Allergic rhinitis associated with nasal polyps and rhinosinusitis – histopathological and immunohistochemical study

Iordache, Mihaela; Balica, Nicolae Constantin; Horhat, Delia Ioana; Morar, Raluca; Tischer, Alina Andreea; Milcu, Adina Iuliana; Salavat, Mădălina Casiana; Borugă, Veronica Mădălina; Niculescu, Bogdan Mihai; Iovănescu, Gheorghe; Popa, Zoran Laurenţiu

doi:10.47162/rjme.63.2.12

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…In all operated children, surgery leads to reduction of nasal discharge and nasal obstruction [ 24 ]. The useful effect of Omalizumab was noticed in our study like in several others regarding chronic nasal polyposis [ 25 , 26 ], with reference to adult patients.…”

Section: Discussionsupporting

confidence: 84%

Nasal polyposis from cystic fibrosis in children – the experience of a single center

Iovănescu¹,

Pop²,

Vintila³

et al. 2023

Rom J Morphol Embryol

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Background: Cystic fibrosis (CF) is the most common monogenic disease, characterized by clinically notable polymorphism. Respiratory disease is the main factor that influences the disease outcome and prognosis of the patient with CF, bacterial infections being responsible for severe exacerbations and rhinosinusitis a difficult complication, besides lung disease. Aim: The aim of the paper was to present a case series of CF-associated nasal polyposis and our management experience, providing new data for nasal and sinus complications. Patients, Materials and Methods: Patients attending the National Cystic Fibrosis Center, Timişoara, Romania, were evaluated for nasal polyposis. Besides clinical examination, endoscopy, and computed tomography (CT) was performed for comprehensive evaluation. Patients with persistent symptoms or with complicated sinusitis underwent surgical approach. Results: Fourteen (18.18%) children were diagnosed with nasal polyposis and had surgery, with positive outcomes. One patient received Omalizumab for an associated, uncontrolled asthma with a subsequent substantial effect with the significant polyp reduction and lack of recurrence. Conclusions: Even if extremely difficult to manage, complicated nasal polyposis CF related might have an improved outcome and better life quality.

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Section: Discussionsupporting

confidence: 84%

Nasal polyposis from cystic fibrosis in children – the experience of a single center

Iovănescu¹,

Pop²,

Vintila³

et al. 2023

Rom J Morphol Embryol

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“…Inflammatory responses: The inflammatory responses in AR entail a sequence of immune reactions incited by allergens, culminating in symptoms such as nasal obstruction, rhinorrhea, nasal itching, and sneezing. This immune cascade is mediated by various cytokines, chemokines, and cells that sustain allergic inflammation, with notable involvement of eosinophilic infiltration and mast cells in conditions like NP and chronic rhinosinusitis [ 8 , 9 ]. The pathophysiology of AR manifests in a two-phase allergic reaction, commencing with an early-phase response featuring immediate symptoms like sneezing and rhinorrhea, followed by a late-phase response marked by nasal congestion and obstruction [ 9 ].…”

Section: Reviewmentioning

confidence: 99%

A Comprehensive Review Exploring Allergic Rhinitis With Nasal Polyps: Mechanisms, Management, and Emerging Therapies

Narasimhan,

Deshmukh,

Gaurkar

et al. 2024

Cureus

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Allergic rhinitis (AR) and nasal polyps (NP) are common inflammatory disorders of the upper airways that often coexist and significantly impact patients' quality of life. This comprehensive review explores the intricate relationship between AR and NP, elucidating the underlying mechanisms, clinical manifestations, and management strategies. Immunological mechanisms, genetic predispositions, and environmental factors contribute to the development and progression of both conditions. Pharmacological therapies, including intranasal corticosteroids and biologic agents, are cornerstone treatments for managing AR with NP. At the same time, surgical interventions such as functional endoscopic sinus surgery (FESS) may be necessary in refractory cases. Emerging therapies, including immunomodulatory agents and precision medicine approaches, hold promise in improving treatment outcomes. A multidisciplinary approach, personalized treatment plans, and patient education are essential for optimizing clinical practice. Future research should focus on identifying novel therapeutic targets, conducting large-scale clinical trials, exploring precision medicine approaches, and investigating the role of the microbiome. Addressing these research priorities and implementing evidence-based treatment strategies can improve outcomes for patients with AR and NP.

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Diagnostics of allergic rhinitis under dupilumab therapy

Huber,

Gröger,

Stihl

et al. 2024

Eur Arch Otorhinolaryngol

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Background Allergic rhinits is a prevalent condition, affecting a substantial proportion of the population. This study investigates the impact of ongoing biologic therapy, specifically with Dupilumab, on allergy diagnostics in patients with allergic rhinits. Methods Various tests, including the Skin Prick Test, serum IgE levels and Allergy Screening Panels, were examined for their effectiveness in detecting sensitizations during biologic treatment. Results The results indicate a significant decline in total IgE levels following biologic therapy initiation, aligning with previous findings on Dupilumab's inhibitory effects on IL-4 and IL-13. However, the specific IgE to total IgE ratio for major allergens was not significantly reduced. Comparing diagnostic tools, the Skin Prick Test demonstrates an impressive retention rate of sensitizations (98%) during Dupilumab treatment, outperforming the Allergy Screening Panel, which shows a 75% detection rate. Notably, the panel displays limitations in capturing lower sensitization levels. Conclusion In summary, this study underscores that, despite the influence of biologic therapy on certain markers, standard allergy tests remain viable while emphasizing the importance of considering specific IgE levels rather than relying solely on CAP classes. The Skin Prick Test in particular proves to be a reliable tool for identifying sensitizations during Dupilumab treatment. The results offer valuable guidance for the diagnostic management of Allergic rhinits in individuals subjected to Dupilumab treatment.

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Allergic rhinitis associated with nasal polyps and rhinosinusitis – histopathological and immunohistochemical study

Cited by 5 publications

References 21 publications

Nasal polyposis from cystic fibrosis in children – the experience of a single center

Nasal polyposis from cystic fibrosis in children – the experience of a single center

A Comprehensive Review Exploring Allergic Rhinitis With Nasal Polyps: Mechanisms, Management, and Emerging Therapies

Diagnostics of allergic rhinitis under dupilumab therapy

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