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International Forum of Allergy & Rhinology

Hongfei Lou, Nan Zhang, Claus Bachert, Luo Zhang
BACKGROUND: Tissue eosinophils are characteristic of inflammation in most but not all patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and may be useful for defining subgroups and making treatment choices. However, no consistent diagnostic criteria for CRSwNP with eosinophilic inflammation have been established. METHODS: Related literature review was performed and current developments in the diagnosis of eosinophilic CRSwNP were summarized. Details in histopathology, definition of tissue eosinophilia, eosinophil as an indicator of disease recurrence, eosinophilic shift, and related biomarkers in CRSwNP are included in this review article...
October 8, 2018: International Forum of Allergy & Rhinology
Jeong-Whun Kim, Gene Huh, Chae-Seo Rhee, Chul Hee Lee, Jaebong Lee, Jin-Hang Chung, Sung-Woo Cho
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multidimensional disease. In this study, we performed an unsupervised cluster analysis of CRSwNP using routinely available clinical markers. METHODS: We conducted a retrospective review of patients treated with endoscopic sinus surgery due to medically intractable bilateral CRSwNP from 2009 to 2017. Unsupervised cluster analysis was performed using a patient's clinical features, including age, peripheral blood eosinophil, tissue eosinophilia, Lund-Mackay computed tomography (CT) scores, ratio of the CT scores for the ethmoid sinus and maxillary sinus (E/M ratio), and comorbid asthma...
October 3, 2018: International Forum of Allergy & Rhinology
Pei-Hsuan Lai, Pei-Shan Yang, Wan-Yu Lai, Cheng-Li Lin, Chung-Y Hsu, Chang-Ching Wei
BACKGROUND: Despite controversy, an association between allergy and nocturnal enuresis (NE) has been reported for almost a century. Allergic rhinitis (AR)-associated sleep-disordered breathing frequently results in microarousals during sleep, decreased sleep efficiency, and change in sleep pattern and behavior. NE is a common sleep disorder in children. Hence, this study aimed to investigate the incidence and risk of NE in children with AR. METHODS: A population-based cohort study was conducted among 327,928 children with AR and 327,601 non-AR controls between 2000 and 2012 in Taiwan...
October 3, 2018: International Forum of Allergy & Rhinology
Ke-Qing Zhao, Yi-Qun Yu, Hong-Meng Yu
BACKGROUND: Postoperative care is an important factor affecting the outcome of endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). The aim of this study was to test the effect of mometasone furoate (MF)-soaked biodegradable nasal dressings (BNDs) on endoscopic appearance in CRS patients with nasal polyps (CRSwNP) after ESS. METHODS: This study was a prospective, randomized, double-blinded, placebo-controlled study. A total of 64 CRSwNP patients with bilateral ESS were enrolled and randomly given 4 mL or 8 mL of MF-soaked BNDs (NasoPore) in 1 nasal cavity and the same amount of normal saline-soaked BNDs in the contralateral side...
October 3, 2018: International Forum of Allergy & Rhinology
Zhi-Chao Wang, Yin Yao, Nan Wang, Jin-Xin Liu, Jin Ma, Cai-Ling Chen, Yi-Ke Deng, Meng-Chen Wang, Yang Liu, Xin-Hao Zhang, Zheng Liu
BACKGROUND: M2 macrophages are characterized by high interleukin-10 (IL-10) expression and are critical for resolving inflammation. Although increased accumulation of M2 macrophages has been demonstrated in chronic rhinosinusitis with nasal polyps (CRSwNP), particularly the eosinophilic type, their functional relevance in CRSwNP remains poorly understood. METHODS: M1 and M2 macrophages and IL-10 expression in sinonasal tissues were detected by double-immunofluorescence staining...
October 3, 2018: International Forum of Allergy & Rhinology
Thorsten Send, Mattis Bertlich, Fritz Horlbeck, Darius Schafigh, Saskia Freytag, Klaus W Eichhorn, Ingo Gräff, Friedrich Bootz, Mark Jakob
BACKGROUND: Epistaxis is one of the more common reasons for emergency room visits. The main risk factor for epistaxis is anticoagulant therapy. Until recently, the main culprit was oral intake of a vitamin K antagonist, such as warfarin, which has a number of side effects. Even more recently, several direct oral anticoagulants, rivaroxaban and dabigatran, have been approved for use. We investigated the possible differences between treatment of epistaxis with direct oral anticoagulants and vitamin K antagonists...
October 3, 2018: International Forum of Allergy & Rhinology
Nyall R London, Anuj Tharakan, Michelle Mendiola, Thomas E Sussan, Mengfei Chen, Alex Dobzanski, Andrew P Lane, Venkataramana Sidhaye, Shyam Biswal, Murugappan Ramanathan
BACKGROUND: Oxidative stress exacerbates lower airway diseases including asthma and chronic obstructive pulmonary disease (COPD); however, its role in upper airway (sinonasal) chronic inflammatory disorders is less clear. Nuclear erythroid 2 p45-related factor (Nrf2) is an endogenous mechanism that upon activation invokes an antioxidant response pathway via nuclear translocation and upregulation of cytoprotective genes. We sought to determine whether deletion of Nrf2 enhances susceptibility to allergic sinonasal inflammation in vivo...
October 3, 2018: International Forum of Allergy & Rhinology
Jeremiah A Alt, Vijay R Ramakrishnan, Michael P Platt, Rodney J Schlosser, Tina Storck, Zachary M Soler
BACKGROUND: Earlier studies have suggested that patients with chronic rhinosinusitis (CRS) report worse sleep quality than population norms. What remains unknown is whether these patients are actually experiencing measurable changes in objective sleep parameters. The goal of this study was to prospectively evaluate objective sleep measures in a cohort of patients with CRS. METHODS: A prospective, multi-institutional, case-control study was designed to compare patients with CRS to nondiseased controls...
October 3, 2018: International Forum of Allergy & Rhinology
Dawei Wu, Stacey T Gray, Eric H Holbrook, Nicolas Y BuSaba, Benjamin S Bleier
BACKGROUND: Differentiating the non-sinogenic headache from chronic rhinosinusitis (CRS) remains a significant clinical challenge due to the extensive overlap in symptoms. The objective of this study was to evaluate the 22-item Sino-Nasal Outcome Test (SNOT-22) score patterns in patients with confirmed non-sinogenic headache in order to develop negative predictors of CRS. METHODS: Institutional Review Board (IRB)-approved, retrospective review of patients diagnosed with CRS or non-sinogenic headache defined as patients with a chief complaint of headache, facial pain, and facial pressure in the absence of both endoscopic and computed tomography (CT) evidence of inflammation...
October 3, 2018: International Forum of Allergy & Rhinology
Yun-Fang An, Yong-Jin Wu, Xian-Hai Zeng, Li-Juan Song, Fei Ma, Wen-Jing Liao, Zhi-Qiang Liu, Gui Yang, Xiao-Wen Zhang, Zhi-Gang Liu, Chang-Qing Zhao, Ping-Chang Yang
BACKGROUND: T-helper 2 (Th2) polarization plays a critical role in the pathogenesis of chronic rhinosinusitis (CRS) with accompanying nasal allergy. Recent studies indicate that B cell lymphoma-2-like protein-12 (Bcl2L12) is associated with immune dysregulation. The purpose of this study was to elucidate the role of Bcl2L12 in the pathogenesis of Th2 polarization of CRS patients. METHODS: CRS patients with nasal allergy (CRSa) and without nasal allergy (CRSna) were recruited into this study...
October 3, 2018: International Forum of Allergy & Rhinology
Wei Sun, Jia-Wei Wei, Hang Li, Fan-Qin Wei, Jian Li, Wei-Ping Wen
BACKGROUND: Regulatory T cells (Tregs) have become promising candidates for immunotherapy in allergic rhinitis (AR). The contributing role of tolerogenic dendritic cells (tDCs) in the augmentation of Tregs in AR remains to be determined. METHODS: The properties of tDCs in expanding Tregs and their potential to ameliorate AR were evaluated in vitro and in vivo. RESULTS: Monocyte-derived tDCs stimulated with Dermatophagoides pteronyssinus allergen 1 favored the generation of activated Tregs (aTregs) and suppressed effector T-cell responses in a transforming growth factor-beta/interleukin-10 (TGF-β/IL-10)-dependent manner in vitro...
October 3, 2018: International Forum of Allergy & Rhinology
Shuangxi Liu, Na Che, Kai Fan, Feifei Xu, Mali Qin, Ruxin Zhang, Rongmin Ge, Shaoqing Yu
BACKGROUND: Endoscopic surgery and postoperative glucocorticoids may effectively control inflammation in patients with chronic rhinosinusitis (CRS). However, some patients who are insensitive to glucocorticoids have a poor prognosis. Studies have shown that the GLCCI1 polymorphism is related to sensitivity to glucocorticoids, but no study has been conducted in China to investigate the relationship between GLCCI1 polymorphisms and postoperative prognosis of CRS. METHODS: A total of 208 CRS patients received routine functional endonasal sinus surgery and then were treated with glucocorticoids...
September 26, 2018: International Forum of Allergy & Rhinology
Hannah N Kuhar, Bobby A Tajudeen, Mahboobeh Mahdavinia, Ashley Heilingoetter, Ashwin Ganti, Paolo Gattuso, Ritu Ghai, Pete S Batra
BACKGROUND: Chronic rhinosinusitis (CRS) is an inflammatory disease process with several different phenotypes. Recent data has shown that CRS phenotypes maintain distinct nasal microbiota that may predict surgical outcomes. Nasal microbiota and structured histopathologic reporting have the potential to further differentiate subtypes and provide additional insight into the pathophysiology of CRS. METHODS: Sinus swabs collected during functional endoscopic sinus surgery (FESS) were studied by polymerase chain reaction analysis of 16S ribosomal RNA...
September 21, 2018: International Forum of Allergy & Rhinology
Yi Dong, Bing Zhou, Zhenxiao Huang, Qian Huang, Shunjiu Cui, Yunchuan Li, Erzhong Fan, Ying Li, Xinyan Wang
BACKGROUND: The traditional method of evaluating bone remodeling in chronic rhinosinusitis is to measure bone thickness. The objective of this study was to determine the feasibility of measuring the computed tomography (CT) value in Hounsfield units (HU) as an method and explore whether it is superior to measuring bone thickness. METHODS: The study was a prospective animal trial. Twenty normal rabbits were included in the control group, and 60 rabbit models were inoculated with Staphylococcus aureus to induce rhinosinusitis...
September 20, 2018: International Forum of Allergy & Rhinology
Saurabh Sharma, Hilary McCrary, Erin Romero, Alexander Kim, Eugene Chang, Christopher H Le
BACKGROUND: Clear patient-physician communication is critical in improving patient compliance, outcomes, and satisfaction. However, constraints of shortened clinic visits, patient anxiety, and poor recall can cause significant barriers to effective communication. We hypothesized that the ability to view patient-physician counseling videos at home would improve health outcomes. METHODS: Patients in a tertiary rhinology clinic were enrolled into a single-blinded prospective study after obtaining institutional review board (IRB) approval and informed consent...
September 17, 2018: International Forum of Allergy & Rhinology
Ricardo Villarreal, Bozena B Wrobel, Luis F Macias-Valle, Greg E Davis, Thomas J Prihoda, Amber U Luong, K Christopher McMains, Erik K Weitzel, William C Yao, Joe Brunworth, David W Clark, Salil Nair, Constanza J Valdés, Ashleigh Halderman, David W Jang, Rahuram Sivasubramaniam, Zhipeng Zhang, Philip G Chen
BACKGROUND: Inconsistencies in the nomenclature of structures of the frontal sinus have impeded the development of a validated "reference standard" classification system that surgeons can reliably agree upon. The International Frontal Sinus Anatomy Classification (IFAC) system was developed as a consensus document, based on expert opinion, attempting to address this issue. The purposes of this study are to: establish the reliability of the IFAC as a tool for classifying cells in the frontal recess among an international group of rhinologists; and improve communication and teaching of frontal endoscopic sinus surgery (ESS)...
September 14, 2018: International Forum of Allergy & Rhinology
Ru Tang, Zhi-Peng Li, Ming-Xian Li, Da-Wei Li, Hai-Bo Ye, Kai-Ming Su, Hai Lin, Wei-Tian Zhang
BACKGROUND: The pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) has not been fully elucidated. This study sought to explore the role and mechanism of transient receptor potential canonical channel 6 (TRPC6) in the pathogenesis of CRSwNP. METHODS: Immunohistochemistry (IHC) was employed to evaluate TRPC6 immunolabeling. Real-time polymerase chain reaction (PCR) was conducted to assay TRPC6, stromal interaction molecule 1 (STIM1), and calcium release-activated calcium channel protein 1 (Orai1) messenger RNA (mRNA) levels in 70 patients with CRSwNP, including eosinophilic CRSwNP (ECRSwNP) or non-eosinophilic CRSwNP (nECRSwNP), and 28 control subjects...
September 14, 2018: International Forum of Allergy & Rhinology
Marco Aurélio Fornazieri, Rafael Goulart Araújo, João Vitor Fernandes Lima, Felipe Bays Favareto, Fábio de Rezende Pinna, Richard Louis Voegels, Richard L Doty
BACKGROUND: In this study, we employed a novel children's olfactory test in order to more accurately assess the relationship between nasopharyngeal obstruction and odor identification ability. We quantified the impact of adenoidectomy on olfactory function, established whether the influences of the operation were related to the preoperative amount of nasopharyngeal obstruction, and determined whether sex influenced the olfactory measures. METHODS: Fifty-three boys and 23 girls were administered a standardized children's olfactory test, the Pediatric Smell Wheel™, before and 45 days after adenoidectomy...
September 11, 2018: International Forum of Allergy & Rhinology
Neil N Patel, Michael A Kohanski, Ivy W Maina, Alan D Workman, De'Broski R Herbert, Noam A Cohen
Recent evidence has demonstrated an expanding role of respiratory epithelial cells in immune surveillance and modulation. Studies have been focusing on the earliest events that link epithelial injury to downstream inflammatory responses. Cytokines produced by and released from respiratory epithelial cells are among these early trigger signals. Epithelial-derived cytokines, namely thymic stromal lymphopoietin (TSLP), interleukin (IL)-25, and IL-33, have come to the forefront of recent investigations. Each of these 3 cytokines has been implicated in chronic rhinosinusitis (CRS), asthma, and atopy...
September 10, 2018: International Forum of Allergy & Rhinology
Xinhua Wang, Hongqing Zhao, Chenhui Ma, Lei Lv, Jinping Feng, Shuguang Han
BACKGROUND: Asthma is an inflammatory disease characterized by airway hyperresponsiveness. Gallic acid is a powerful anti-inflammatory agent. In this study we aimed to investigate the efficacy of gallic acid in asthma treatment and its mechanisms. METHODS: An ovalbumin-induced asthma mouse model was generated. Pro-inflammatory cell infiltration and T helper (Th2)-associated cytokine release in the bronchoalveolar lavage fluid (BALF) were analyzed to reflect the severity of asthma in mice...
September 7, 2018: International Forum of Allergy & Rhinology
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