Role of atopy in chronic rhinosinusitis with nasal polyps: does an atopic condition affect the severity and recurrence of disease?

Li, QC; Cheng, K.-J.; Wang, F; Songyang, Zhou

doi:10.1017/s0022215116008112

Cited by 23 publications

(15 citation statements)

References 32 publications

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“…Therefore, we can conclude that eosinophils may trigger a more severe form of inflammation in the context of CRSwNP compared to the noneosinophilic inflammatory cells. However, our results showed no significant difference between the ECRSwNP and nECRSwNP groups with respect to the SNOT-20 score, VAS score, endoscopy score, or CT score ( p > 0.05); these findings are consistent with the results of a recently published paper that compared the clinical markers of CRS with disease severity [21,22,23]. …”

Section: Discussionsupporting

confidence: 92%

IL-33 Expression in Chronic Rhinosinusitis with Nasal Polyps and Its Relationship with Clinical Severity

Song

Wang²,

Zhou³

et al. 2017

ORL

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Background: Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by epithelial inflammation and tissue eosinophilic infiltration. Interleukin-33 (IL-33) is a key inflammatory cytokine that mediates eosinophilic infiltration. Objective: The aim of our study was to investigate the expression and role of IL-33 in eosinophilic CRS with nasal polyps (ECRSwNP) and in noneosinophilic CRS with nasal polyps (nECRSwNP), and to analyze their correlation with clinical severity. Methods: The study enrolled 25 patients with ECRSwNP, 27 patients with nECRSwNP, and 12 control subjects, based on immunohistochemical staining. Protein and mRNA expressions of IL-33 in sinus mucosal samples were determined by immunohistochemistry and real-time polymerase chain reaction. Sino-Nasal Outcome Test-20 (SNOT-20) score, visual analog scale (VAS) score, endoscopy score, and computed tomography (CT) score were assessed preoperatively. Results: IL-33 expression levels in the CRSwNP group were significantly higher than those in the control group (p < 0.01), especially in the ECRSwNP group (p < 0.05). There were no significant differences between the ECRSwNP and nECRSwNP groups with respect to SNOT-20 score, VAS score, endoscopy score, or CT score. IL-33 mRNA expression showed a positive correlation with the number of eosinophils (p < 0.05) and endoscopy score (p < 0.05) but not with VAS score and CT score. Conclusion: IL-33 expression plays an important role in patients with CRSwNP. No significant differences were observed between the ECRSwNP and nECRSwNP groups with respect to SNOT-20 score, VAS score, endoscopy score, or CT score. IL-33 expression was correlated with eosinophil counts and endoscopy score.

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Section: Discussionsupporting

confidence: 92%

IL-33 Expression in Chronic Rhinosinusitis with Nasal Polyps and Its Relationship with Clinical Severity

Song

Wang²,

Zhou³

et al. 2017

ORL

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“…In investigating the role of allergy in CRS patients, Li et al 11 found 47% of their patients had allergy but the disease severity and recurrence rates were the same, irrespective of the allergy status. When the presence of allergy was related to the findings of CTPNS, Erbek et al 12 and Peric et al 13 found no association between allergy with both endoscopic findings and LM scores in their respective studies.…”

Section: Discussionmentioning

confidence: 99%

<p>The Clinical and Radiological Characterizations of the Allergic Phenotype of Chronic Rhinosinusitis with Nasal Polyps</p>

Abdullah¹,

Vengathajalam²,

Daud³

et al. 2020

JAA

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Purpose The allergic phenotype of chronic rhinosinusitis (CRS) and central compartment atopic disease (CCAD) have been described. The CCAD is a radiological phenotype in patients with CRS that presents as a central mucosal disease due to allergy. The subset of patients having chronic rhinosinusitis with nasal polyps (CRSwNP) has not been well characterized. We aim to describe the clinical and radiological characterizations of patients presenting with the allergic phenotype of CRSwNP. Patients and Methods A cross-sectional study at a tertiary hospital was performed. Adult patients diagnosed with CRSwNP who had both allergology and radiological assessments were enrolled. The symptoms of allergic rhinitis, Lund–Kennedy (LK) endoscopic scoring, Lund–Mackay (LM) computed tomography scan of paranasal sinuses (CTPNS) scoring, CCAD features, skin prick test (SPT) and level of specific IgE were assessed. All the patients underwent SPT for house dust mites. Results A total of 38 patients were enrolled. Symptoms, endoscopic and CTPNS scores were higher in the allergy and CCAD groups compared to the nonallergy and nonCCAD groups. The symptom of “need to blow nose” was statistically significant in allergy vs nonallergy ( p =0.01) and CCAD vs nonCCAD ( p =0.02). There were significant differences in the endoscopic scores in both allergy and CCAD (allergy vs nonallergy, p =0.01; CCAD vs nonCCAD, p =0.03), and CT scores in both allergy and CCAD (allergy vs nonallergy, p =0.02; CCAD vs nonCCAD, p =0.02). All patients with CCAD have worse scoring than nonCCAD (LK score, p =0.03; LM score, p =0.02). Patients with allergy have more polypoidal involvement of the middle turbinates (left middle turbinate, p =0.141; right middle turbinate, p =0.074) and CCAD (left middle turbinate, p =0.017; right middle turbinate, p =0.009) than nonallergy and nonCCAD patients. Conclusion Allergic phenotype of CRSwNP has a worse clinical and radiological disease burden. Optimal treatment of allergy is essential for a better outcome.

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“…The Lund‐Mackay CT score was found to be similar between the allergen‐sensitized and nonatopic patients among our CRS population (Table ). Other studies also did not find a statistically significant association between atopy status and CRS or differences in the Lund‐Mackay CT score between the atopic and nonatopic group . The Lund‐McKay score does not differentiate diseased sinuses between 5% opacified sinus and 95% opacified sinus, and does not differentiate location of disease.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies also did not find a statistically significant association between atopy status and CRS or differences in the Lund-Mackay CT score between the atopic and nonatopic group. 16,17 The Lund-McKay score does not differentiate diseased sinuses between 5% opacified sinus and 95% opacified sinus, and does not differentiate location of disease. It is not surprising that an absolute Lund-Mackay score did not differentiate these groups.…”

Section: Discussionmentioning

confidence: 99%

Allergic phenotype of chronic rhinosinusitis based on radiologic pattern of disease

et al. 2018

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Role of atopy in chronic rhinosinusitis with nasal polyps: does an atopic condition affect the severity and recurrence of disease?

Abstract: There was no association between atopy status and either disease severity or recurrence in patients with chronic rhinosinusitis with nasal polyps, although atopic patients were younger than non-atopic patients.

Cited by 23 publications

References 32 publications

IL-33 Expression in Chronic Rhinosinusitis with Nasal Polyps and Its Relationship with Clinical Severity

IL-33 Expression in Chronic Rhinosinusitis with Nasal Polyps and Its Relationship with Clinical Severity

<p>The Clinical and Radiological Characterizations of the Allergic Phenotype of Chronic Rhinosinusitis with Nasal Polyps</p>

Allergic phenotype of chronic rhinosinusitis based on radiologic pattern of disease

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