Department, Kasr Al-Aini, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Bola Hosny Shawky
- Otolaryngology Department, Kasr Al-Aini, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Yousef
- Kasr Al-Aini, Faculty of Medicine, Cairo University, Cairo, Egypt
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Correa-Jimenez O, Restrepo-Gualteros S, Nino G, Cunningham-Rundles C, Sullivan KE, Fuleihan RL, Gutierrez MJ. Respiratory Comorbidities Associated with Bronchiectasis in Patients with Common Variable Immunodeficiency in the USIDNET Registry. J Clin Immunol 2023; 43:2208-2220. [PMID: 37932514 DOI: 10.1007/s10875-023-01593-6] [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: 08/05/2023] [Accepted: 09/23/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Bronchiectasis is a major respiratory complication in patients with common variable immunodeficiency (CVID) and is associated with recurrent pulmonary infections. However, it is unclear whether other infections or non-infectious respiratory conditions are related to its development. OBJECTIVE To identify respiratory comorbidities associated with bronchiectasis in patients with CVID. METHODS A total of 1470 CVID patients enrolled in the USIDNET registry were included in a cross-sectional analysis. The primary outcome of our study was to determine the clinical characteristics and other respiratory conditions associated with respiratory comorbidities and physician-reported bronchiectasis. RESULTS One hundred ninety-seven CVID patients were noted to have bronchiectasis (13.4%). Affected patients were significantly older than patients without bronchiectasis (median age 54 years vs. 49 years, p = 0.0004). These patients also had lower serum IgA (13 mg/dL IQR 60 mg/dL vs. 28.4 mg/dL IQR 66 mg/dL, p = 0.000). Notably, chronic rhinosinusitis (OR = 1.69 95%CI 1.05-2.75), sinusitis (OR = 2.06 95%CI 1.38-3.09), pneumonia (OR = 2.70 95%CI 1.88-3.88), COPD (OR = 2.66 95%CI 1.51-4.67), and interstitial lung disease (OR = 2.34 95%CI 1.41-3.91) were independently associated with the development of bronchiectasis in this population. CONCLUSION These data suggest that lower and upper respiratory infections, chronic lower airway disease, and interstitial lung diseases are independently associated with bronchiectasis in CVID patients. Further study into predisposing conditions related to the development of bronchiectasis in CVID patients may allow prediction and early intervention strategies to prevent the development of this complication.
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Affiliation(s)
- Oscar Correa-Jimenez
- Allergy and Immunology Unit, Fundación Neumológica Colombiana, Bogotá, D.C., Colombia
| | - Sonia Restrepo-Gualteros
- Department of Pediatrics, Universidad Nacional de Colombia School of Medicine, Bogotá, D.C., Colombia
| | - Gustavo Nino
- Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
| | - Charlotte Cunningham-Rundles
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kathleen E Sullivan
- Division of Pediatric Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ramsay L Fuleihan
- Division of Allergy & Immunology, Columbia University Irving Medical Center, New York, NY, USA
| | - Maria J Gutierrez
- Division of Pediatric Allergy, Immunology and Rheumatology, Johns Hopkins University, 600 N. Wolfe St, CMSC 1102, Baltimore, MD, 21287, USA.
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Sobh E, Elhussieny F, Ismail T. Elimination of nasal obstruction improves pulmonary functions and oxygenation. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2021. [DOI: 10.1186/s43168-021-00079-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nasal obstruction is a significant medical problem. This study aimed to examine the effect of nasal obstruction and nasal packing on arterial blood gases and pulmonary function indices, and the impact of the elimination of nasal obstruction on preoperative values.
Results
The mean age of the study population was 26.6 ± 10.1 years, males represented 50.8%. Spirometric indices showed statistically significant improvement (preoperative forced expiratory volume in 1st second 66.9 ± 13.9 vs 79.6 ± 14.9 postoperative and preoperative forced vital capacity 65.5 ± 12.7 vs 80.4 ± 13.8 postoperative). Oxygen saturation was significantly lower during nasal packing (95.6 ± 1.6 preoperative vs 94.7 ± 2.8 with nasal pack), and significant improvement (97.2 ± 1.4) was observed after removal of the nasal pack. Nasal obstruction scores significantly improved.
Conclusion
The results of this study indicate that either simple nasal obstruction or nasal packing may cause hypoxemia and abnormalities in lung function tests. Hypoxemia was more evident with nasal packing.
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Tai Li Min E, Abdullah B. Nasal Polyps and Chronic Obstructive Pulmonary Disease-An Oft Overlooked Association. EAR, NOSE & THROAT JOURNAL 2020; 99:NP103-NP104. [PMID: 31184208 DOI: 10.1177/0145561319856576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Evelyn Tai Li Min
- Department of Ophthalmology, School of Medical Sciences, 65271Universiti Sains Malaysia, Kelantan, Malaysia
| | - Baharudin Abdullah
- Department of Otorhinolaryngology, School of Medical Sciences, 65271Universiti Sains Malaysia, Kelantan, Malaysia
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Majima S, Wakahara K, Nishio T, Nishio N, Teranishi M, Iwano S, Hirakawa A, Hashimoto N, Sone M, Hasegawa Y. Bronchial wall thickening is associated with severity of chronic rhinosinusitis. Respir Med 2020; 170:106024. [PMID: 32843166 DOI: 10.1016/j.rmed.2020.106024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Though the relationship between chronic rhinosinusitis (CRS) and lower airway diseases is well recognized, the impact of CRS on bronchial wall structure has not been elucidated. Here, we evaluated the bronchial wall structure of CRS patients with or without diagnosed airway diseases by three-dimensional computed tomography (3D-CT). METHODS Subjects who underwent both chest CT and sinus CT within a year were recruited from consecutive medical records. CRS was defined as a Lund-Mackay score (LMS) of over 5 points. Airway dimensions were measured using validated software. Standard blood tests and pulmonary function tests were performed, and their correlation with airway thickness was examined. RESULTS One-hundred-seventy-two patients were recruited (93 CRS subjects and 79 non-CRS subjects). The bronchial walls of CRS subjects were significantly thicker than those of non-CRS subjects. CRS and asthma were related to bronchial wall thickening by multivariate linear regression analysis adjusted for age, smoking status, and chest symptoms. In addition, LMS was significantly correlated with bronchial wall thickening. CONCLUSION Airway walls in CRS subjects were thicker than those in non-CRS subjects and associated with the severity of CRS. These data indicate strong relationship between upper and lower airways regardless of chest symptoms or diagnosed airway diseases.
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Affiliation(s)
- Suguru Majima
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keiko Wakahara
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Tomoko Nishio
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Teranishi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shingo Iwano
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihiro Hirakawa
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Naozumi Hashimoto
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinori Hasegawa
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Gudiseva A, Ramaswamy B, Singh R, Dalakoti P. Comparative Study of Nasal Symptoms and Pulmonary Function Tests Post FESS in Ethmoidal Polyposis. Indian J Otolaryngol Head Neck Surg 2019; 71:2000-2003. [PMID: 31763283 DOI: 10.1007/s12070-018-1422-4] [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: 05/06/2018] [Accepted: 06/04/2018] [Indexed: 11/28/2022] Open
Abstract
The objective of this study were to assess the pulmonary function in patients with ethmoidal polyposis who did not respond to medical treatment; to evaluate the effect of Functional Endoscopic Sinus Surgery on the lung function of these patients and to compare the total nasal symptom score in these patients. A prospective observational study was conducted in Department of ENT, KMC Manipal on 50 subjects with ethmoidal polyposis who were unresponsive to medical treatment and hence underwent FESS. Pulmonary function tests were assessed using spirometry and nasal symptoms were scored as per TNSS system prior to surgery and 3 months post-surgery and compared with the pre-operative values and analysed. Pre operatively majority (35 patients) had TNSS value of 6-9 whereas post operatively the score was reduced to 2-3 in many patients (38 patients). The mean TNSS was 7.24 before surgery which declined to 2.82 after surgery with a p value < 0.0001 indicating a statistically significant improvement in the nasal symptoms post FESS. The mean pre-operative FVC, FEV1, MEFR were 2.94, 2.41 and 2.51 L respectively whereas the mean post-operative values were 2.95, 2.39 and 2.49 L respectively. There was no statistically significant change in lung function tests following FESS. Our study shows that FESS benefits patients with nasal polyposis by improving the symptoms and there by the quality of life without any adverse effects on the lower airways.
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Affiliation(s)
- Amrutha Gudiseva
- Department of Otolaryngology - Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Balakrishnan Ramaswamy
- Department of Otolaryngology - Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Rohit Singh
- Department of Otolaryngology - Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Pooja Dalakoti
- Department of Otolaryngology - Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
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Yıldırım M, Belli S, Ozyilmaz C, Ogurlu O. The Effect Of Functional Endoscopic Sinus Surgery On Lung Function In Patients With Chronic Sinusitis And Nasal Polyps Without Asthma. ENT UPDATES 2018. [DOI: 10.32448/entupdates.459007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Yousof AM, Awada OG, Abdel Fattah MT, Ahmada SF. Pulmonary function tests in patients with chronic rhinosinusitis and the effect of surgery. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2017. [DOI: 10.4103/ejb.ejb_91_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Kishimoto K, Kobayashi R, Hori D, Sano H, Suzuki D, Yasuda K, Kobayashi K. Pretransplant paranasal sinus disease is associated with a high incidence of transplant-related mortality in hematopoietic stem cell transplantation for children and adolescents. Pediatr Transplant 2016; 20:1111-1116. [PMID: 27748554 DOI: 10.1111/petr.12793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/11/2022]
Abstract
To determine whether pretransplant PSD affects the clinical outcomes in HSCT, a retrospective cohort analysis of 73 pediatric and adolescent patients who underwent HSCT was performed. Pretransplant PSD was defined as the presence of a fluid level or mucosal swelling or total opacity on sinus X-ray or CT examination performed before HSCT. Pretransplant PSD was observed in 21 (29%) patients. The probability of 2-year OS after HSCT was 42% in patients with pretransplant PSD (PSD group), and 64% in those without (non-PSD group) (P=.012). The cumulative incidence of 2-year TRM was 48% in the PSD group, and 17% in the non-PSD group (P=.005). The cumulative incidences of pulmonary complications and respiratory failure at 2 years after HSCT were significantly higher in the PSD group (41% vs 15%, P=.022; 44% vs 14%, P=.009, respectively). PSD at the time of HSCT should be recognized as an additional potential risk factor for mortality. Further investigation is required to clarify the reasons for the present findings to improve the outcomes of patients with pretransplant PSD.
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Affiliation(s)
- Kenji Kishimoto
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Daiki Hori
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Hirozumi Sano
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Daisuke Suzuki
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Kazue Yasuda
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Kunihiko Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
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Zhang L, Zhang L, Zhang CH, Fang XB, Huang ZX, Shi QY, Wu LP, Wu P, Wang ZZ, Liao ZS. The Lung Function Impairment in Non-Atopic Patients With Chronic Rhinosinusitis and Its Correlation Analysis. Clin Exp Otorhinolaryngol 2016; 9:339-345. [PMID: 27604625 PMCID: PMC5115140 DOI: 10.21053/ceo.2015.01641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/08/2015] [Accepted: 01/09/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives Chronic rhinosinusitis (CRS) is common disease in otorhinolaryngology and will lead to lower airway abnormality. However, the only lung function in CRS patients and associated factors have not been much studied. Methods One hundred patients with CRS with nasal polyps (CRSwNP group), 40 patients with CRS without nasal polyps (CRSsNP group), and 100 patients without CRS were enrolled. The difference in lung function was compared. Meanwhile, CRSwNP and CRSsNP group were required to undergo a bronchial provocation or dilation test. Additionally, subjective and objective outcomes were measured by the visual analogue scale (VAS), 20-item Sino-Nasal Outcome Test (SNOT-20), Lund-Mackay score, Lund-Kennedy endoscopic score. The correlation and regression methods were used to analyze the relationship between their lung function and the above parameters. Results The forced expiratory volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75) of CRSwNP group were significantly lower than other groups (P<0.05). On peak expiratory flow, there was no difference between three groups. In CRSwNP group, FEV1 was negatively correlated with peripheral blood eosinophil count (PBEC) and duration of disease (r=–0.348, P=0.013 and r=–0.344, P=0.014, respectively), FEF25-75 negatively with VAS, SNOT-20 (r=–0.490, P=0.028 and r=–0.478, P=0.033, respectively) in CRSsNP group. The incidence of positive bronchial provocation and dilation test was lower in CRSwNP group (10% and 0%, respectively), with both 0% in CRSsNP group. The multiple linear regression analysis indicated that change ratio of FEV1 before and after bronchial provocation or dilation test were correlated with PBEC in CRSwNP group (β=0.403, P=0.006). Conclusion CRS leading to impaired maximum ventilation and small airway is associated with the existence of nasal polyp. Lung function impairments can be reflected by PBEC, duration, VAS, and SNOT-20. In CRSwNP patients, PBEC is independent predictor of FEV1 change ratio.
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Affiliation(s)
- Linghao Zhang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lu Zhang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chun-Hong Zhang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao-Bi Fang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhen-Xiao Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, Beijing, China
| | - Qing-Yuan Shi
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li-Ping Wu
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peng Wu
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhen-Zhen Wang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhi-Su Liao
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Tint D, Kubala S, Toskala E. Risk Factors and Comorbidities in Chronic Rhinosinusitis. Curr Allergy Asthma Rep 2016; 16:16. [PMID: 26800681 DOI: 10.1007/s11882-015-0589-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Chronic rhinosinusitis (CRS) is a heterogeneous disorder that creates a significant burden on the healthcare system. It is caused by a combination of inflammatory, environmental, and host factors; however, the precise mechanism of how each factor leads to CRS continues to be a source of debate. Previous data regarding this topic is often inconsistent or of lower quality. In this article, we review the recent literature on the risk factors and comorbidities in CRS. Large population-based studies have helped establish smoking as a significant risk factor for CRS. The focus has now shifted towards smoking and its effect on long-term outcomes after endoscopic sinus surgery (ESS). Ciliary dyskinesia, both primary and secondary, can affect both the sinonasal cavity and lower airways simultaneously by decreasing the beat frequency of cilia and inducing mucostasis. The effects of secondary dyskinesia may be reversible and there is some evidence to suggest the use of topical mucolytics in patients with CRS. Allergy and variants of sinonasal anatomy have been hypothesized to increase the risk of developing CRS by inducing chronic inflammation and obstructing the sinus ostia. Nevertheless, emerging data regarding these topics continue to produce inconclusive results. Inflammation of the upper and lower airways can occur simultaneously as seen in patients with asthma and aspirin sensitivity. The connection between these pro-inflammatory disease states has been known for many years. Newer evidence include large population-based studies and studies that correlate objective tests, such as computer tomography scans to pulmonary function tests. However, the treatment of CRS and its effects on obstructive airway disease continues to be a topic of debate. More large prospective studies are needed in order to continue refining our knowledge of the disease processes in CRS.
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Affiliation(s)
- Derrick Tint
- Temple Head & Neck Institute, 3440 N. Broad Street, Kresge West 3rd Floor, Philadelphia, PA, 19140, USA
| | - Stephanie Kubala
- Lewis Katz School of Medicine at Temple University, 3500 N. Broad Street, Philadelphia, PA, 19140, USA
| | - Elina Toskala
- Temple Head & Neck Institute, 3440 N. Broad Street, Kresge West 3rd Floor, Philadelphia, PA, 19140, USA.
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Kim DY, Cho SH, Takabayashi T, Schleimer RP. Chronic Rhinosinusitis and the Coagulation System. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 7:421-30. [PMID: 26122502 PMCID: PMC4509654 DOI: 10.4168/aair.2015.7.5.421] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/02/2015] [Indexed: 12/16/2022]
Abstract
Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in adults and severely affects quality of life in patients. Although various etiologic and pathogenic mechanisms of CRS have been proposed, the causes of CRS remain uncertain. Abnormalities in the coagulation cascade may play an etiologic role in many diseases, such as asthma and other inflammatory conditions. While studies on the relationship between asthma and dysregulated coagulation have been reported, the role of the coagulation system in the pathogenesis of CRS has only been considered following recent reports. Excessive fibrin deposition is seen in nasal polyp (NP) tissue from patients with chronic rhinosinusitis with nasal polyp (CRSwNP) and is associated with activation of thrombin, reduction of tissue plasminogen activator (t-PA) and upregulation of coagulation factor XIII-A (FXIII-A), all events that can contribute to fibrin deposition and crosslinking. These findings were reproduced in a murine model of NP that was recently established. Elucidation of the mechanisms of fibrin deposition may enhance our understanding of tissue remodeling in the pathophysiology of NP and provide new targets for the treatment of CRSwNP.
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Affiliation(s)
- Dong Young Kim
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seong H Cho
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Division of Rheumatology, Department of Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Tetsuji Takabayashi
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Robert P Schleimer
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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