Does air pollutant exposure impact disease severity or outcomes in chronic rhinosinusitis?

Abstract

BackgroundPoor air quality increases the risk of developing chronic rhinosinusitis (CRS) and other airway diseases. However, there are limited data on air pollutants and CRS‐specific disease severity. We assessed the impact of air pollutants on sinonasal‐specific and general quality‐of‐life (QOL) measures in a multi‐institutional cohort of patients with CRS.MethodsParticipants with CRS were prospectively enrolled in a cross‐sectional study and self‐selected continued appropriate medical therapy or endoscopic sinus surgery (ESS). The 22‐item SinoNasal Outcome Test (SNOT‐22) and Medical Outcomes Study Questionnaire Short‐Form 6‐D (SF‐6D) health utility value scores were recorded. Patient exposure to air pollutants was determined using residence zip codes. Unadjusted group differences were compared and correlation coefficients were evaluated to identify the magnitude of bivariate association.Results486 patients were enrolled and followed for a mean of 6.9 [SD±2.3] months. Pollutant exposure did not significantly correlate with baseline SNOT‐22 or SF‐6D scores. Revision ESS was associated with higher median fine particulate matter (PM2.5; Δ = 0.12, (95% CI: 0.003, 0.234); p = 0.006) compared to primary surgery. PM2.5, PM10 and nitrogen dioxide concentrations (ug/m3) did not correlate with change in total SNOT‐22 or SF‐6D scores after treatment. Nevertheless, sulfur dioxide (SNOT‐22: ρ = ‐0.121 (95% CI: ‐0.210, ‐0.030); p = 0.007; SF‐6D: ρ = 0.095 (95% CI: 0.002, 0.186); p = 0.04) and carbon monoxide (SNOT‐22: ρ = ‐0.141 (95% CI: ‐0.230, 0.050); p = 0.002) exposure did correlate with these outcome measures.ConclusionAir pollutants may contribute, at least in part, to disease severity in CRS; future investigation is needed to further elucidate the nature of this relationship.This article is protected by copyright. All rights reserved

Health care disparities and chronic rhinosinusitis: Does neighborhood disadvantage impact outcomes in sinonasal disease?

“…ADI scores were divided into quintiles, as previously described. 27 ANOVA testing showed no significant difference correlation between any quintiles and within-subject changes in SNOT-22 or SF-6D HUV scores (Table 6).…”

“…19,20,22 Although indices including the neighborhooddisadvantage metric have been investigated in many diseases, the impact of this variable on CRS outcomes remains unstudied. 21,[23][24][25] Given that SES factors, including race and income, 17,18 as well as environmental exposures, 26,27 such as pollution, weather, and pollen, may all contribute to CRS pathophysiology and treatment response, 28 we sought to utilize multi-center outcomes study data to ascertain the potential impact of neighborhood disadvantage on sinonasal-specific and general QOL treatment response. As a secondary outcome, we also assessed the association between ADI and key medical comorbidities via the functional comorbidity index (FCI), a tool developed to understand the impact of 18 common comorbidities known to have a negative impact on physical function.…”

Retinoic Acid Treatment Mitigates PM2.5-Induced Type 2 Inflammation: Insights into Modulation of Innate Immune Responses

“…The mRNA expression of cytokines in nasal tissue and HNECs was examined using qRT-PCR, as previously described [15]. Briefly, total RNA was extracted using an easy-BLUE reagent (Intron Biotechnology, Seongnam, Republic of Korea), followed by cDNA synthesis from 2 µg of total RNA using the AccuPower cDNA synthesis kit (Bioneer, Daejeon, Republic of Korea).…”

“…However, particles smaller than 2.5 µm can escape the nasal mucosa and travel down the lower airways. Although the pathogenesis of CRS is unclear, some studies have suggested that environmental factors are associated with its development [14][15][16]. For example, PM10 exposure significantly increased the IL-33/ST2 pathway-mediated type 2 immune response in patients with CRSwNP [17].…”