Rhinosinusitis: Developing guidance for clinical trials

Meltzer, Eli O.; Hamilos, Daniel L.; Hadley, James A.; Lanza, Donald C.; Marple, Bradley F.; Nicklas, Richard A.; Adinoff, Allen; Bachert, Claus; Borish, Larry; Chinchilli, Vernon M.; Danzig, Melvyn R.; Ferguson, Berrylin J.; Fokkens, Wytske J.; Jenkins, Stephen G.; Lund, Valerie J.; Mafee, Mahmood F.; Naclerio, Robert M.; Pawankar, Ruby; Ponikau, Jens U.; Schubert, Mark S.; Slavin, Raymond G.; Stewart, Michael G.; Togias, Alkis; Wald, Ellen R.; Winther, Birgit

doi:10.1016/j.otohns.2006.09.014

Cited by 318 publications

(238 citation statements)

References 146 publications

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“…In the absence of specific intervention studies in COPD, nasal symptoms should currently be managed by reference to appropriate guidelines. 13 For those considering intervention studies, guidelines exist for the conduct of such research, 36 and it must be hoped that such studies are indeed performed given the urgent need for truly novel treatment strategies to treat this prevalent and devastating disease.…”

Section: Discussionmentioning

confidence: 99%

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Hurst

2009

Thorax

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This review presents the evidence that chronic obstructive pulmonary disease (COPD) is associated with significant sinonasal symptoms, inflammation and airway obstruction. Upper airway symptoms in COPD cause impairment to quality of life. The severity of upper airway involvement relates to that present in the lower airway, suggesting that the nose may be used to model the lung in COPD. More importantly, relationships between upper and lower airway bacteria and inflammation, and the association between sinusitis and treatment failure at exacerbation raise the possibility that nasal intervention in COPD may not only improve health status but may also affect important clinical outcomes such as exacerbation frequency.

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Section: Discussionmentioning

confidence: 99%

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Hurst

2009

Thorax

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“…Guidelines for the diagnosis and treatment of rhinosinusitis differ in terms of diagnosis of CRS and therapy; oral and intranasal corticosteroids are the standard therapy for CRS and NP [6][7][8][9][10]. Glycosaminoglycans (GAGs) also known as mucopolysaccharides, are long unbranched chains of disaccharide units that are repeated in the determined order by alternating an amminosaccaride (containing an amino group instead of a simple-OH group) to a monosaccharide usually acid (containing one or more carboxyl groups and/or sulphates and thus negative charges).…”

Section: Introductionmentioning

confidence: 99%

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Cassandro

Chiarella

Cavaliere

et al. 2014

Indian J Otolaryngol Head Neck Surg

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Chronic rhinosinusitis (CRS) is a common condition and affects the quality of life of approximately 16 % of adults in US and 10.9 % in Europe. Hyaluronan (HA) is a nonsulphate glycosaminoglycan found in the extracellular matrix of connective tissues, and plays an important role in the healing process and repair of mucosal surfaces. We aim to evaluate the effect of HA on nasal symptoms and endoscopic appearance in patients with CRS and nasal polyps (NP) who have not undergone sinus surgery. Eighty patients older than 18 years old were randomized to receive either open-label nebulized saline solution (NS) or intranasal corticosteroid spray (ICS) 200 lg bid or nebulized sodium hyaluronate (NHA, YABRO Ò ) or both ICS and NHA. Results were collected at 1 month, 3 months and 3 months after treatment. Significant improvements in nasal symptoms scores, endoscopic appearance scores, radiologic scores, rhinomanometry and saccharine clearance test were observed in the NHA, ICS and ICS ? NHA groups after 1 month and 3 months of treatment compared with baseline (all p B 0.005). The use of oral steroids was significantly reduced after 3 months of therapy in the same groups versus baseline (all p \ 0.05). The incidence of adverse events at 3 months was similar between the 4 groups (all p [ 0.05). Throat irritation, nasal burning and drug-related epistaxis were not reported in the group NHA. HA, as a nebulized nasal douche preparation, improved nasal symptoms and endoscopic appearances in patients with CRS and NP who have not undergone sinus surgery.

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“…CRS is one of the most common comorbidities among patients with asthma, and the comorbidities share similar inflammatory processes and histopathology (17). CRS has been recently divided into two subgroups: with and without nasal polyps (18). The majority of cases of CRS with nasal polyps show Th2-type inflammation with prominent accumulation of eosinophils in the nasal polyps and are thus called eosinophilic CRS (ECRS) (19).…”

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confidence: 99%

Thy1⁺IL-7⁺lymphatic endothelial cells in iBALT provide a survival niche for memory T-helper cells in allergic airway inflammation

Shinoda

Hirahara

Iinuma

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

100

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Memory CD4 + T helper (Th) cells are central to long-term protection against pathogens, but they can also be pathogenic and drive chronic inflammatory disorders. How these pathogenic memory Th cells are maintained, particularly at sites of local inflammation, remains unclear. We found that ectopic lymphoid-like structures called inducible bronchus-associated lymphoid tissue (iBALT) are formed during chronic allergic inflammation in the lung, and that memory-type pathogenic Th2 (Tpath2) cells capable of driving allergic inflammation are maintained within the iBALT structures. The maintenance of memory Th2 cells within iBALT is supported by Thy1 + IL-7-producing lymphatic endothelial cells (LECs). The Thy1 + IL-7-producing LECs express IL-33 and T-cell-attracting chemokines CCL21 and CCL19. Moreover, ectopic lymphoid structures consisting of memory CD4 + T cells and IL-7 + IL-33 + LECs were found in nasal polyps of patients with eosinophilic chronic rhinosinusitis. Thus, Thy1 + IL-7-producing LECs control chronic allergic airway inflammation by providing a survival niche for memory-type Tpath2 cells.

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Rhinosinusitis: Developing guidance for clinical trials

Cited by 318 publications

References 146 publications

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Thy1⁺IL-7⁺lymphatic endothelial cells in iBALT provide a survival niche for memory T-helper cells in allergic airway inflammation

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Rhinosinusitis: Developing guidance for clinical trials

Cited by 318 publications

References 146 publications

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Thy1+IL-7+lymphatic endothelial cells in iBALT provide a survival niche for memory T-helper cells in allergic airway inflammation

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Thy1⁺IL-7⁺lymphatic endothelial cells in iBALT provide a survival niche for memory T-helper cells in allergic airway inflammation