Self-reported food allergy is an independent risk factor for potentially fatal childhood asthma. Asthmatic children or adolescents with food allergy are a target population for more aggressive asthma management.
Food allergies have increased in prevalence significantly in the past decade and so, apparently, has eosinophilic esophagitis. Although the cause of eosinophilic esophagitis is unknown, allergic responses including food allergies have been implicated. This article reviews both conditions, focusing on how to detect and manage them.
Background:The pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) is still not completely understood. Regarding the pathogenesis an impaired barrier function of the sino-nasal epithelium has been shown in CRS. Intranasal corticosteroids are widely used for treatment and part of current guidelines. This study aims to analyse the influence of corticosteroids on the epithelial integrity in air-liquid-interface (ALI) epithelial cell cultures of patients with CRSwNP.Methodology: Polyp tissue from 11 patients with CRSwNP undergoing a sphenoethmoidectomy was collected. The epithelial cells were cultured in ALI. After differentiation of the cells, the permeability of the cell layer was defined by measuring the transepithelial resistance (TER). Commonly used corticosteroids, (Fluticasone & Mometasone) and Azelastine were added and their impact on the TER was documented and compared to the TER of ALI cultures without additives (controls).
Results:After 48 hours, Fluticasone showed a significant increase of the TER. Mometasone and Azelastine had no significant impact on the TER. The paracellular passage of Dextran molecules in ALI cultures showed a negative correlation to the TER. Preoperative in vivo corticosteroid treatment had no effect on the baseline TER. Further analysis of the impact of preoperative corticosteroid treatment showed no effect on polyp size, sense of smell, histopathologic eosinophilic count and allergic sensitization.
Conclusion:Fluticasone shows a direct effect in restoring sino-nasal epithelial barrier in-vitro, even in the absence of inflammatory cells.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.