scholarly journals Different effects of allergic rhinitis on nasal mucosa remodeling in chronic rhinosinusitis with and without nasal polyps

2018 ◽  
Vol 276 (1) ◽  
pp. 115-130 ◽  
Author(s):  
Rong Xiang ◽  
Qing-ping Zhang ◽  
Wei Zhang ◽  
Yong-gang Kong ◽  
Lu Tan ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Mucosa ◽  
Nasal Polyps

Overexpression of the Superoxide Anion and NADPH Oxidase Isoforms 1 and 4 (NOX1 and NOX4) in Allergic Nasal Mucosa

2009 ◽  
Vol 23 (4) ◽  
pp. 370-376 ◽  
Author(s):  
Joon Hwan Moon ◽  
Tae Hoon Kim ◽  
Heung Man Lee ◽  
Seung Hoon Lee ◽  
Whan Choe ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Allergic Rhinitis ◽  
Nadph Oxidase ◽  
Nasal Mucosa ◽  
Vascular Endothelium ◽  
Superoxide Anion ◽  
Nasal Polyps ◽  
Inflammatory Cells ◽  
Submucosal Glands ◽  
Cellular Source

Background The purpose of this study was to investigate the expression and distribution of superoxide anion, NADPH oxidase (NOX)1, and NOX4 in healthy, allergic nasal mucosa and nasal polyps to evaluate the possible influence of oxidative stress on the development of allergic rhinitis and nasal polyps. Methods The expression and distribution of superoxide anion, NOX1 and NOX4 were evaluated in healthy and allergic nasal mucosa and nasal polyps, using dihydroethidium fluorescence, semiquantitative reverse transcriptase-polymerase chain reaction, immunohistochemistry, and Western blot. Results NOX1 and NOX4 were localized mainly in the epithelial layer, submucosal glands, vascular endothelium, and inflammatory cells in healthy and allergic nasal mucosa and nasal polyps. The cellular source that generated superoxide anion is also localized in the epithelial cells, submucosal glands, vascular endothelium, and inflammatory cells, demonstrating the similar sites of expression of NOX1 and NOX4 in healthy and allergic nasal mucosa and nasal polyps. NOX1 and NOX4 mRNA and proteins and superoxide anions had increased levels of expression in allergic nasal mucosa and nasal polyps compared with healthy nasal mucosa. Conclusions These results indicate that NOX1 and NOX4 may play an important role in reactive oxygen species production, contributing to the oxidative stress in allergic rhinitis and nasal polyp tissues.

scholarly journals Expression of Matrix Metalloproteinases and Their Tissue Inhibitors in Chronic Rhinosinusitis With Nasal Polyps: Etiopathogenesis and Recurrence

2020 ◽  
pp. 014556131989663
Author(s):  
Germano Guerra ◽  
Domenico Testa ◽  
Francesco Antonio Salzano ◽  
Domenico Tafuri ◽  
Eleonora Hay ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Matrix Metalloproteinases ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Polymerase Chain Reaction Analysis ◽  
Sinus Surgery ◽  
Control Group ◽  
Nonallergic Rhinitis ◽  
Tissue Inhibitors ◽  
Immunologic Diseases

Chronic rhinosinusitis with nasal polyps is a multifactorial disease of the nasal and paranasal sinus mucosa and it includes, as comorbidities, anatomic and morphologic alterations, allergic rhinitis, and immunologic diseases. We investigated matrix metalloproteinases (MMP-2, MMP-7, and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2) concentration in different etiopathogenetical groups of patients with nasal polyposis (NP) in relation to recurrence after sinonasal surgery. The study group consisted of 45 patients with NP (those with allergic rhinitis, nonallergic rhinitis and asthma or nonallergic rhinitis, and obstruction of osteomeatal complex [OMC]) who underwent endonasal sinus surgery. We also collected 10 patients who underwent septoplasty as control. Immunohistochemistry of nasal mucosa fragments, Western blotting, and polymerase chain reaction analysis showed increased MMPs levels (MMP-9 more than MMP-2 and MMP-7) and decreased tissue inhibitors of MMPs levels (TIMP-1 less than TIMP-2), in patients with chronic rhinosinusitis with nasal polyps compared with control group, in particular in patients with nonallergic rhinitis and asthma compared to those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC. We observed a higher risk of recurrence in patients with nonallergic rhinitis and asthma than in those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC after 36 months from surgery. In this research, we evaluated pathogenesis of NP related to MMPs and their inhibitors concentrations in polypoid tissue.

scholarly journals Association of chronic rhinosinusitis with nasal polyps and asthma: Clinical and radiological features, allergy and inflammation markers

Medicina ◽  
2008 ◽  
Vol 44 (4) ◽  
pp. 257 ◽  
Author(s):  
Jūratė Staikūnienė ◽  
Saulius Vaitkus ◽  
Lidija Japertienė ◽  
Silvija Ryškienė
Keyword(s):  
Allergic Rhinitis ◽  
Pulmonary Function ◽  
Chronic Rhinosinusitis ◽  
Systemic Inflammation ◽  
Eosinophil Count ◽  
Nasal Polyps ◽  
Older Age ◽  
Bronchial Obstruction ◽  
Inflammation Markers ◽  
Nasal Symptoms

Chronic rhinosinusitis (CRS) with and without nasal polyps represent different stages of one chronic inflammatory disease of the mucosa of the nasal cavity and paranasal sinuses. Coexistence of chronic rhinosinusitis with nasal polyps and asthma and rather similar characteristics of inflammation support assumption that chronic rhinosinusitis and nasal polyps and asthma may be, at least in part, the same disease process. We therefore aimed to evaluate the differences of sinus radiologic findings, systemic inflammation and allergy markers, pulmonary function of chronic rhinosinusitis associated with nasal polyps and asthma. A total of 121 patients with chronic rhinosinusitis referred to tertiary center were evaluated; 23 healthy persons served as controls. Sinus CT scans and nasal endoscopy were performed. Allergic rhinitis was diagnosed according to history and positive skin prick tests to common inhalant allergens. Asthma was diagnosed according to GINA by history and pulmonary function tests. Aspirin intolerance was assessed by history. Total IgE, Aspergillus fumigatus-specific IgE levels, leukocyte and eosinophil count in the peripheral blood were measured. Nasal polyps were detected in 84 patients (69.4%), asthma diagnosed in 48 patients (39.6%), associated with nasal polyps (91.7%) and allergic rhinitis in 45.5% of patients. Forty-four patients with chronic rhinosinusitis and having nasal polyps and asthma were characterized by older age (P<0.01), greater duration of nasal symptoms (P<0.001), higher number previous surgeries (P<0.01), more severe sinus disease on CT scan (P<0.001), greater blood leukocyte and eosinophil count, total IgE level (P<0.01), bronchial obstruction (P<0.05), incidence of allergic rhinitis (P<0.01), and sensitivity to house dust mite D. pteronyssinus (47.7%, P<0.01) and mold allergens (29.5%, P<0.01) comparing to the patients with isolated chronic rhinosinusitis. The extent of sinus CT changes was greater in asthmatics and correlated with greater duration of asthma (P<0.0001), higher number of previous surgeries (P=0.001), leukocyte count in blood (P=0.025), and age (P=0.039). Conclusion. Our data indicate that patients with chronic rhinosinusitis compose clinically heterogeneous group and when associated with nasal polyps and asthma constitutes the most severe form of unified respiratory tract disease, which is characterized by older age of the patients, greater duration of nasal symptoms, extent of sinus radiological changes, more prominent systemic inflammation markers, greater bronchial obstruction, incidence of perennial allergic rhinitis

Mast cell stabilizers

1992 ◽  
Vol 107 (6_part_2) ◽  
pp. 841-844 ◽  
Author(s):  
Hueston C. King
Keyword(s):  
Allergic Rhinitis ◽  
Mast Cell ◽  
Cell Membrane ◽  
Nasal Mucosa ◽  
Nasal Polyps ◽  
Nasal Congestion ◽  
Correct Diagnosis ◽  
Vasomotor Rhinitis ◽  
Ige Mediated ◽  
Exercise Induced

The precise mode of action of the well-studied cromolyn sodium and the newer nedocromil sodium has not been completely elucidated. Because the drugs do not pass the cell membrane and enter the cell, they are virtually not metabolized, do not exert a systemic action, and therefore are associated with only minimal systemic toxicity. To be effective either drug must be applied topically and directly to the nasal mucosa. Proper contact with the nasal mucosa is essential for efficacy; in patients with nasal congestion and secretions, vasoconstrictors or saline lavages are indicated before cromolyn or nedocromil use. Both products are highly effective in patients who have IgE-mediated allergic rhinitis but must be administered prophylactically before exposure to an allergen to prevent development of the allergic event. Neither drug is effective in vasomotor rhinitis, exercise-induced rhinitis, or in the management of nasal polyps. Correct diagnosis is essential before therapy.

Experience of the center for diagnosis and treatment of chronic rhinosinusitis with nasal polyps

2020 ◽  
Vol 19 (6) ◽  
pp. 8-15
Author(s):  
V. I. Egorov ◽  
◽  
O. M. Kurbacheva ◽  
E. L. Savlevich ◽  
K. N. Shachnev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Study Data ◽  
Diagnosis And Treatment ◽  
Dynamic Monitoring ◽  
Surgical Interventions ◽  
Regional Center

Polypous rhinosinusitis (PRS) ranks as one of the most important chronic inflammatory ENT diseases that significantly impair the quality of life. Today, it is known that chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial heterogeneous disease characterized by chronic inflammation of the mucosa of the nasal cavity and paranasal sinuses, leading to the growth of polyps. The interrelation of CRSwNP, atopy and bronchial asthma (BA), their pathogenetic mechanisms, as well as the effect on the severity of the course and the frequency of each other’s relapses, are the subject of study. Data on the role of allergy in CRSwNP are controversial, while the relationship between PRS and BA is not in doubt. Patients suffering from CRSwNP and BA and / or allergic rhinitis (AR) require dynamic monitoring and regular correction of treatment not only by an otorhinolaryngologist, but also by an allergist-immunologist. To this end, since 2016, in Vladimirsky Moscow Regional Research Clinical Institute the Moscow Regional Center for Diagnosis and Treatment of Polypous Rhinosinusitis and Allergic Rhinitis was established, which monitored and treated patients with ARS and comorbid diseases from various medical institutions of the Moscow region. By using a multidisciplinary approach during our work from 2016 to 2020, we managed to achieve a stable remission in most patients, significantly improve their quality of life and reduce the number of surgical interventions.

Intranasal steroid therapy – EPOS 2020

2020 ◽  
Vol 74 (3) ◽  
pp. 41-49
Author(s):  
Piotr Rot ◽  
Piotr Rapiejko ◽  
Dariusz Jurkiewicz
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Over The Counter ◽  
Acute Rhinosinusitis ◽  
Counter Medication ◽  
Anti Inflammatory ◽  
New Generation ◽  
Country Specific

Introduction: Due to their strong, multidirectional anti-inflammatory activity, intranasal glucocorticoids are the mainstay of treatment in rhinosinusitis, including acute rhinosinusitis, chronic rhinosinusitis, and chronic rhinosinusitis with nasal polyps, as well as allergic rhinitis. Owing to its high systemic safety and high anti-inflammatory efficacy, mometasone furoate – a new-generation intranasal glucocorticoid – was approved in 2019 as an over-the-counter medication for Polish patients diagnosed with allergic rhinitis. Scientific societies and expert groups recommend the use of intranasal glucocorticoids in a much broader range of indications. In February 2020, an updated version of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020) was published. Aim: This article discusses the role of nasal glucocorticoids in regimens used in the treatment of nasal sinusitis as published in EPOS 2020 with Polish country-specific realities being taken into account.

Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

2020 ◽  
Vol 34 (5) ◽  
pp. 610-617 ◽  
Author(s):  
Joseph S. Schertzer ◽  
Joshua M. Levy ◽  
Sarah K. Wise ◽  
Kelly R. Magliocca ◽  
John M. DelGaudio
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Benign Lesion ◽  
Retrospective Chart Review ◽  
Central Compartment ◽  
Atopic Disease ◽  
Sinus Surgery ◽  
Respiratory Epithelial Adenomatoid Hamartoma ◽  
Respiratory Epithelial

Background Respiratory epithelial adenomatoid hamartoma (REAH) is a benign lesion of the sinonasal tract that may mimic more concerning pathology. Clinical factors associated with REAH have not been well characterized. Objective To report our findings on patients with this pathologic diagnosis. Methods A retrospective chart review of patients with REAH between September 2006 and November 2019 was conducted. Data collected included clinical allergic rhinitis and asthma history, additional sinonasal diagnoses, prior sinus surgery, and the location of the REAH within the sinonasal cavity. Results Twenty-six patients were identified (53.8% male, mean age 62 years [range, 29–93]). Bilateral REAH occurred in 50%. REAH was located at the superior nasal septum in 84.6% cases, with the remainder identified in sinus contents submitted for pathology, making definitive site uncertain. Concurrent sinonasal inflammatory disorders were identified in 18 patients (69.2%), including chronic rhinosinusitis with nasal polyps—not otherwise specified (6), chronic rhinosinusitis without nasal polyps (4), aspirin-exacerbated respiratory disease (2), allergic fungal rhinosinusitis (1), central compartment atopic disease (5), and IgG4-related sclerosing disease (1). Eight patients had isolated REAH. Adequate allergy records were available for 19 patients, of which 18 of 19 (94.7%) had clinical allergic rhinitis. Conclusions REAH is a benign sinonasal lesion commonly located within the central compartment of the nasal cavity, a site of significant allergen exposure. Affected patients have a high incidence of allergy along with chronic inflammatory conditions. The coexistence of REAH within inflammatory nasal mucosa in a consistent anatomic location, suggests REAH may have a similar etiology to central compartment atopic disease, with resultant respiratory glandular ingrowth within long-standing reactive changes of mucosa derived from ethmoid embryologic origin.

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