Asthma Is the Dominant Factor for Recurrence in Chronic Rhinosinusitis

Sella, Guilherme Constante Preis; Tamashiro, Edwin; Sella, Juliana Augusta; Aragon, Davi Casale; Mendonça, Thaís; Arruda, L. Karla; Lima, Wilma Terezinha Anselmo; Valera, Fabiana Cardoso Pereira

doi:10.1016/j.jaip.2019.08.007

Cited by 46 publications

(43 citation statements)

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“…Another interesting finding was that small MMAs are significantly associated with important edema, epithelial hyperplasia, and increased goblet cells. In line with other published papers [32][33][34], we found that augmentation of inflammatory cells was associated with a higher number of goblet cells and epithelial hyperplasia. This finding is predictable, since the extracellular space significantly increases during inflammation [38][39][40].…”

Section: Discussionsupporting

confidence: 93%

“…Histology in our group of patients demonstrated that the mononuclear cell infiltration, goblet cells, edema, and epithelial hyperplasia were prominent and persistent in the control side compared to in the SC side. During the healing process, epithelial cells cooperate with inflammatory cells and release cytokines and growth factors, including transforming growth factor ß (TGF-ß) [32][33][34][35][36][37]. TGF-ß is an inflammation modulator and is considerably involved in extracellular matrix production in the respiratory system.…”

Section: Discussionmentioning

confidence: 99%

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Maxillary Antrostomy Patency Following Intraoperative Use of Spray Cryotherapy

Trombitaș

Zolog

Toader³

et al. 2019

JCM

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Objectives/Hypothesis: Stenosis of the middle meatus antrostomy (MMA) represents a major cause of recurrent disease following endoscopic sinus surgery (ESS). Various strategies have been developed to prevent the occurrence of MMA stenosis. The aim of the present study was to evaluate the effects of spray cryotherapy (SC) on nasal wound healing following ESS. Methods: This is a prospective within-subject, randomized, and controlled trial. Twenty-six patients submitted to bilateral ESS with chronic rhinosinusitis without polyps were included. Following surgery, patients were randomized to receive SC on one side and saline contralaterally. Outcomes were represented by MMA diameter and area, histology of nasal mucosa, and nasal symptoms. Variables were assessed at 3 and 12 months postoperatively. Results: The MMA size in the SC group at 3 and 12 months (area-0.578 ± 0.1025 cm 2 , diameter-0.645 ± 0.1024 cm; 0.605 ± 0.1891 cm 2 , 0.624 ± 0.0961 cm, respectively) was significantly larger (p = 0.000) than in the control group. Histology established that cell infiltration, goblet cells, edema, and epithelial hyperplasia were prominent and persistent in the control side compared to the SC side. Nasal obstruction and discharge were significantly improved in the SC group compared to the control group. Conclusion: SC is a promising therapy following ESS, since it precludes MMA stenosis and decreases inflammation, edema, and goblet cell hyperplasia.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Maxillary Antrostomy Patency Following Intraoperative Use of Spray Cryotherapy

Trombitaș

Zolog

Toader³

et al. 2019

JCM

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“…severity, higher recurrence rates of nasal polyps after surgery, poorer asthma control and higher costs [4][5][6].…”

mentioning

confidence: 99%

Distinct Type 2-high Inflammation Associated Molecular Signatures of Chronic Rhinosinusitis with Nasal Polyps with Comorbid Asthma

Wang

Luan

et al. 2020

Preprint

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Abstract Background: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and comorbid asthma have more severe disease and are difficult to treat. However, the molecular endotypes associated with CRSwNP with comorbid asthma (CRSwNP+AS) are not clear. This study aimed to investigate the characteristics of type 2 inflammation and the molecular signatures associated with CRSwNP+AS. Methods: A total of 195 subjects; including 65 CRSwNP+AS patients, 99 patients with CRSwNP-alone, and 31 healthy control subjects; were enrolled in the study. Nasal tissues from patients with CRSwNP+AS, CRSwNP-alone and control subjects were assessed for infiltration of inflammatory cells and concentrations of total IgE. Whole-transcriptome sequencing was performed and differentially expressed (DE) mRNAs and long non-coding RNAs (lncRNAs) and their associated pathways were analyzed. The correlations between type 2 cytokines and local eosinophils, tissue IgE, and transcriptome signatures were evaluated. Results: Significantly higher local eosinophil infiltration and higher levels of total IgE were found in nasal tissues from CRSwNP+AS patients than in nasal tissues from CRSwNP-alone patients. Furthermore, atopy and recurrence were significantly more frequent in patients with CRSwNP+AS than in patients with CRSwNP-alone (62.5% vs 28.6% and 66.7% vs 26.9%, respectively). RNA sequencing analysis identified 1988 common DE-mRNAs, and 176 common DE-lncRNAs shared by CRSwNP+AS versus control and CRSwNP-alone versus control. Weighted gene coexpression network analysis (WGCNA) identified LINC01146 as hub lncRNA dysregulated in both subtypes of CRSwNP. Overall, 968 DE-mRNAs and 312 DE-lncRNAs were identified between CRSwNP+AS and CRSwNP-alone. Both pathway enrichment analysis and WGCNA indicated that the phenotypic traits of CRSwNP+AS were mainly associated with higher activities of arachidonic acid metabolism, type 2 cytokines related pathway and fibrinolysis pathway, and lower activity of IL-17 signalling pathway. Furthermore, the expression of type 2 cytokines; IL5 and IL13, was positively correlated with local eosinophil infiltration, tissue IgE level, and the expression of DE-mRNAs that related to arachidonic acid metabolism. Moreover, WGCNA identified HK3-006 as hub lncRNA in yellow module that most positively correlated with phenotypic traits of CRSwNP+AS. Conclusions: Patients with CRSwNP+AS have distinct type 2-high inflammation-associated molecular signatures in nasal tissues compared to patients with CRSwNP-alone.

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“…Thus, the local features of nasal tissue were closely associated with the clinical characteristics. Together with the recent finding that asthma is a dominant factor increased the chance of recurrence in CRSwNP [6], comorbid asthmatic conditions might be a strong indicator for CRSwNP recurrence.…”

Section: Discussionmentioning

confidence: 82%

“…Studies have reported that up to 60% of CRSwNP patients have comorbid asthma (CRSwNP + AS), which is one of the most challenging subtypes to treat [3]. Patients with CRSwNP + AS have greater disease severity, higher recurrence rates of nasal polyps after surgery, poorer asthma control and higher costs [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Distinct Type 2-high Inflammation Associated Molecular Phenotypes of Chronic Rhinosinusitis with Nasal Polyps with Comorbid Asthma

Wang

Luan

et al. 2020

Preprint

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Abstract Background Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and comorbid asthma have more severe disease and are difficult to treat. However, the phenotypes especially the molecular phenotypes of CRSwNP with comorbid asthma (CRSwNP+AS) are not clear. This study aimed to investigate the molecular phenotypes associated with CRSwNP+AS. Methods Nasal tissues from patients with CRSwNP+AS, CRSwNP-alone and control subjects were assessed with infiltrated inflammatory cells and concentrations of total IgE, and performed whole-transcriptome sequencing. Differentially expressed mRNAs (DE-mRNAs) and lncRNAs (DE-lncRNAs) and their associated pathways were analyzed. The correlations between type 2 cytokines and local eosinophils, tissue IgE, and transcriptome signatures were evaluated. Results More local eosinophils infiltration and higher levels of total IgE were found in nasal tissues from CRSwNP+AS than from CRSwNP-alone. RNA sequencing analysis identified 1988 common DE-mRNAs, and 176 common DE-lncRNAs shared by CRSwNP+AS versus control and CRSwNP-alone versus control. Weighted gene coexpression network analysis (WGCNA) identified LINC01146 as hub lncRNA dysregulated in both subtypes of CRSwNP. We identified 968 DE-mRNAs and 312 DE-lncRNAs between CRSwNP+AS and CRSwNP-alone. Both pathway enrichment analysis and WGCNA indicated that the phenotypic traits of CRSwNP+AS were mainly associated with higher activities of arachidonic acid metabolism, Th2 cytokines related pathway and fibrinolysis pathway, and oppositely lower activities of IL-17 signaling pathway. We further showed that the expression of Th2 cytokines, IL5 and IL13, were positively correlated with local eosinophils infiltration, tissue IgE level, and the expression of DE-mRNAs that related to arachidonic acid metabolism. Moreover, WGCNA identified HK3-006 as hub lncRNA in yellow module that most positively correlated with phenotypic traits of CRSwNP+AS. Conclusions Patients with CRSwNP+AS have distinct type 2-high inflammation and its associated transcriptome signatures in nasal tissues compared to patients with CRSwNP alone.

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Asthma Is the Dominant Factor for Recurrence in Chronic Rhinosinusitis

Cited by 46 publications

References 50 publications

Maxillary Antrostomy Patency Following Intraoperative Use of Spray Cryotherapy

Maxillary Antrostomy Patency Following Intraoperative Use of Spray Cryotherapy

Distinct Type 2-high Inflammation Associated Molecular Signatures of Chronic Rhinosinusitis with Nasal Polyps with Comorbid Asthma

Distinct Type 2-high Inflammation Associated Molecular Phenotypes of Chronic Rhinosinusitis with Nasal Polyps with Comorbid Asthma

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