While type 2 immune responses to environmental antigens are thought to play pivotal roles in asthma and allergic airway diseases, the immunological mechanisms that initiate the responses are largely unknown. Many allergens have biologic activities, including enzymatic activities and abilities to engage innate pattern-recognition receptors such as TLR4. Here we report that IL-33 and thymic stromal lymphopoietin (TSLP) were produced quickly in the lungs of naïve mice exposed to cysteine proteases, such as bromelain and papain, as a model for allergens. IL-33 and TSLP sensitized naïve animals to an innocuous airway antigen OVA, which resulted in production of type 2 cytokines and IgE antibody and eosinophilic airway inflammation when mice were challenged with the same antigen. Importantly, upon exposure to proteases, uric acid (UA) was rapidly released into the airway lumen, and removal of this endogenous UA by uricase prevented type 2 immune responses. UA promoted secretion of IL-33 by airway epithelial cells in vitro, and administration of UA into the airways of naïve animals induced extracellular release of IL-33, followed by both innate and adaptive type 2 immune responses in vivo. Finally, a potent UA synthesis inhibitor, febuxostat, mitigated asthma phenotypes that were caused by repeated exposure to natural airborne allergens. These findings provide mechanistic insights into the development of type 2 immunity to airborne allergens and recognize airway UA as a key player that regulates the process in respiratory mucosa.

Endoscopic ligation of the sphenopalatine or maxillary artery is safer than arterial embolization and is less invasive than transantral ligation of the maxillary artery. This technique appears to be a simple and highly effective surgical treatment for patients with intractable posterior epistaxis.

To evaluate the effectiveness and usefulness of transnasal endoscopic surgery for the treatment of odontogenic maxillary cysts. Methods: Between February 2003 and February 2008, transnasal endoscopic surgery was performed under general anesthesia in 13 patients (male 6 and female 7, 19 to 75 years old) with odontogenic maxillary cysts that extended to the maxillary sinus. Ten patients had a radicular cyst and three patients had a dentigerous cyst. After the resection of anterior edge of the inferior turbinate, the lateral wall of the inferior nasal meatus was opened. Then, the cyst wall of the maxillary sinus was partially or completely removed under the endoscope. Results: The cyst walls were completely removed in five of ten patients with a radicular cyst and in all three patients with a dentigerous cyst. Five patients with a radicular cyst received partial resection of the cyst wall. The affected teeth could be preserved in seven of ten patients with a radicular cyst and in one of three patients with a dentigerous cyst. There were no complications, and postoperative courses were uneventful. Follow-up period ranged from 11 to 72 months (mean 42 months), and no recurrence has been noted in any of the cases. Conclusions: Endoscopic transnasal surgery for the odontogenic maxillary cyst is less invasive than conventional dental approach, and most of the affected teeth can be preserved. This technique appears to be a simple and highly effective surgical treatment for the treatment of patients with odontogenic cysts that extend to the maxillary sinus.

AQP1, -2, -3, -4, and -5 were present in normal human nasal mucosa. mRNA expression of AQP1, -3, and -5 did not change among control, AR, and CRS patients.

The results indicate that PDGF is produced by macrophages, eosinophils, and epithelial cells in rhinosinusitis and that it acts on receptors in epithelial cells and fibroblasts. PGDF may be an important cytokine in the pathogenesis of rhinosinusitis by promoting tissue fibrosis and formation of nasal polyps.