Modification of the LK system by excluding the subscores of scarring and crusting improves its reliability and its correlation with PROMs. In addition, the MLK system retains the familiarity of the widely used LK system and is applicable to any patient irrespective of surgical status. The MLK system may be a more suitable and reliable endoscopic scoring system for clinical practice and outcomes research.

ABSTRACT

Aspirin desensitization following ESS appears to be a well-tolerated and effective adjunctive therapy for long-term control of nasal polyposis in patients with AERD.

Allergic asthma is an inflammatory airway disease caused by T helper type 2 (Th2)-driven immune responses. Recent studies have demonstrated that adipose-derived stromal cells (ASC) have an immunosuppressive effect on T-cell activity. This study was performed to investigate whether ASC can inhibit Th2-dependent allergic airway inflammation in mice. BALB/c mice were sensitized to ovalbumin (OVA) by intraperitoneal injection. To investigate the effect of ASC on the development of asthma phenotypes, 2 × 10⁶ ASC were injected intravenously before OVA challenge. We evaluated the airway hyperresponsiveness (AHR), the proportion of eosinophils and cytokine production in bronchoalveolar lavage fluid (BALF), airway inflammation, and the intracellular cytokine staining of T cells in the BALF and spleen. Airway hyperresponsiveness, airway eosinophilia, and mucus production were markedly reduced after ASC administration before OVA challenge. The increased interleukin (IL)-4, IL-5, and transforming growth factor (TGF)-β1 levels in the BALF after OVA challenge were significantly reduced by the administration of ASC. This inhibition was accompanied by decreased IL-4(+) CD4(+) T cells and increased interferon (IFN)-γ(+) CD4(+) T cells in the BALF and spleen. The results of this study suggest that ASC administration before an allergen challenge inhibits AHR, lung inflammation, and Th2 cytokine production induced by an allergen challenge through inhibition of Th2 cell activity.

Although several studies have demonstrated that mesenchymal stem cells derived from adipose tissue (ASCs) can ameliorate allergic airway inflammation, the immunomodulatory mechanism of ASCs remains unclear. In this study, we investigated whether regulatory T cells (Tregs) induction is a potential mechanism in immunomodulatory effects of ASCs on allergic airway disease and how these induced Tregs orchestrate allergic inflammation. Intravenous administration of ASCs significantly reduced allergic symptoms and inhibited eosinophilic inflammation. Airway hyperresponsiveness, total immune cell and eosinophils in the bronchoalveolar lavage fluid, mucus production, and serum allergen-specific IgE and IgG1 were significantly reduced after ASCs administration. ASCs significantly inhibited Th2 cytokines (IL-4, IL-5, and IL-13) and enhanced Th1 cytokine (IFN-γ) and regulatory cytokines (IL-10 and TGF-β) in the bronchoalveolar lavage fluid and lung draining lymph nodes. Furthermore, levels of IDO, TGF-β, and PGE2 were significantly increased after ASCs administration. Interestingly, this upregulation was accompanied by increased Treg populations. In conclusion, ASCs ameliorated allergic airway inflammation and improved lung function through the induction of Treg expansion. The induction of Treg by ASCs involves the secretion of soluble factors such as IDO, TGF-β, and PGE2 and Treg might be involved in the downregulation of Th2 cytokines and upregulation of Th1 cytokines production.

2b.

Cutanplast nasal pack results in significantly less pain and less bleeding compared to Merocel pack.

4. Laryngoscope, 126:763-767, 2016.