Nasal lavage cytology and mucosal histopathological alterations in patients with rhinitis

Kovalhuk, Loreni; Telles, Ederaldo Queiroz; Cat, Mônica Nunes Lima; Filho, Nelson Augusto Rosário

doi:10.1016/j.bjorl.2019.01.005

Cited by 13 publications

(12 citation statements)

References 42 publications

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“…Histological observations of nasal mucosa from AR patients clearly showed the increased thickness, epithelial cell detachment and fibrosis of the basement membrane and intense collagen deposition in the superficial and submucosal layers in the turbinate [ 3 , 4 , 5 ]. A significant increase in size and density of the submucosal glands and goblet cells was also reported in AR patients compared with healthy individuals [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to these responses, structural alterations in the nasal wall have been observed in AR patients. The structural alterations observed in AR patients include epithelial disruption, goblet cell hypertrophy, basement membrane thickening and collagen deposition [ 3 , 4 , 5 ]. These histological changes are called tissue remodeling, and several types of proteins, especially matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), are reported to be essential factors for tissue remodeling [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Inhibition of Angiogenic Factor Productions by Quercetin In Vitro and In Vivo

et al. 2021

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Background: Angiogenesis is well known to be an important event in the tissue remodeling observed in allergic diseases. Although there is much evidence that quercetin, one of the most abundant dietary flavonoids, exerts anti-allergic effects in both human and experimental animal models of allergic diseases, the action of quercetin on angiogenesis has not been defined. Therefore, in this study, we first examined the action of quercetin on the secretion of angiogenic factors from murine mast cells in vitro. We also examined the action of quercetin on angiogenic factor secretion in the murine allergic rhinitis model in vivo. Methods: Mast cells (1 × 105 cells/mL) sensitized with ovalbumin (OVA)-specific murine IgE were stimulated with 10.0 ng/mL OVA in the presence or the absence of quercetin for 24 h. The concentrations of angiogenic factors, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), tumor necrosis factor-α, IL-6 and IL-8 in the supernatants were examined by ELISA. BALB/c male mice immunized with OVA were challenged intranasally with OVA every other day, starting seven days after the final immunization. These mice were then orally administered quercetin once a day for five days, starting seven days after the final immunization. Clinical symptoms were assessed by counting the number of sneezes and nasal rubbing behaviors during the 10 min period just after OVA nasal provocation. The angiogenic factor concentrations in the nasal lavage fluids obtained 6 h after nasal antigenic provocation were examined by ELISA. Results: Quercetin significantly inhibited the production of angiogenetic factors induced by IgE-dependent mechanisms at 5.0 µM or more. Oral administration of 25.0 mg/kg quercetin into the mice also suppressed the appearance of angiogenetic factors in nasal lavage fluids, along with the attenuation of nasal symptoms. Conclusions: These results strongly suggest that the inhibitory action of quercetin on angiogenic factor secretion may be implicated in the therapeutic action of quercetin on allergic diseases, especially allergic rhinitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inhibition of Angiogenic Factor Productions by Quercetin In Vitro and In Vivo

et al. 2021

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“…In AR patients an alteration in the nasal mucosa due to inflammation exists, although these changes and its correlation with inflammatory cells and mediators is not well-characterized yet ( 55 ). Patients with allergic phenotypes of rhinitis show a T2 mucosal inflammatory pattern with an infiltrate of eosinophils, mast cells and T cells, leading to a nasal production of mediators such as tryptase and eosinophilic cationic protein (ECP) ( 41 , 56 ), and sIgE ( 57 ).…”

Section: Subsections Relevant For the Subjectmentioning

confidence: 99%

“…There are both invasive and non-invasive techniques for sample collecting, although nasal lavage is the most used method, allowing the quantitative determination of cell distribution and inflammatory mediators ( 41 , 55 ). Thus, mediators can be quantified in the supernatant of nasal lavage using different approaches, such as high-performance liquid chromatography and immunoassay ( 4 , 57 , 58 ), whereas nasal cytology can be analyzed in the sample pellet ( 55 ).…”

Section: Subsections Relevant For the Subjectmentioning

confidence: 99%

Diagnostic Tools in Allergic Rhinitis

et al. 2021

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Allergic mechanisms account for most cases of chronic rhinitis. This condition is associated with significant impairment of quality of life and high indirect costs. The identification of the allergic triggers of rhinitis has been historically based on the performance of atopy test [skin prick test (SPT) and serum allergen-specific (s)IgE]. Nevertheless, these tests only denote sensitization, and atopy and allergy represent two different phenomena. It is now clear that allergic phenotypes of rhinitis can exist in both atopic (allergic rhinitis, AR) and non-atopic (local allergic rhinitis, LAR) individuals. Moreover, both allergic phenotypes can coexist in the same rhinitis patient (dual allergic rhinitis, DAR). Therefore, a diagnostic approach merely based on atopy tests is associated with a significant rate of misdiagnosis. The confirmation of the allergic etiology of rhinitis requires the performance of in vivo test like the nasal allergen challenge (NAC). NAC is mandatory for the diagnosis of LAR and DAR, and helps decide the best management approach in difficult cases of AR. Nevertheless, NAC is a laborious technique requiring human and technical resources. The basophil activation test (BAT) is a patient-friendly technique that has shown promising results for LAR and DAR diagnosis. In this review, the diagnostic usefulness for chronic rhinitis of SPT, NAC, olfactory tests, serum sIgE, BAT and the quantification of inflammatory mediators in nasal samples will be discussed. The accurate performance of an etiologic diagnosis of rhinitis patients will favor the prescription of specific therapies with disease-modifying potential like allergen immunotherapy.

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“…The nasal cytological examination (NCE) technique allows physicians to detect cellular modifications in the nasal mucosa caused by exposure to physical or chemical, acute or chronic irritation. It also makes it easy to evaluate different types of inflammation (viral, bacterial, fungal, or parasitic) [5][6]. The nasal mucosa consists of a ciliated pseudo-stratified epithelium composed of striated and basal ciliated mucosa-secreting cells.…”

Section: Academic Journal Of Pediatrics and Neonatologymentioning

confidence: 99%

The Importance of Nasal Cytological Examination in Determining The Etiology and Treatment of Idiopathic Recurrent Epistaxis İn Children

Yosunkaya

2021

AJPN

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Background and aim : It was aimed to clarify the etiology of recurrent idiopathic epistaxis (RIE) by evaluating the results of the nasal cytological examination (NCE) and to evaluate their responses to treatment prepared according to nasal cytological findings. Materials and methods:Pre and post-treatment the results of NCE, 78 children who applied to the ENT clinic for RIE and 40 healthy children were evaluated. In the majority of cases with RIE, the main cell type was determined to be neutrophils (70%) followed by eosinophils (20%). The treatments of the children were tailored by their nasal cytology findings. According to the results of NCE, 25 / 3.6 mg/kg of amoxicillin /clavulanate was administered orally twice a day for 7 days to children with high neutrophil counts. Children with high eosinophil count were given 5 ml of desloratadine orally once a day for 15 days. These treatments were administered together and at the same doses to children with high neutrophil and eosinophil counts.Results : Clinical evaluation and NCE was performed at the end of the first month. Families reported that epistaxis did not occur in children after treatment. As a result of the re-performed NCE, 74 (94.8%) of the patients responded to the treatment. In children with recurrent epistaxis due to inflammation caused by neutrophils and eosinophils, the dominance of cells decreased after treatment and no epistaxis was observed. The relationship between the dominance of inflammatory cells in the nasal mucosa and epistaxis was found to be statistically significant (p<0.05). Conclusion :NCE, which is used in the differential diagnosis and follow-up of rhinological diseases, can help us to clarify the etiology of RIE in children. According to the results of the nasal cytological examination, anti-inflammatory treatment with a high response to treatment can be planned in these children.

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Nasal lavage cytology and mucosal histopathological alterations in patients with rhinitis

Cited by 13 publications

References 42 publications

Inhibition of Angiogenic Factor Productions by Quercetin In Vitro and In Vivo

Inhibition of Angiogenic Factor Productions by Quercetin In Vitro and In Vivo

Diagnostic Tools in Allergic Rhinitis

The Importance of Nasal Cytological Examination in Determining The Etiology and Treatment of Idiopathic Recurrent Epistaxis İn Children

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