scholarly journals Nasal cytology with emphasis on mast cells can improve the diagnosis and treatment of chronic rhinosinusitis

2019 ◽  
Vol 132 (18) ◽  
pp. 2237-2241
Author(s):  
Hua-Li Ren ◽  
Jian-Dong Li ◽  
Feng-Shu Yue ◽  
Jin-Lu Sun ◽  
Elie E. Rebeiz ◽  
...  
Keyword(s):  
Mast Cells ◽  
Chronic Rhinosinusitis ◽  
Diagnosis And Treatment ◽  
Nasal Cytology

Association of Mast Cell Burden and TIM-3 Expression with Recalcitrant Chronic Rhinosinusitis with Nasal Polyps

2021 ◽  
pp. 000348942199503
Author(s):  
Michael A. Belsky ◽  
Erica Corredera ◽  
Hridesh Banerjee ◽  
John Moore ◽  
Li Wang ◽  
...  
Keyword(s):  
Mast Cell ◽  
Mast Cells ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Cell Activation ◽  
Enzymatic Digestion ◽  
Sinus Surgery ◽  
Mast Cell Activation ◽  
Need For Treatment ◽  
Inflammatory State

Objectives: Previous work showed that higher polyp mast cell load correlated with worse postoperative endoscopic appearance in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Polyp epithelial mast cells showed increased expression of T-cell/transmembrane immunoglobulin and mucin domain protein 3 (TIM-3), a receptor that promotes mast cell activation and cytokine production. In this study, CRSwNP patients were followed post-operatively to investigate whether mast cell burden or TIM-3 expression among mast cells can predict recalcitrant disease. Methods: Nasal polyp specimens were obtained via functional endoscopic sinus surgery (FESS) and separated into epithelial and stromal layers via enzymatic digestion. Mast cells and TIM-3-expressing mast cells were identified via flow cytometry. Mann-Whitney U tests and Cox proportional hazard models assessed whether mast cell burden and TIM-3 expression were associated with clinical outcomes, including earlier recurrence of polypoid edema and need for treatment with steroids. Results: Twenty-three patients with CRSwNP were studied and followed for 6 months after undergoing FESS. Higher mast cell levels were associated with earlier recurrence of polypoid edema: epithelial HR = 1.283 ( P = .02), stromal HR = 1.103 ( P = .02). Percent of mast cells expressing TIM-3 in epithelial or stromal layers was not significantly associated with earlier recurrence of polypoid edema. Mast cell burden and TIM-3+ expression were not significantly associated with need for future treatment with steroids post-FESS. Conclusions: Mast cell load in polyp epithelium and stroma may predict a more refractory postoperative course for CRSwNP patients. The role of TIM-3 in the chronic inflammatory state seen in CRSwNP remains unclear.

scholarly journals Clinical Significance of Cytoplasmic IgE-Positive Mast Cells in Eosinophilic Chronic Rhinosinusitis

2020 ◽  
Vol 21 (5) ◽  
pp. 1843 ◽  
Author(s):  
Yuka Gion ◽  
Mitsuhiro Okano ◽  
Takahisa Koyama ◽  
Tokie Oura ◽  
Asami Nishikori ◽  
...  
Keyword(s):  
Mast Cell ◽  
Mast Cells ◽  
Chronic Rhinosinusitis ◽  
Clinical Significance ◽  
Severity Score ◽  
Cell Infiltration ◽  
Ige Receptor ◽  
Total Ige ◽  
Eosinophilic Chronic Rhinosinusitis

Cross-linking of antigen-specific IgE bound to the high-affinity IgE receptor (FcεRI) on the surface of mast cells with multivalent antigens results in the release of mediators and development of type 2 inflammation. FcεRI expression and IgE synthesis are, therefore, critical for type 2 inflammatory disease development. In an attempt to clarify the relationship between eosinophilic chronic rhinosinusitis (ECRS) and mast cell infiltration, we analyzed mast cell infiltration at lesion sites and determined its clinical significance. Mast cells are positive for c-kit, and IgE in uncinated tissues (UT) and nasal polyps (NP) were examined by immunohistochemistry. The number of positive cells and clinicopathological factors were analyzed. Patients with ECRS exhibited high levels of total IgE serum levels and elevated peripheral blood eosinophil ratios. As a result, the number of mast cells with membranes positive for c-kit and IgE increased significantly in lesions forming NP. Therefore, we classified IgE-positive mast cells into two groups: membrane IgE-positive cells and cytoplasmic IgE-positive cells. The amount of membrane IgE-positive mast cells was significantly increased in moderate ECRS. A positive correlation was found between the membrane IgE-positive cells and the radiological severity score, the ratio of eosinophils, and the total serum IgE level. The number of cytoplasmic IgE-positive mast cells was significantly increased in moderate and severe ECRS. A positive correlation was observed between the cytoplasmic IgE-positive cells and the radiological severity score, the ratio of eosinophils in the blood, and the total IgE level. These results suggest that the process of mast cell internalization of antigens via the IgE receptor is involved in ECRS pathogenesis.

Mast Cells with a Unique Phenotype Are Highly Elevated in Chronic Rhinosinusitis with Nasal Polyps

2012 ◽  
Vol 129 (2) ◽  
pp. AB43
Author(s):  
T. Takabayashi ◽  
A. Kato ◽  
A.T. Peter ◽  
L.A. Suh ◽  
R. Carter ◽  
...  
Keyword(s):  
Mast Cells ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps

Nasal Cytology in the Diagnosis and Treatment of Sinusitis in Atopic and Nonatopic Children

2006 ◽  
Vol 35 (04) ◽  
pp. 255 ◽  
Author(s):  
Tijen Basibuyuk ◽  
Eda Ozaydin ◽  
Reha Cengizlier
Keyword(s):  
Diagnosis And Treatment ◽  
Nasal Cytology

scholarly journals Diagnosis and treatment of chronic rhinosinusitis: focus on intranasal Amphotericin B

2007 ◽  
Vol 3 (2) ◽  
pp. 319-325 ◽  
Author(s):  
Eugene B Kern ◽  
David Sherris ◽  
Angelos M Stergiou ◽  
Laura M Katz ◽  
Lisa C Rosenblatt ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Chronic Rhinosinusitis ◽  
Diagnosis And Treatment

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.

Diagnostic Value of Nasal Cytology in Chronic Rhinosinusitis Assessed by a Liquid-based Cytological Technique

2018 ◽  
Vol 32 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Wenyu She ◽  
Jun Yang ◽  
Chengshuo Wang ◽  
Luo Zhang
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Inflammatory Cell ◽  
Chronic Sinusitis ◽  
Inferior Turbinate ◽  
Inflammatory Cells ◽  
Diagnostic Value ◽  
Cell Counts ◽  
Nasal Cytology ◽  
Sinus Mucosa

Back ground: Nasal cytology has generally been employed as a useful diagnostic tool in the differentiation of rhinopathies. Objective The aim of this study was to assess the extent and diagnostic value of inflammation of nasal and paranasal sinus mucosa in chronic rhinosinusitis patients by employing a combination of nasal brushings and a liquid-based cytological technique. Methods Forty-eight patients with chronic sinusitis and 20 control subjects without any sign of sinusitis undergoing endoscopic surgery, although not all underwent endoscopic sinus surgery, were recruited to the study. Nasal cytology samples were collected from all subjects using nasal brush and processed a liquid-based cytological technique for evaluation of total and differential inflammatory cell counts. Biopsies were also taken from the inferior turbinates from its anterior margin in all subjects and from identical lateral maxillary sinus mucosa in patients with chronic sinusitis during surgery and routinely processed for staining and evaluation of inflammatory cells. Results Total and individual inflammatory cell counts in nasal brushings were significantly correlated with the respective inflammatory cell counts in biopsies obtained from the inferior turbinate (eosinophils: r = .519 and P = .016; neutrophils: r = .540 and P = .012; lymphocytes: r = .540 and P = .011) but not in biopsies obtained from the maxillary sinus. No correlation was observed between the inflammatory cells in biopsies from the inferior turbinate and biopsies from the maxillary sinus. The liquid-based cytological technique showed higher sensitivity (94.1%), specificity (76.9%), and positive predictive value (84.2%) for inflammation in the inferior turbinates than for inflammation in the maxillary sinus (sensitivity = 63.4% and positive predictive value = 63.4%). Conclusion Nasal cytology evaluated by use of nasal brushings processed by a liquid-based cytological technique is likely to have higher diagnostic value for the inflammatory response in noninfectious rhinitis than in chronic rhinosinusitis.

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