Impact of allergy on phenotypic and endotypic profiles of nasal polyposis

Mortuaire, G.; Gengler, Isabelle; Balden, Maïté; Capron, Moníque; Lefèvre, Guillaume

doi:10.1016/j.anorl.2017.11.005

Cited by 16 publications

(12 citation statements)

References 22 publications

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“…The variability in the levels of activation of these inflammatory pathways was associated with the presence of clinical characteristics such as nasal polyposis or comorbid asthma . Clustering of CRS patients based on the inflammatory signatures observed in the nasal mucus, which correlates with clinical disease characteristics, has also been reported …”

Section: Discussionmentioning

confidence: 92%

“…30 Clustering of CRS patients based on the inflammatory signatures observed in the nasal mucus, which correlates with clinical disease characteristics, has also been reported. 34,35 Interestingly, studies have shown diversity in association between inflammatory signatures and CRS disease characteristics based on geography and racial backgrounds. [36][37][38] For example, in Europe, North America and Oceania CRSwNP is associated with a predominantly Th2 inflammatory signature in the sinonasal mucosa in contrast to a mixed Th1/Th2/Th17 cytokine profile with generally lower levels Th2 inflammation in Asian CRSwNP patients.…”

Section: Crs Endotypesmentioning

confidence: 99%

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Understanding and clinical relevance of chronic rhinosinusitis endotypes

Husain

Sedaghat

2019

Clinical Otolaryngology

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Background Chronic rhinosinusitis (CRS) is the downstream manifestation of heterogeneous pathophysiologic mechanisms leading to chronic sinonasal inflammation. Traditional grouping of patients by symptoms or clinical findings/phenotypes is being replaced by classification of CRS patients based on the underlying pathophysiologic mechanisms: endotypes. Objective of Review To provide an up‐to‐date review on the current knowledge of CRS endotypes with a focus on how the pathophysiologic mechanisms defined by each endotype may be targeted therapeutically. Special emphasis is placed on the clinical relevance of the material and how it may inform the current practice of otolaryngologists. Type of Review A systematic review of contemporary literature review focusing on the latest studies examining the role of endotypes in the management and treatment of CRS. Search Strategy A MEDLINE and PubMed Central search were undertaken to perform this review using the keywords “Endotype” and “Sinusitis.” Evaluation Method Articles containing the keywords, as well as the references of those articles, were then examined for relevance. Results The endotypes for CRS are often defined based on the balance of T‐helper cell patterns of inflammation and can be grouped into Th2 and non‐Th2 inflammation. These groups have shown a variable response to medical and surgical therapy, demonstrating that existing mainstream treatments can be tailored to patients with specific endotypes. The inflammatory mediators of Th2 inflammation, IL‐4, IL‐5 and IL‐13 as well as IgE, are targeted by available biologic drugs that can be used for treatment of refractory disease. Conclusions Increased understanding of CRS endotypes has led to the identification of biomarkers that define these endotypes and act as targets for potential therapeutics. Increasing knowledge about characteristics associated with these endotypes and their responses to treatments, including both established mainstream CRS treatments and novel biologic medications, has allowed incorporation of CRS endotypes into the current clinical decision‐making. Treatment of CRS patients based on consideration of their endotypes is therefore not only presently possible but may improve clinical outcomes of those patients as well.

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Section: Discussionmentioning

confidence: 92%

Section: Crs Endotypesmentioning

confidence: 99%

Understanding and clinical relevance of chronic rhinosinusitis endotypes

Husain

Sedaghat

2019

Clinical Otolaryngology

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“…They found that there is no difference between the mentioned two groups. In fact, the atopic status has no effect on the levels of IgA in both serum and nasal secretions (17). However, an old study reported that local IgA production occurred in both allergic and non-allergic CRSwNP patients, resulting in degranulation of cytotoxic proteins from eosinophils.…”

Section: Discussionmentioning

confidence: 99%

Levels of total IgA and IgA subclasses in the serum of chronic rhinosinusitis patients

Aazami

Seif

Ghalehbaghi

et al. 2018

Med. J. Islam. Repub. Iran

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Background: Different inflammatory mechanisms take part in the immunopathogenesis of chronic rhinosinusitis (CRS). Immunoglobulin (Ig) A is the first-line defense in the airway tracts and other mucosal sites, but little is reported regarding its serum level in CRS patients. The purpose of current study is to determine the serum levels of total IgA, and its subclasses (IgA1, and IgA2) in CRS with nasal polyps (CRSwNP), CRS without nasal polyps (CRSsNP), and control groups. Methods: In this case-control study the serum levels of total IgA and IgA subclasses were determined by Nephelometry and ELISA methods, respectively. The difference of the median concentrations was analyzed with the Kruskal-Wallis test. Collected data were analyzed using SPSS and presented by GraphPad Prism software. Results: A total of 10 CRSwNP patient, 10 CRSsNP patients and 10 healthy controls participated in our study. The mean age of the groups were 38.2±12.6, 25.6±10.54, and 30.1±9.5, respectively. The concentrations of total IgA were 156(120-165), 165 (149-173), and 172 (152.8-184.3) mg/dl, respectively. The concentrations of IgA1 were 107 (77.9-169.9), 156.1(112.8-175.6), and 130.4 (118.8- 175.2) mg/dl, respectively. The concentrations of IgA2 were 26.11 (18.41-38.11), 26.96 (15.48-38.39), and 23.2 (18.42-31.78) mg/dl, respectively. There was no significant difference in total IgA (p=0.120), IgA1 (p=0.397) and IgA2 (p=0.925) serum levels among three groups. Conclusion: Our study showed there is no difference in total IgA and IgA subclasses in the serum of CRS patients in comparison to healthy controls.

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“…8 According to this system, a higher score correlates with a more severe disease (six regions on each side, scored 0-2). 7 This score was also subclassified into mild (1)(2)(3)(4)(5)(6)(7)(8), moderate (9-16) and severe (17)(18)(19)(20)(21)(22)(23)(24). A complete blood cell count with differential cell count was performed in all patients and eosinophil parameters were collected.…”

Section: Methodsmentioning

confidence: 99%

“…All patients underwent preoperative CT scan. The mean Lund-Mackay score was 12.7±4.7 and 21% of study population had a severe paranasal sinus obliteration (score [17][18][19][20][21][22][23][24]. A Spearman's correlation was performed to determine the relationship between the Lindholt and Lund-Mackay score system.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Chronic rhinosinusitis with nasal polyps: predictive factors for recurrence and revision surgery

Salvador

Lombo

Silva

et al. 2020

Int J Otorhinolaryngol Head Neck Surg

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Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory condition which may have a significant impact on quality of life. Endoscopic sinus surgery (ESS) is indicated for patients refractory to maximal medical treatment and presents high recurrence and revision surgery rates. Aim of the study was to evaluate ESS outcome in CRSwNP management and to assess independent predictive factors for recurrence and revision surgery.Methods: Retrospective medical chart review of patients who underwent ESS for recalcitrant CRSwNP, from January 2013 to December 2017, with a minimum follow-up time of 12 months. Results: This study enrolled 132 patients, 62.1% of whom were males, with a mean age of 43.4±11.5 years. Asthma was the most common comorbidity (39.4%, n=52) and aspirin exacerbated respiratory disease (AERD) was present in 9.8% (n=12) of the study population. We found a recurrence rate of 34.1% (n=45) and 9% (n=12) of patients required revision surgery. Multivariate analysis identified as independent variables of recurrence (95% CI): a history of asthma (OR=8.81, CI 3.87-20.03; p<0.001) and a severe Lund-Mackay score (17-24) (OR=5.85, CI 2.73-12.51; p=0.001). Revision surgery was related to a severe endoscopic Lund-Kennedy score at presentation (OR=4.05, CI 1.91-8.01, p=0.001).Conclusions: CRSwNP presents a high tendency to recur after ESS. Asthma, severe sinus opacification and severe endoscopic score are poor prognostic factors that hallmark a more aggressive disease. A more extensive surgical procedure and/or middle turbinate resection with a rigorous postoperative compliance should be considered to improve long term results.

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Impact of allergy on phenotypic and endotypic profiles of nasal polyposis

Cited by 16 publications

References 22 publications

Understanding and clinical relevance of chronic rhinosinusitis endotypes

Understanding and clinical relevance of chronic rhinosinusitis endotypes

Levels of total IgA and IgA subclasses in the serum of chronic rhinosinusitis patients

Chronic rhinosinusitis with nasal polyps: predictive factors for recurrence and revision surgery

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