Nasal cytology identifies allergic rhinitis phenotypes for managing allergen immunotherapy in clinical practice

2021 ◽  
Author(s):  
Paolo Luperto ◽  
Simonetta Masieri ◽  
Carlo Cavaliere ◽  
Enrico Compalati ◽  
Giorgio Ciprandi ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Practice ◽  
Allergen Immunotherapy ◽  
Nasal Cytology

When Allergic Rhinitis is not Only Allergic

2009 ◽  
Vol 23 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Matteo Gelardi ◽  
Cosimo Russo ◽  
Maria Luisa Fiorella ◽  
Raffaele Fiorella ◽  
Giorgio Walter Canonica ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Practice ◽  
Mast Cells ◽  
Large Population ◽  
Positive Skin ◽  
Duration Of Symptoms ◽  
Nasal Cytology ◽  
Cytological Characteristics ◽  
Nasal Inflammation ◽  
Sensitization Pattern

Background In clinical practice it can be observed that some patients with seasonal allergic rhinitis (AR) continue to have symptoms even when the exposure to allergens is expected to be low or absent. We studied the clinical and cytological characteristics of these atypical forms of (AR) in a large population of patients. Methods Consecutive patients with symptoms of rhinitis and with positive skin test to pollens only were interviewed for the duration of symptoms, correlation with sensitization pattern, and presence of reactivity to nonspecific stimuli. All underwent rhinoscopy and nasal scraping for cytology. Results Five hundred nineteen patients with AR were studied. Of these 519 patients 60 (11.5%) had an atypical or mixed form of rhinitis, with symptoms independent of the exposure and also elicited by nonspecific stimuli. These patients clearly differed from typical forms, especially for the nasal inflammation. They had a greater number of eosinophils and mast cells out of season (p < 0.05). Moreover, these atypical forms had, more frequently, asthma and eosinophilic polyps. Conclusion In ∼12% of patients with AR, other mechanisms of inflammation seem to intervene. Nasal cytology can be helpful in discriminating these atypical forms.

Serum immunoglobulin E reactivity to cross-reacting panallergen components in north-eastern Poland patients pollen sensitized

2020 ◽  
Vol 41 (3) ◽  
pp. 183-191
Author(s):  
Krzysztof Kowal ◽  
Agnieszka Pampuch ◽  
Ewa Sacharzewska ◽  
Ewa Swiebocka ◽  
Zenon Siergiejko ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Allergen Immunotherapy ◽  
Immunoglobulin E ◽  
Pollen Allergy ◽  
Serum Ige ◽  
Ige Reactivity ◽  
Allergen Components ◽  
North Eastern ◽  
Allergen Sources ◽  
Seasonal Pollen

Background: The presence of immunoglobulin E (IgE), which cross-reacts with allergen components, such as profilins, polcalcins, and cross-reacting carbohydrate determinants (CCD), creates a problem when selecting patients for allergen immunotherapy by using conventional methods. The aim of this study was to evaluate the prevalence of sensitization to profilins, polcalcins, and CCDs in patients with seasonal pollen allergic rhinitis. Methods: The study was performed on a group of 112 patients with seasonal pollen allergic rhinitis, ages 14 to 55 years, with sensitization to at least one seasonal allergen (IgE > 0.7 kUA/L). The presence of IgE sensitization to recombinant (r) Bet v 2, rPhl p 12, rBet v 4, rPhl p 7, and CCDs, in addition to rBet v 1, rPhl p 1, rPhl p 5, was evaluated by using a multiparameter immunoblot. Results: Among the studied patients, 64.3, 80.4, and 41.1% were sensitized to birch, timothy grass, and mugwort pollen, respectively. Sensitization to profilins rBet v 2/Phl p 12 was demonstrated in 28.6%, to polcalcins Bet v 4/Phl p 7 in 8.9%, and to CCDs in 25%. In 29.3%, serum IgE reactivity to any of the cross-reactive components could be demonstrated. Serum IgE reactivity to rBet v 2 was always accompanied by IgE reactivity to rPhl p 12, and IgE reactivity to rBet v 4 was always accompanied by IgE reactivity to rPhl p 7. Among the patients with pollinosis co-sensitized to at least two allergen sources according to extract-based diagnosis, possible false-positive results due to sensitization to cross-reactive components were detected in 17.9%. Conclusion: Evaluation of sensitization to cross-reacting components may be useful in evaluation of patients with pollen allergy who are being assessed for allergen immunotherapy to optimize the constitution of their immunotherapy vaccines.

Nasal Cytology in Radiofrequency Turbinate Volume Reduction

ORL ◽  
2021 ◽  
pp. 1-6
Author(s):  
Giancarlo Pecorari ◽  
Giuseppe Riva ◽  
Claudia Bartoli ◽  
Mattia Ravera ◽  
Valeria Dell’Era ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Effective Treatment ◽  
Nasal Obstruction ◽  
Nasal Mucosa ◽  
Inferior Turbinate ◽  
Volume Reduction ◽  
Nonallergic Rhinitis ◽  
Turbinate Hypertrophy ◽  
Nasal Cytology ◽  
Rhinitis Medicamentosa

Introduction: Radiofrequency turbinate volume reduction (RFTVR) is an effective treatment of inferior turbinate hypertrophy. RFTVR can reduce epithelial cell alterations in nasal mucosa. The aim of this observational study was to evaluate the effects of RFTVR on nasal obstruction and cytology, stratifying for different types of rhinitis. Methods: Nasal cytology and subjective nasal obstruction were evaluated on 113 patients before RFTVR (T0) and after 3 months (T1). The patients were divided into groups on the basis of the underlying disease: allergic rhinitis, nonallergic rhinitis, rhinitis medicamentosa, and other diseases (e.g., hormonal-based turbinate hypertrophy). Results: Nasal cytology at T0 identified 42 patients with allergic rhinitis, 40 with nonallergic rhinitis, 19 with rhinitis medicamentosa, and 12 with other diseases. An improvement of nasal cytology at T1 was observed in 29.2% of cases. They mainly consisted of patients with nonallergic rhinitis with neutrophils, whose neutrophil infiltrate decreased. Only 2 cases (1.7%) showed a worsening of nasal cytology at T1. A statistically significant decrease in subjective nasal obstruction was observed for every group (p < 0.05). Higher differences of nasal obstruction between T0 and T1 were found in patients with rhinitis medicamentosa or other diseases. Conclusion: RFTVR represents a safe and effective treatment for turbinate hypertrophy of various etiology. It is not responsible for a worsening of inflammatory infiltrate of the nasal mucosa.

Quality Improvement in Otolaryngology–Head and Neck Surgery: Developing Registry-Enabled Quality Measures From Guidelines for Cerumen Impaction and Allergic Rhinitis Through a Transparent and Systematic Process

2021 ◽  
pp. 019459982110119
Author(s):  
Jeremy J. Michel ◽  
Seth R. Schwartz ◽  
Douglas E. Dawson ◽  
James C. Denneny ◽  
Eileen Erinoff ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Practice ◽  
Head And Neck ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Care ◽  
Quality Measures ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Quality Reporting

Background and Significance Quality measurement can drive improvement in clinical care and allow for easy reporting of quality care by clinicians, but creating quality measures is a time-consuming and costly process. ECRI (formerly Emergency Care Research Institute) has pioneered a process to support systematic translation of clinical practice guidelines into electronic quality measures using a transparent and reproducible pathway. This process could be used to augment or support the development of electronic quality measures of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) and others as the Centers for Medicare and Medicaid Services transitions from the Merit-Based Incentive Payment System (MIPS) to the MIPS Value Pathways for quality reporting. Methods We used a transparent and reproducible process to create electronic quality measures based on recommendations from 2 AAO-HNSF clinical practice guidelines (cerumen impaction and allergic rhinitis). Steps of this process include source material review, electronic content extraction, logic development, implementation barrier analysis, content encoding and structuring, and measure formalization. Proposed measures then go through the standard publication process for AAO-HNSF measures. Results The 2 guidelines contained 29 recommendation statements, of which 7 were translated into electronic quality measures and published. Intermediate products of the guideline conversion process facilitated development and were retained to support review, updating, and transparency. Of the 7 initially published quality measures, 6 were approved as 2018 MIPS measures, and 2 continued to demonstrate a gap in care after a year of data collection. Conclusion Developing high-quality, registry-enabled measures from guidelines via a rigorous reproducible process is feasible. The streamlined process was effective in producing quality measures for publication in a timely fashion. Efforts to better identify gaps in care and more quickly recognize recommendations that would not translate well into quality measures could further streamline this process.

scholarly journals @IT2020: An innovative algorithm for allergen immunotherapy prescription in seasonal allergic rhinitis

2021 ◽  
Author(s):  
Stefania Arasi ◽  
Sveva Castelli ◽  
Marco Di Fraia ◽  
Danilo Villalta ◽  
Salvatore Tripodi ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Seasonal Allergic Rhinitis ◽  
Allergen Immunotherapy

Allergen immunotherapy for allergic rhinitis

2008 ◽  
Vol 8 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Mary Dell Railey ◽  
Margaret A. Adair ◽  
A. Wesley Burks
Keyword(s):  
Allergic Rhinitis ◽  
Allergen Immunotherapy

Effect of a moustache on nasal Staphylococcus aureus colonisation and nasal cytology results in men

2015 ◽  
Vol 129 (2) ◽  
pp. 155-158 ◽  
Author(s):  
E Soylu ◽  
I Orhan ◽  
A Cakir ◽  
A Istanbullu ◽  
G Altin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Allergic Rhinitis ◽  
Nasal Cavity ◽  
Control Group ◽  
Study Group ◽  
Left Nasal Cavity ◽  
Adult Men ◽  
Nasal Cytology ◽  
Non Allergic Rhinitis

AbstractObjective:This study compared the results of nasal Staphylococcus aureus carriage and nasal cytology in men with and without a moustache.Methods:The study group comprised 118 adult men with a moustache, and the control group consisted of 123 adult men without a moustache. Samples were taken from the participants' right nasal cavity for cytology and from the left nasal cavity for microbiology.Results:The results for S aureus were positive in 19.5 per cent (n = 23) of participants with a moustache and in 20.3 per cent (n = 25) of men without a moustache. This difference was not significant (p > 0.05). However, nasal cytology revealed rich eosinophil clusters in participants with a moustache.Conclusion:The presence or absence of a moustache had no effect on nasal S aureus colonisation. However, further research is needed to understand whether the presence of a moustache increases the risk of allergic or non-allergic rhinitis.

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