Introduction: Central compartment atopic disease (CCAD) has recently been suggested as a phenotype of chronic rhinosinusitis (CRS). This study aims to investigate the prevalence of the radiologic CCAD phenotype in CRS within a pediatric population and identify its ability to predict comorbid allergy and asthma. Methods: Computed tomography and endoscopic examination were conducted on pediatric patients with CRS either with or without nasal polyps. Allergen sensitization was determined with the multiple-allergen simultaneous test and skin prick test. Serum total immunoglobulin E (IgE), peripheral blood eosinophil percentage, and presence of asthma were also evaluated. Results: A total of 82 pediatric patients were enrolled. Overall, 55 (67.1%) of the participants demonstrated aeroallergen sensitization, and 31 (18.9%) of the 164 sides of sinuses were radiologically defined to fit the CCAD phenotype. Patients having CRS with the CCAD phenotype had a higher prevalence of aeroallergen sensitization (87.1% vs 62.4%, P = .008), particularly house dust mite (74.2% vs 53.4%, P = .035), and a higher incidence of asthma (16.1% vs 3.8%, P = .010). Additionally, patients having CRS with the CCAD phenotype demonstrated a high serum total IgE levels (51.6% vs 30.1%, P = .023) in comparison to patients having CRS without CCAD. Conclusion: In pediatric CRS, the radiological CCAD phenotype was associated with allergen sensitization and asthma. Furthermore, the CCAD phenotype was associated with high serum total IgE levels, suggesting allergy etiology should be considered with this type of pediatric patients with CRS.

Objective To determine age-related risk factors for chronic rhinosinusitis (CRS) with asthma. Methods Data were obtained from a national survey of non-hospitalized civilians conducted by the Korean Center for Disease Control and Prevention. CRS diagnosis was based on the guidelines of the European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Asthma was judged based on whether the patient had been diagnosed with asthma in the past. Of the 45,811 survey participants, 26,335 were included in the cross-sectional study. Participants included in the study were divided into the control, CRS, and CRS with asthma groups. Age-related risk factors were analyzed in patients aged < 60 or > 60 years. Univariate logistic analyses were performed to evaluate the relationship between groups. Risk factors included age, sex, household income, residence, education level, occupation, and body mass index (BMI). Results Education level (Odds Ratio [OR]: 0.342, P = .0003), BMI (OR: 1.09, P = .0082), and total IgE (TIgE) levels (OR: 5.582, P = .003) were significantly different between the control and the CRS with asthma group. Education level (OR: 0.478, P = .0016) and TIgE levels (OR: 4, P = .0218) were significantly different between the CRS and CRS with asthma groups under 60 years of age. BMI (OR: 1.087, P = .0443; OR: 1.104, P = .0224) showed a significant difference between all three groups with age > 60 years. Conclusion Progression to CRS with asthma is influenced by education level, occupation, and TIgE levels in patients under 60 years of age. BMI was the only influencing factor associated with the progression to CRS with asthma in those aged > 60 years.

Background and Objectives: Retinoids are naturally occurring vitamin A derivatives that regulate cellular processes and metabolism. In particular, retinoids play a key role in cellular proliferation by binding to retinoic acid receptors (RAR)-alpha, beta, and gamma. Considering the functional role of nasal mucosa where active cell regeneration occurs, RAR may play a role in tissue remodeling of the human nasal mucosa. Methods: In this study, we investigated the expression and distribution pattern of RAR using reverse transcription-polymerase chain reaction (RT-PCR), immunohistochemistry (IHC) and Western blot in normal ethmoid mucosa (NE), chronic rhinosinusitis (IE) and polyp (P).Results: IE and P samples showed higher expression levels of RAR in RT-PCR and Western blot than NE samples. RAR reactivity was also observed in the NE group, which indicates that cell regeneration also occurs in normal condition. Through IHC, we found the localization of RAR. RAR-α was distributed in the epithelial cells, submucosal glands, and endothelial cells. RAR-β was located in the basal epithelium, while RAR-γ was present in goblet cells and submucosal glands. The staining intensity of RAR-α, β and γ was higher than that in the NE group. Especially in the P group, RARs were abundantly distributed in the stalks of polyps. Conclusion:The stalk region contains a lot of collagen and fibroblasts to support polyp formation, and the greater amount of RAR in the stalk suggested that RARs may be associated with angiogenesis and cell proliferation. Accordingly, elevated RAR levels in chronic rhinosinusitis could indicate that RARs play a critical role in cell regeneration, angiogenesis and immunomodulation under inflammatory conditions in the human nasal mucosa.