Clinical characteristics and cytokine profiles of central‐compartment‐type chronic rhinosinusitis

Lin, Young-Tso; Lin, Chih‐Feng; Liao, Chun-Kang; Chiang, Bor‐Luen; Yeh, Te‐Huei

doi:10.1002/alr.22759

Cited by 17 publications

(43 citation statements)

References 47 publications

(62 reference statements)

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“…In our study, the mean SNOT‐22 score for loss of smell or taste in the CCAD group was higher (2.92 of 5) than that in the LDNP group (1.96 of 5) ( p < 0.01). This result is consistent with a previous study showing that patients with central compartment–type CRS had more hyposmia or anosmia than patients with other types of CRS (37.5% vs 13.7%, p = 0.036) 16 …”

Section: Discussionsupporting

confidence: 93%

“…One possible explanation is that serum tests for specific allergies have limitations in confirming “local allergic rhinitis.” In other words, some of our patients’ allergic symptoms were limited to the nasal mucosa. A study conducted by Lin et al in Taiwan also showed no significant relationship between allergen sensitization and CCAD 16 …”

Section: Discussionmentioning

confidence: 89%

“…Table 4 lists the current results available from the Western and Asian populations (Table 4). 7,9,10,15–18 Thus, we conducted this cross‐sectional study to determine the clinical presentations, risk factors, and surgical outcomes of patients with CCAD in Taiwan. We found that the prevalence of asthma and AR symptoms was higher in CCAD patients compared with LDNP patients.…”

Section: Discussionmentioning

confidence: 99%

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A comparison of central compartment atopic disease and lateral dominant nasal polyps

Shih

Hsieh

et al. 2022

Int Forum Allergy Rhinol

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Background: The characteristics and surgical outcomes of central compartment atopic disease (CCAD) vary by region and race. Therefore, we aimed to identify the risk factors, symptom severity, and prognosis of CCAD in the Asian population. Methods: This case-control study recruited patients diagnosed with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery (FESS) at a tertiary hospital in Taiwan. Patients were classified into CCAD and lateral-dominant nasal polyp (LDNP) groups based on endoscopic and computed tomography imaging findings. The demographic data, symptom severity scores, and surgical outcomes of the 2 groups were analyzed.Results: Our study included 442 patients (CCAD group: n = 51; LDNP group: n = 391). We found that CCAD was strongly related to both asthma (9.8% vs 3.5%, p = 0.04) and allergic rhinitis symptoms (43.3% vs 26.6%, p = 0.01). Higher eosinophil counts were detected in blood serum (5.8% vs 2.8%, p < 0.01) and histopathologic profiles (57.0 vs 17.3, p < 0.01) among patients with CCAD. Improvements in 22item Sino-Nasal Outcome Test (SNOT-22) score and mucociliary clearance time (MCT) after surgical intervention revealed that the CCAD group had a better response to FESS (SNOT-22 score: −31.82 vs −22.66, p < 0.01; MCT: −233.06 vs −191.93 seconds, p = 0.03). The revision FESS rate was not different between the 2 groups. Conclusion:Polyps originating from the central compartment were found to be related to asthma and allergic rhinitis in Taiwanese patients. A higher eosinophil count was suggested in both serum and local nasal tissue from patients with CCAD. FESS serves as an effective treatment for symptom relief in patients with CCAD.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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A comparison of central compartment atopic disease and lateral dominant nasal polyps

Shih

Hsieh

et al. 2022

Int Forum Allergy Rhinol

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“…However, a study from Taiwan demonstrated that hyposmia or anosmia was the major symptom and more common in the central compartment-type CRS group. 32 The distinct presentations of olfactory dysfunction may attribute to the recruited patients with different stages of CCAD.…”

Section: Discussionmentioning

confidence: 99%

Chinese Central Compartment Atopic Disease: The Clinical Characteristics and Cellular Endotypes Based on Whole-Slide Imaging

Kong¹,

Wu²,

Chen³

et al. 2022

JAA

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Purpose Histopathologic characterizations of central compartment atopic disease (CCAD) by whole-slide imaging remains lacking. We aim to study clinical presentations and cellular endotyping diagnosis of Chinese CCAD using artificial intelligence (AI). Methods A total of 72 patients diagnosed with chronic rhinosinusitis with nasal polyps (CRSwNP) were enrolled. CCAD was defined by positive result of serology specific IgE, endoscopic and radiological findings. The aeroallergen sensitization status, endoscopic results, radiological findings, and symptoms were evaluated and compared between patients with CCAD (n=14), eosinophilic CRSwNP (ENP, n=32) and non-eosinophilic CRSwNP (NENP, n=26). The cellular endotypes including eosinophils, neutrophils, lymphocytes, and plasma cells were analyzed by the AI chronic rhinosinusitis evaluation platform 2.0. Results CCAD was most common in male (71.43%). The positive rate of aeroallergen in patients with CCAD is 100%, which is much higher than those in patients with ENP (40.63%) and NENP (23.08%). Allergic rhinitis incidence was found to be 57.14% in Chinese CCAD subjects, which is obviously higher when compared with those in patients with ENP (21.88%) or NENP (0.00%). The presence of asthma was not significantly different between groups. Chinese CCAD population demonstrated mild symptoms and lower endoscopic and radiological scores than those in patients with ENP and NENP. For cellular endotypes in CCAD subjects, the median of eosinophils, neutrophils, lymphocytes, and plasma cells was 26.55%, 0.49%, 60.85%, and 7.33%, respectively. The proportion of eosinophils in nasal tissue and peripheral blood mononuclear cells from the CCAD group is between the proportions in those patients with ENP and NENP. Conclusion Chinese CCAD was associated with aeroallergen sensitivity, and displayed an eosinophil-dominant inflammatory pattern. Thus, proper management with allergy control and topical steroids could be recommended for CCAD treatment.

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“…A centrally limited sinus inflammation entity on the CT scan has been defined as having normal sinus mucosal or mucosal thickening involving only the floor or medial wall of the ethmoid sinuses ( 25 , 26 ). We previously found that central-compartment-type CRS represented an eosinophilic/type 2 inflammation endotype, with elevated expression of IL-5 and IL-13 in the sinonasal tissues, and patients with this central-compartment subtype of CRS had more smell problems as major symptoms than patients with other CRS subtypes ( 27 ).…”

Section: Olfactory Dysfunction and Chronic Rhinosinusitis Endotypesmentioning

confidence: 99%

Studies on Clinical Features, Mechanisms, and Management of Olfactory Dysfunction Secondary to Chronic Rhinosinusitis

Lin

Yeh

2022

Front. Allergy

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Chronic rhinosinusitis (CRS) is one of the most common causes of inflammation of the olfactory system, warranting investigation of the link between chronic inflammation and the loss of olfactory function. Type 2 inflammation is closely related to the clinical features and disease mechanisms of olfactory dysfunction secondary to CRS. Patients with eosinophilic CRS, aspirin-exacerbated respiratory disease, and central compartment atopic disease report increased olfactory dysfunction. Increased levels of interleukin-(IL-)2, IL-5, IL-6, IL-10, and IL-13 in the mucus from the olfactory slit have been reported to be associated with reduced olfactory test scores. The influence of several cytokines and signaling transduction pathways, including tumor necrosis factor-α, nuclear factor-κB, and c-Jun N-terminal kinases, on olfactory signal processing and neurogenesis has been demonstrated. Corticosteroids are the mainstay treatment for olfactory dysfunction secondary to CRS. Successful olfaction recovery was recently demonstrated in clinical trials of biotherapeutics, including omalizumab and dupilumab, although the treatment effect may diminish gradually after stopping the use of the medications. Future studies are required to relate the complex mechanisms underlying chronic inflammation in CRS to dysfunction of the olfactory system.

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Clinical characteristics and cytokine profiles of central‐compartment‐type chronic rhinosinusitis

Cited by 17 publications

References 47 publications

A comparison of central compartment atopic disease and lateral dominant nasal polyps

A comparison of central compartment atopic disease and lateral dominant nasal polyps

Chinese Central Compartment Atopic Disease: The Clinical Characteristics and Cellular Endotypes Based on Whole-Slide Imaging

Studies on Clinical Features, Mechanisms, and Management of Olfactory Dysfunction Secondary to Chronic Rhinosinusitis

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