Prevalence and characterization of chronic rhinosinusitis in patients with non‒cystic fibrosis bronchiectasis at a tertiary care center in the United States

Somani, Shaan N.; Kwah, Jason; Chen, Yeh; Conley, David B.; Grammer, Leslie C.; Kern, Robert C.; Prickett, Michelle L.; Schleimer, Robert P.; Smith, Stephanie Shintani; Stevens, Whitney W.; Tan, Bruce K.; Welch, Kevin C.; Peters, Anju T.

doi:10.1002/alr.22436

Cited by 19 publications

(12 citation statements)

References 22 publications

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“…Steroid-dependent asthma is predominately mediated by eosinophilic airway inflammation and is more likely to be associated with bronchiectasis [ 30 ], indicating that eosinophilic airway inflammation is related to bronchiectasis formation in asthma patients. Similarly, recent data also found that peripheral eosinophil counts were elevated in patients with bronchiectasis and CRS [ 13 ]. Bronchiectasis may be induced by eosinophil infiltration and eosinophil-derived cationic proteins, lipid mediators, cytokines, chemokines, and growth factors [ 5 ].…”

Section: Discussionmentioning

confidence: 70%

Prevalence and clinical implications of bronchiectasis in patients with overlapping asthma and chronic rhinosinusitis: a single-center prospective study

et al. 2021

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Background As a typical “united airway” disease, asthma-chronic rhinosinusitis (CRS) overlap has recently drawn more attention. Bronchiectasis is a heterogeneous disease related to a variety of diseases. Whether bronchiectasis exists and correlates with asthma-CRS patients has not been fully elucidated. The purpose of the study was to explore the presence and characteristics of bronchiectasis in patients with overlapping asthma and CRS. Methods This report describes a prospective study with consecutive asthma-CRS patients. The diagnosis and severity of bronchiectasis were obtained by thorax high-resolution computed tomography (HRCT), the Smith radiology scale and the Bhalla scoring system. CRS severity was evaluated by paranasal sinus CT and the Lund-Mackay (LM) scoring system. The correlations between bronchiectasis and clinical data, fraction of exhaled nitric oxide, peripheral blood eosinophil counts and lung function were analyzed. Results Seventy-two (40.91%) of 176 asthma-CRS patients were diagnosed with bronchiectasis. Asthma-CRS patients with overlapping bronchiectasis had a higher incidence rate of nasal polyps (NPs) (P = 0.004), higher LM scores (P = 0.044), higher proportion of ≥ 1 severe exacerbation of asthma in the last 12 months (P = 0.003), lower postbronchodilator forced expiratory volume in one second (FEV1) % predicted (P = 0.006), and elevated peripheral blood eosinophil counts (P = 0.022). Smith and Bhalla scores were shown to correlate positively with NPs and negatively with FEV1% predicted and body mass index. Cutoff values of FEV1% predicted ≤ 71.40%, peripheral blood eosinophil counts > 0.60 × 109/L, presence of NPs, and ≥ 1 severe exacerbation of asthma in the last 12 months were shown to differentiate bronchiectasis in asthma-CRS patients. Conclusions Bronchiectasis commonly overlaps in asthma-CRS patients. The coexistence of bronchiectasis predicts a more severe disease subset in terms of asthma and CRS. We suggest that asthma-CRS patients with NPs, severe airflow obstruction, eosinophilic inflammation, and poor asthma control should receive HRCT for the early diagnosis of bronchiectasis.

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Section: Discussionmentioning

confidence: 70%

Prevalence and clinical implications of bronchiectasis in patients with overlapping asthma and chronic rhinosinusitis: a single-center prospective study

et al. 2021

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“…The concept of “united airway disease” or “one linked airway disease” has emerged, and allergic rhinitis, sinusitis, and asthma are expressed in different parts of the respiratory tract as one pathological process that is inflammatory in nature 12 . In addition, the concept has expanded beyond asthma, and an association with CRS has been reported in other lung diseases, including bronchiectasis 7 , 13 and COPD 8 . In a systematic review, the pooled prevalence of CRS in adults with bronchiectasis was 62%, and CRS was associated with a greater degree of bronchiectasis severity, poorer quality of life, reduction in olfactory detection, and elevated levels of inflammatory markers 7 .…”

Section: Discussionmentioning

confidence: 99%

Association between chronic rhinosinusitis and pneumonia: a longitudinal follow-up study using a national health screening cohort

Wee

Min

Jung

et al. 2022

Sci Rep

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This study was aimed to compare the risk of pneumonia between patients with chronic rhinosinusitis (CRS) and those without CRS (control) in a Korean population. The population aged 40 years or over was included from the Korean National Health Insurance Service-Health Screening Cohort. Participants with CRS (n = 6393) and controls (n = 25,572) were selected by 1:4 matching for age, sex, income, region of residence, and history of pneumonia for the previous 1 year. The index date (ID) of the controls was set as the treatment date of their matched CRS participants. The incidence of pneumonia after the ID was measured from 2003 to 2015. Simple and multiple linear regressions were performed to calculate estimated values (EVs) and 95% confidence intervals (CIs) for 1-y post-ID pneumonia, 2-y post-ID pneumonia, and 3-y post-ID pneumonia in CRS participants compared to controls. Statistical significance was noted in the 3-y post-ID period (EV = 0.017, 95% CI = 0.002–0.031, P = 0.030). In the subgroup analyses according to age and sex, statistical significance was seen in the younger age group (< 60 years old) in the 3-y post-ID period and in the female group in the 1-y and 3-y post-ID periods. This study revealed an increased risk for pneumonia following a diagnosis of CRS.

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“…We included individuals with a primary diagnosis of bronchiectasis, including those with primary ciliary dyskinesia. 45 This, together with comorbid respiratory conditions, including asthma, COPD, allergens or gastro‐esophageal reflux disease, 46 , 47 smoking history, 48 and frequency of acute exacerbations of bronchiectasis, 9 are all factors which are associated with chronic rhinosinusitis and may have contributed to the symptoms reported on the SNOT‐22 questionnaire. In the absence of collating this information, the extent to which the underlying cause of bronchiectasis and comorbid conditions contributed to symptoms of chronic rhinosinusitis or quality of life scores is not clear.…”

Section: Discussionmentioning

confidence: 99%

The clinical impact of self‐reported symptoms of chronic rhinosinusitis in people with bronchiectasis

Lee

Nicolson

Bondarenko

et al. 2021

Immunity Inflam & Disease

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Background: Chronic rhinosinusitis affects 62% of adults with bronchiectasis and is linked to greater bronchiectasis severity. However, the impact of symptoms of chronic rhinosinusitis on disease-specific and cough-related quality of life is unknown. Methods:In this cross-sectional study, adults with stable bronchiectasis and chronic rhinosinusitis symptoms completed the sinonasal outcome test-22 (SNOT-22), quality of life-bronchiectasis questionnaire, and Leicester cough questionnaire. Bronchiectasis severity was assessed using the bronchiectasis severity index (BSI) and chest high-resolution computed tomography (HRCT).Results: Sixty participants with bronchiectasis (mean [SD] forced expiratory volume in 1 s of 73.2 [25.5] %predicted) were included. Greater severity of chronic rhinosinusitis symptoms (based on SNOT-22) was moderately associated with impaired cough-related quality of life (according to the Leicester cough questionnaire; all r > −.60) and impaired bronchiectasis-specific quality of life (based on the quality of life-bronchiectasis questionnaire), with impaired physical function (r = −.518), less vitality (r = −.631), reduced social function (r = −.546), greater treatment burden (r = −.411), and increased severity of respiratory symptoms (r = −.534). Chronic rhinosinusitis symptoms were unrelated to disease severity according to the BSI (r = .135) and HRCT scoring (all r < .200). The severity of chronic rhinosinusitis symptoms was not affected by sputum color (p = .417) or the presence of Pseudomonas aeruginosa colonization (p = .73). Conclusions: In adults with bronchiectasis, chronic rhinosinusitis has a consistent and negative impact on both cough-related and bronchiectasisspecific quality of life.

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Prevalence and characterization of chronic rhinosinusitis in patients with non‒cystic fibrosis bronchiectasis at a tertiary care center in the United States

Cited by 19 publications

References 22 publications

Prevalence and clinical implications of bronchiectasis in patients with overlapping asthma and chronic rhinosinusitis: a single-center prospective study

Prevalence and clinical implications of bronchiectasis in patients with overlapping asthma and chronic rhinosinusitis: a single-center prospective study

Association between chronic rhinosinusitis and pneumonia: a longitudinal follow-up study using a national health screening cohort

The clinical impact of self‐reported symptoms of chronic rhinosinusitis in people with bronchiectasis

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