Nasal Cytology: A Easy Diagnostic Tool in Precision Medicine for Inflammation in Epithelial Barrier Damage in the Nose. A Perspective Mini Review

Giancaspro, Rossana; Guida, Giuseppe; Macchi, Alberto; Landi, Massimo; Heffler, Enrico; Gelardi, Matteo

doi:10.3389/falgy.2022.768408

Cited by 13 publications

(8 citation statements)

References 31 publications

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“…Inflammatory infiltrate contributes to epithelial barrier damage worsening, establishing a vicious circle through secretion of several cationic proteins, including Major Basic Protein (MBP), which induce a marked decrease in the number of desmosomes and an exfoliation of epithelial cells increasing the epithelium permeability. The mucosal permeability allows allergens and other noxious substances to penetrate the barrier ( 37 , 68 ).…”

Section: Discussionmentioning

confidence: 99%

“…Examination of histological samples from nasal mucosa epithelium or nasal cytology allows the evaluation of the barrier damage directly or indirectly ( 37 ). In a cytological context, the Hyperchromatic Supranuclear Stria (SNS) has been reported as a specific marker for the anatomic and functional integrity of ciliated cells.…”

Section: Introduction: Epithelial Damage As a Common Beginning Of All...mentioning

confidence: 99%

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The last step to achieve barrier damage control

Baglivo,

Colantuono,

Lumaca

et al. 2024

Front. Immunol.

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Heterogeneity characterises inflammatory diseases and different phenotypes and endotypes have been identified. Both innate and adaptive immunity contribute to the immunopathological mechanism of these diseases and barrier damage plays a prominent role triggering type 2 inflammation through the alarmins system, such as anti-Thymic Stromal Lymphopoietin (TSLP). Treatment with anti-TSLP monoclonal antibodies showed efficacy in severe asthma and clinical trials for other eosinophilic diseases are ongoing. The aim of this perspective review is to analyse current advances and future applications of TSLP inhibition to control barrier damage.

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Section: Discussionmentioning

confidence: 99%

Section: Introduction: Epithelial Damage As a Common Beginning Of All...mentioning

confidence: 99%

The last step to achieve barrier damage control

Baglivo,

Colantuono,

Lumaca

et al. 2024

Front. Immunol.

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“…The role of nasal cytology in the definition of type-2 inflammation is still underused and nonstandardized (31). However, our clinical practice usually provides a cytological evaluation in most of the centers involved in this study: nasal cytology allows the definition of predominant cells of the nasal inflammatory infiltrate with possible diagnostic and prognostic implications (32). The samples were read by a semiquantitative reading (33).…”

Section: Discussionmentioning

confidence: 99%

Sense of smell in chronic rhinosinusitis: A multicentric study on 811 patients

et al. 2023

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IntroductionThe impairment of the sense of smell is often related to chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP, CRSsNP). CRSwNP is a frequent condition that drastically worsens the quality of life of those affected; it has a higher prevalence than CRSsNP. CRSwNP patients experience severe loss of smell with earlier presentation and are more likely to experience recurrence of their symptoms, often requiring revision surgery.MethodsThe present study performed a multicentric data collection, enrolling 811 patients with CRS divided according to the inflammatory endotype (Type 2 and non-Type 2). All patients were referred for nasal endoscopy for the assessment of nasal polyposis using nasal polyp score (NPS); Sniffin’ Sticks olfactory test were performed to measure olfactory function, and SNOT-22 (22-item sinonasal outcome test) questionnaire was used to assess patients’ quality of life; allergic status was evaluated with skin prick test and nasal cytology completed the evaluation when available.ResultsData showed that Type 2 inflammation is more common than non-type 2 (656 patients versus 155) and patients suffer from worse quality of life and nasal polyp score. Moreover, 86.1% of patients with Type 2 CRSwNP were affected by a dysfunction of the sense of smell while it involved a lesser percentage of non-Type 2 patients. Indeed, these data give us new information about type-2 inflammation patients’ characteristics.DiscussionThe present study confirms that olfactory function weights on patients’ QoL and it represents an important therapeutic goal that can also improve patients’ compliance when achieved. In a future – and present – perspective of rhinological precision medicine, an impairment of the sense of smell could help the clinician to characterize patients better and to choose the best treatment available.

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“…The formation of CLCs is strongly associated with disease severity, since it can induce a crystallopathy by the activation of NLRP 3 inflammasome and the stimulation of innate and adaptative immunity 28 . This crystallopathy, together with the release of lytic enzymes such as major basic protein (MBP), tryptase and collagenase by both eosinophils and MC induces an exfoliation of epithelial cells and the rupture of desmosomes, allowing pathogens and other exogenous substances to penetrate the mucosal barrier 29 , 30 . Among pathogens, Staphylococcus aureus , traditionally associated with the pathogenesis of CRSwNP, has been shown to replicate within the MCs of the nasal mucosa and ultimately induces lysis of MCs and release of intracellular content 31 , 32 .…”

Section: Discussionmentioning

confidence: 99%

Eosinophil-mast cell pattern of intraepithelial infiltration as a marker of severity in CRSwNP

Gelardi,

Giancaspro,

Duda

et al. 2023

Sci Rep

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Chronic rhinosinusitis with nasal polyps (CRSwNP) is defined as a Type 2 eosinophilic disease, while CRSsNP is considered a Type 1 neutrophilic disease. Since neutrophils are also activated in eosinophilic CRSwNP, the eosinophil–neutrophil dualism has been revaluated. Among the inflammatory cells infiltrating sinus-nasal tissues, the role of mast cells (MCs) is not already recognized, although Clinical-Cytological Grading, which defines the severity of CRSwNP, attributes to mixed eosinophil-MC forms of CRSwNP a greater risk of recurrence. We aimed to examine nasal polyps from both a cytological and histopathological point of view, to evaluate the presence and localization of MCs. Cytological and histological examination of 39 samples of nasal polyps were performed. Immunohistochemistry was used to evaluate the presence of Tryptase + CD117 + MCs, which were counted both in the epithelial layer and in the lamina propria. A statistically significant correlation was found between intraepithelial MCs and CRSwNP severity (p < 0.001) and between the total eosinophil count and the total mast cell count (p < 0.001). Cytological examination and immunohistochemistry were comparable in detecting the presence of intraepithelial MCs (p = 0.002). The histological cut-off of 6 intraepithelial MCs was identified to detect severe CRSwNP (p < 0.001). MCs have been shown to be located in the lamina propria of almost all eosinophilic nasal polyps without significantly affecting their severity. Intraepithelial MCs are associated with greater severity of CRSwNP. Histopathological criteria of the eosinophil-MC form of CRSwNP in addition to the eosinophilic one, should be defined to guarantee patients effective and tailored treatments.

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Nasal Cytology: A Easy Diagnostic Tool in Precision Medicine for Inflammation in Epithelial Barrier Damage in the Nose. A Perspective Mini Review

Cited by 13 publications

References 31 publications

The last step to achieve barrier damage control

The last step to achieve barrier damage control

Sense of smell in chronic rhinosinusitis: A multicentric study on 811 patients

Eosinophil-mast cell pattern of intraepithelial infiltration as a marker of severity in CRSwNP

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