Nasal brushing: a clinically useful procedure in pediatric patients with rhinosinusitis?

Activity of budesonide on nasal neutrophilic inflammation and obstruction in children with recurrent upper airway infections

“…Interestingly, neither before nor after treatment, the presence of bacteria in the nasal swabs was associated with more severe upper airway symptoms nor more intense nasal neutrophilic inflammation, as compared with children with negative nasal swabs, decreasing the pathogenetic relevance of this finding, as previously reported [1][2][3].…”

“…Nasal brushing was performed using a channel cleaning brush designed for fiberoptic bronchoscopes (model BW-15SH, Olympus Italia s.r.l., Milan, Italy) [3,18]. The brush was inserted into the nostril along the tip of the inferior turbinate and the adjacent median nasal wall under direct visualization, using a headlamp.…”

“…Cytocentrifuge preparations (Cytospin; Shandon Southern Products Ltd., Runcorn, UK) were set to evaluate differential cell counts. Briefly, the slides were air-dried, stained with Romanovsky stain (Diff-Quick, Merz & Dade AG, Dudingen, Switzerland) and evaluated by light microscopy (Carl Zeiss, Oberkochenk, Germany) [3,18]. The proportions of neutrophils, eosinophils, mononuclear and epithelial cells were determined by counting 400 cells/sample and were expressed as percentage.…”

“…Nasal brushing and nasal washing, through the collection of airway epithelial cells and inflammatory cellular and non-cellular components, have been shown to accurately gauge and characterize upper airway inflammation [3][4][5][6].…”

“…In this context, it has been shown that high neutrophil proportion in nasal brushing may represent a reliable tool in the diagnosis of infectious rhinitis [1][2][3][4], being fairly sensitive and predictive of sinus involvement [3]. Once recruited in the nose in response to chemotactic factors such as interleukin (IL)-8, [4][5][6][7], neutrophils may produce factors able to damage the epithelial surface of the airways and release pro-inflammatory cytokines perpetuating the inflammatory cascade [2,4,8].…”