Sex and age-related differences in chronic rhinosinusitis with nasal polyps electing ESS

Brescia, Giuseppe; Contro, Giacomo; Ruaro, Alessandra; Barion, Umberto; Frigo, Anna Chiara; Sfriso, Paolo; Marioni, Gino

doi:10.1016/j.amjoto.2021.103342

Cited by 11 publications

(13 citation statements)

References 27 publications

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“…70 Young males recurrence rate of CRSwNP is reported to be higher than young-adult females and elderly males. 71 Younger females with CRS have been reported to have higher symptom burden. 71,72 Given our results, and previous studies, the role of estradiol in pathophysiology of sinusitis needs further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…71 Younger females with CRS have been reported to have higher symptom burden. 71,72 Given our results, and previous studies, the role of estradiol in pathophysiology of sinusitis needs further investigation. A majority of the upstream regulators identified in this study, have been subsequently replicated in our study between ethmoidal tissue of CRS versus ethmoidal tissue of controls, thus providing validation to our results.…”

Section: Discussionmentioning

confidence: 99%

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Genome-wide Epigenetic Study of Chronic Rhinosinusitis Tissues Reveals Dysregulated Inflammatory, Immunologic and Remodeling Pathways

Brar

Baheti

Marino

et al. 2023

Am J Rhinol�Allergy

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Background Epigenetics studies mechanisms such as DNA methylation, histone modifications, non-coding RNAs, and alternative polyadenylation that can modify gene activity without changing the underlying DNA nucleotide base-pair structure. Because these changes are reversible, they have potential in developing novel therapeutics. Currently, seven pharmaceutical agents targeting epigenetic changes are FDA approved and commercially available for treatment of certain cancers. However, studies investigating epigenetics in chronic rhinosinusitis (CRS) have not been undertaken previously in the United States. Objectives The goal of this study was to investigate sinonasal DNA methylation patterns in CRS versus controls, to discern environmentally-induced epigenetic changes impacting CRS subjects. Methods and Results Ethmoidal samples from CRS and inferior turbinate mucosal tissue samples from controls without CRS were studied. DNA methylation was studied by Reduced Representation Bisulfite Sequencing. RADMeth® biostatistical package was used to identify differentially methylated regions (DMRs) between CRS and controls. Ingenuity Pathway analysis of DMRs was performed to identify top upstream regulators and canonical pathways. Ninety-three samples from 64 CRS subjects (36 CRSwNP; 28 CRSsNP) and 29 controls were studied. CRS and control samples differed in 13 662 CpGs sites and 1381 DMRs. Top upstream regulators identified included: 1. CRS versus controls: TGFB1, TNF, TP53, DGCR8, and beta-estradiol. 2. CRSwNP versus controls: TGFB1, CTNNB1, lipopolysaccharide, ID2, and TCF7L2. 3. CRSsNP versus controls: MYOD1, acetone, ID2, ST8SIA4, and LEPR. Conclusions Differential patterns of methylation were identified between controls and CRS, CRSwNP, and CRSsNP. Epigenetic, environmentally-induced changes related to novel, inflammatory, immunologic, and remodeling pathways appear to affect epithelial integrity, cell proliferation, homeostasis, vascular permeability, and other yet uncharacterized pathways and genes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Genome-wide Epigenetic Study of Chronic Rhinosinusitis Tissues Reveals Dysregulated Inflammatory, Immunologic and Remodeling Pathways

Brar

Baheti

Marino

et al. 2023

Am J Rhinol�Allergy

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“…In the 20‐ to 40‐year age cohort, males had a higher rate of nasal polyp recurrence compared with females 44 . In the pediatric population, males more frequently presented with protracted (more than 3 months) nasal discharge after ESS compared with females 45 .…”

Section: Resultsmentioning

confidence: 99%

“…In the 20-to 40-year age cohort, males had a higher rate of nasal polyp recurrence compared with females. 44 In the pediatric population, males more frequently presented with protracted (more than 3 months) nasal discharge after ESS compared with females. 45 These sex-based differences highlight significant variations of disease presentation and should be taken into consideration during preoperative counseling of patients.…”

Section: Discussionmentioning

confidence: 98%

Biological sex as a modulator in rhinologic anatomy, physiology, and pathology: A scoping review

Ramkumar

Brar

Marks

et al. 2023

Int Forum Allergy Rhinol

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BackgroundBiological sex is increasingly recognized as a critical variable in health care. The authors reviewed the current literature regarding sex‐based differences in rhinology to summarize the data and identify critical knowledge gaps.MethodsA scoping review was conducted. Publications reporting sex‐based differences in anatomy, physiology, and pathology focusing on disease prevalence, disease burden, and outcomes in rhinology were identified.ResultsSeventy‐five relevant manuscripts were identified. While paranasal sinuses are of similar size at birth, they become larger in males leading to differences in ostium location. Females outperform males in olfactory identification but only in the 18‐ to 50‐year age group. Estrogen and progesterone administration can impact muscarinic and α1‐adrenergic nasal mucosa receptor density. Chronic rhinosinusitis (CRS) and CRS without nasal polyps are more prevalent in females while CRS with nasal polyps is more prevalent in males. CRS symptom burden is higher in females before and after endoscopic sinus surgery; however, no difference in endoscopic sinus surgery utilization was found based on sex. Allergic rhinitis is more common in males before puberty and in females after puberty. Epistaxis is more prevalent in males and postmenopausal females compared with premenopausal females, perhaps from differences in sex‐hormonal and hypertension status. In nasopharyngeal carcinoma, the incidence of sinus abnormalities was higher in males than females.ConclusionsAlthough many sex‐based differences exist in rhinology, further research is necessary to offer evidence‐based treatment guidelines. Gonadal hormones should be studied as a therapeutic in rhinologic pathology as baseline physiologic differences exist such as those found in nasal mucosa receptor density.

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“…18 The Jurlin group found no subjective gender differences in the postsurgical CRSwNP group 20 in contrast with Brescia et al (n = 172), who studied nasal polyp recurrences in patients with CRSwNP and found that young adult males had higher recurrence rates than young adult females. 29 These studies suggests again that gender plays a role in CRS pathophysiology.…”

Section: Gender Differences In Pathophysiology (Table 2)mentioning

confidence: 93%

Gender Differences in Adults With Chronic Rhinosinusitis: A Scoping Review

Behnke,

Dundervill,

Al‐Asadi

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveGender differences in chronic rhinosinusitis (CRS) have been demonstrated in many studies over the last 15 years. The purpose of this scoping review is to investigate the current knowledge on gender differences in CRS and to analyze the gaps in the literature.Data SourcesA systematic search of PubMed, Cochrane Library, and Embase databases was performed.Review MethodsThis scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Extension for Scoping Reviews (PRISMA‐ScR) guidelines. Studies that evaluated gender differences in CRS were included in the review.ResultsOf the 523 abstracts reviewed, a total of 23 studies met the criteria for inclusion. Articles consisted of retrospective and prospective cohort studies. They were divided into 3 categories based on whether they evaluated gender differences in (1) presentation and baseline quality of life, (2) pathophysiology, and/or (3) outcomes of treatment. Eleven studies addressed differences in presentation, 5 addressed differences in pathophysiology, and 10 dealt with differences in outcomes after surgical or medical management. Most of the studies showed worse baseline QoL secondary to CRS in women, with outcome of treatment being similar in both genders.ConclusionThe experience of CRS appears to vary between genders, with women experiencing a greater subjective burden of disease than men, though with similar outcomes after treatment. Further research is indicated, particularly involving the pathophysiology of CRS, to fully understand the underlying causes of these discrepancies.

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Sex and age-related differences in chronic rhinosinusitis with nasal polyps electing ESS

Cited by 11 publications

References 27 publications

Genome-wide Epigenetic Study of Chronic Rhinosinusitis Tissues Reveals Dysregulated Inflammatory, Immunologic and Remodeling Pathways

Genome-wide Epigenetic Study of Chronic Rhinosinusitis Tissues Reveals Dysregulated Inflammatory, Immunologic and Remodeling Pathways

Biological sex as a modulator in rhinologic anatomy, physiology, and pathology: A scoping review

Gender Differences in Adults With Chronic Rhinosinusitis: A Scoping Review

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