Advancing the Field of Rhinology and Allergy

Abstract

The May/June issue of the American Journal of Rhinology & Allergy contains several articles that advance the field of rhinology and allergy. This editorial will provide a high level summary of the articles contained in this issue-be sure to examine the articles in more depth on the following pages.Several studies in this issue focus on the pathophysiology of airway inflammation. Wang et al 1 studied the regulation of aquaporin-5, a channel protein important for fluid secretion in allergic inflammation. They tested the 4 concentrations of histamine on the expression of aquaporin-5 in human nasal epithelial cells, findings a dose dependent decrease in expression. They further discovered that the downregulation of aquaporin by histamine occurs via inhibition of the cyclic adenosine monophosphate-responsive element binding protein. Choi et al 2 found that Asian sand dust, generated from the deserts in China, are capable of inducing MUCH8 and MUC5b expression via TLR-4 dependent signaling pathways. These findings were derived from experiments using human nasal epithelial cells. Asian sand dust may be an important environmental trigger for TLR-4 pathway expression and subsequent promotion of airway inflammation. Lam et al 3 used sinus mucosal samples to demonstrate increased IL-25 and IL-33 expression, but not TSLP expression, in patients with chronic rhinosinusitis, nasal polyps, and Ͼ10 eosinophils/high power field, in a comparison study with normal control tissue. Linke et al, 4 in another study using human samples, this time nasal polyps and inferior turbinate tissue, found that STAT5b, but not STAT5a, is activated compared to controls in patients with chronic rhinosinusitis and nasal polyps. Finally, Esmaeilzadeh et al 5 identified genetic variabilities of major histocompatibility complex class II for patients with aspirin exacerbated respiratory disease, suggesting a role for T cell activation in the pathophysiology of this disease process.One study focused on sinonasal tumor pathophysiology. Jung et al 6 studied expression of the Wnt signaling pathway to better understand the mechanism involved in the malignant transformation of sinonasal inverted papillomas. Their findings suggest several Wnt pathway signaling proteins, including ␤-catenin, cyclin D1, and Dvl-1, are associated with malignant transformation.Two studies analyzed imaging results as a means to better understand challenging diagnostic and management issues in rhinology. Craig and Goyal 7 analyzed images of patients who sustained sphenoid fractures and found that CSF leaks occurred in 9% and blunt carotid injury occurred in just 2% of sphenoid fractures. They also found a significant association between sphenoid roof fractures and CSF leak and that penetrating issues were strongly associated with CSF leak. Lin et al 8 describe the use of volumetric analysis for assessment of orbital volume in patients with chronic maxillary atelectasis, also called silent sinus syndrome. They concluded that expansion of maxillary sinus and decrease in orbit volume ca...