Reversal of Chronic Rhinosinusitis-Associated Sinonasal Ciliary Dysfunction

Chen, Bei; Antunes, Marcelo B.; Claire, Steven Eau; Palmer, James N.; Chiu, Alexander G.; Kennedy, David W.; Cohen, Noam A.

doi:10.2500/ajr.2007.21.3029

Cited by 50 publications

(46 citation statements)

References 70 publications

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“…In 1 study, ciliated cells that were removed from the inflammatory milieu of CRS regained their ability to be stimulated and again functioned in a normal fashion. 495 Therefore, most effort clinically should be in treating the underlying CRS, as opposed to treating the dysfunctional cilia separately. Topical antimicrobial therapy results in not only symptomatic improvement, but in 1 study of 10 patients also showed an increase in CBF back to expected levels.…”

Section: Discussionmentioning

confidence: 99%

“…Genetic and acquired defects in mucociliary flow are associated with a high incidence of CRS, and these entail variations in viscosity and ciliary activity. [493][494][495][496] Beneath the mucus reside the epithelial cells (ECs), which are linked by tight and adherens junctions. Tight and adherens junctions comprise the apical junctional complex (AJC), creating a relatively impermeable barrier.…”

Section: Discussionmentioning

confidence: 99%

“…564 Chronically increased CBF has a potential consequence of downregulating endogenous stimulatory pathways, and the cell loses responsiveness to natural CBF stimulants and cannot be modulated normally. 495 Epithelial damage in CRSwNP has also been associated with squamous metaplasia, and abnormal or absent cilia are often associated with this metaplastic change. 941 examined a prospective case series and concluded that a link between IgG subclass deficiency and CRSwNP seemed unlikely.…”

Section: Viiic1h Crswnp Pathophysiologymentioning

confidence: 99%

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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

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557

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Viiic1h Crswnp Pathophysiologymentioning

confidence: 99%

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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

Self Cite

557

888

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“…The therapy addressed to the nasal MCC can be of benefit to the MCC of the lower respiratory tract [8].…”

Section: Viscosity Therapymentioning

confidence: 99%

“…Mucus layer is moved up and over the larynx and then is swallowed to the stomach. Stomach acid generally inactivates the bacteria [8].…”

Section: Functions Of MCCmentioning

confidence: 99%

Mucociliary Clearance: Measures and Therapies

Grossan¹

2017

Otolaryngol

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Mucociliary Clearance can be measured clinically with the Saccharine Test in the sino-nasal system. When clearance is slow, treat mucus viscosity and slow ciliary beat frequency. Chronic sinusitis and bronchitis are often due to poor MCC. Therapy to upper or lower respiratory system benefits both.Therapy for Mucociliary Clearance includes proteolytic enzymes to reduce mucus viscosity, vibrations for improving ciliary beat frequency, irrigation with Locke-Ringer's solution for cilia frequency, glucosteroids and surfactants.

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