Chronic Rhinosinusitis with Nasal Polyps and Asthma

Laidlaw, Tanya M.; Mullol, Joaquim; Woessner, Katharine M.; Amin, Nikhil; Mannent, Leda

doi:10.1016/j.jaip.2020.09.063

Cited by 205 publications

(220 citation statements)

References 95 publications

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“…CRSwNP patients with Th2 endotypes often have severe disease that is difficult to manage and frequently have comorbid lower airway disease. 34 Interestingly, similar inflammatory profiles have been found in nasal polyp specimens and bronchial specimens in CRSwNP patients, indicating the existence of similar inflammation throughout the upper and lower airways in these patients. 35 Surprisingly, however, Th2 cytokine concentrations were significantly higher in nasal polyps compared to bronchial specimens, leading the authors to question whether the sinus disease plays an important role in lower airway inflammation.…”

Section: Asthma and Crssupporting

confidence: 52%

Insights into the Implications of Coexisting Type 2 Inflammatory Diseases

McCormick¹,

Lee²

2021

JIR

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The role of type 2 inflammation in the pathogenesis of certain human diseases is an area of active investigation. Certain asthma, atopic dermatitis, eosinophilic esophagitis, and chronic rhinosinusitis phenotypes are characterized by a Th2 predominant inflammatory pathway and are frequently associated with comorbid conditions in patients. The purpose of this article is to review the evidence behind concurrent Th2-mediated diseases and explore how the presence of these comorbid conditions affect patient and disease outcomes.

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Section: Asthma and Crssupporting

confidence: 52%

Insights into the Implications of Coexisting Type 2 Inflammatory Diseases

McCormick¹,

Lee²

2021

JIR

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“…These variables and cutoffs included highest BEC ever ($ 300 cells/mL, $ 150-300 cells/mL, or <150 cells/mL), anti-IL-5/5 receptor treatment, long-term OCS use ever, elevated FENO ($ 25 parts per billion) ever, nasal polyps diagnosis ever, and adult asthma onset ($ 18 years) and were informed by the published evidence base and asthma management guidelines. 16,[22][23][24][25][26][27] Phenotypes were classified as grade 3 (most likely eosinophilic), grade 2 (likely eosinophilic), grade 1 (least likely eosinophilic), and grade 0 (noneosinophilic) (Fig 1). Patients most likely to have an eosinophilic phenotype (grade 3) were those with highest BEC ever of $ 300 cells/mL or receiving anti-IL-5/anti-IL-5 receptor therapy, or with BEC of $ 150 to 300 cells/mL with (1) mOCS or (2) $ 2 of nasal polyps, elevated FENO, or late onset of disease.…”

Section: Development Of Gradient Eosinophilic Phenotype Algorithmmentioning

confidence: 99%

Eosinophilic and Noneosinophilic Asthma

Heaney

Llano²,

Al‐Ahmad

et al. 2021

Chest

147

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“…Больные полипозным синуситом (ПС) составляют 5% среди всех пациентов лор-кабинетов поликлиник, 4% пациентов наблюдаются у аллерголога [1,2]. До сих пор остаются неясными факторы, вызывающие запуск механизмов, ответственных за развитие ПС, в основе которых лежит эозинофильное воспаление, отличающееся по ряду проявлений и механизмов от классического (макрофагального) воспаления [3][4][5][6][7]. Следствием эозинофильной активации в слизистых оболочках являются их морфологическая перестройка и ремоделирование, что в случае ПС проявляется ростом полипов.…”

Section: Introductionunclassified

The role of Staphylococcus aureus in the course of polyposis sinusitis

2021

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Introduction. Today, there are lot of theories of pathogenesis of polypoid sinusitis. The contribution of Starchylocossus aureus (S. aureus) to the occurrence of this pathogenetic reaction is being actively discussed.Objective: to improve the effectiveness of treatment of polypoid sinusitis using the results of the study of the effect of persistent staphylococcal infection on the onset and course of the disease.Materials and methods. The authors examined 105 patients with recurrent polyposis sinusitis aged 20 to 65 years. All patients underwent FESS surgery for recurrent polypous sinusitis at the initial visit. In the postoperative period, all patients received treatment according to one of two schemes. The first scheme included antihistamines and topical steroids, the second additionally included clarithromycin. The patients underwent bacteriological examination of smears for flora and fungi from the cavity; cytological examination of smears-prints from the mucous membrane of the nasal cavity (we counted neutrophils, eosinophils and lymphocytes in the preparation); immunological and allergic examination (skin tests, serum specific IgE levels).Results and discussion. It has been established that the presence of a carriage and sensitization to S. aureus in a patient, especially in combination with atopy, results in a more severe course of polyposis sinusitis severe nasal obstruction (91% versus 69.5%, respectively) and is characterized by more pronounced eosinophilic inflammation than Polypoid Sinusitis associated with infection with other microorganisms (the number of eosinophils in the blood: 7.5% and 4.3%, respectively; the level of eosinophils in smears from the nasal mucosa is 13 and 4.8%, respectively; the average ECP level is 17.6 and 8.1 ug / ml, respectively).Conclusions. The use of topical GCS remains one of the leading methods for preventing recurrence of PS. However, in addition to the backbone therapy with topical GCS and antihistamines, it is advisable to complete a course of antibiotics during nasal colonization with S. aureus.

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Chronic Rhinosinusitis with Nasal Polyps and Asthma

Cited by 205 publications

References 95 publications

Insights into the Implications of Coexisting Type 2 Inflammatory Diseases

Insights into the Implications of Coexisting Type 2 Inflammatory Diseases

Eosinophilic and Noneosinophilic Asthma

The role of Staphylococcus aureus in the course of polyposis sinusitis

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