The role of type 2 innate lymphoid cells in the pathogenesis of eosinophilic chronic rhinosinusitis with nasal polyps / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the type 2 innate lymphoid cells (ILC2s) in eosinophilic nasal polyps, non-eosinophilic nasal polyps and controls, and to compare the characteristics of ILC2s indifferent types of nasal polyp.@*Methods@#Flow cytometric analysis was used to quantify the ILC2s and Th2 cells in tissues from 19 patients with chronic rhinosinusitis with nasal polyp (CRSwNP) and 6 controls. The patients were classified into two groups as eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and non-eosinophilic chronic rhinosinusitis with nasal polyps (non-ECRSwNP) based on eosinophil counts under hematoxylin-eosin staining. ILC2 and Th2 cell frenquencies, measured as a percentage of CD45+ cells, were compared among ECRSwNP group (n=9), non-ECRSwNP group (n=10) and control group (n=6) using Mann-Whitney U test .The correlation between ILC2, Th2 cell frequencies and eosinophil count in tissues was analyzed using Pearson correlation coefficient.@*Results@#ILC2 frequencies in ECRSwNP group were significantly higher than non-ECRSwNP group and controls ((0.051±0.025) vs (0.011±0.017), (0.051±0.025) vs (0.004±0.004), Z value was -3.185, -3.186, respectively, both P<0.05). There was no significant difference between ILC2 frequencies in non-ECRSwNP and controls ((0.011±0.017) vs (0.004±0.004), Z=-0.712, P=0.492). Th2 cell frequencies in ECRSwNP and non-ECRSwNP group were significantly higher than controls ((0.500±0.437) vs (0.106±0.102), (0.275±0.170) vs (0.106±0.102), Z value was -2.946, -2.278, respectively, both P<0.05). There was no significant difference between Th2 frequencies in non-ECRSwNP group and ECRSwNP group ((0.275±0.170) vs (0.500±0.437), Z=-1.306, P=0.211). ILC2 frequencies significantly correlated with Th2 cell frequencies (r=0.571, P=0.011) and tissue eosinophilia (r=0.579, P=0.009). Th2 cell frequencies significantly correlated with tissue eosinophilia (r=0.844, P=0.001). There was no significant association between ILC2 and allergic status.@*Conclusion@#ILC2s are elevated in ECRSwNP, and not influenced by allergic status, suggesting that ILC2s play an important role in ECRSwNP without allergic diseases.

Impact of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the effect of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps (CRSwNP).@*Methods@#From March 2011 to March 2016, 72 cases with CRSwNP were treated by endoscopic sinus surgery in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People′s Hospital. The clinical records were retrospectively reviewed, and the cases were divided into eosinophilia elevated and non-elevated group according to blood eosinophils, and nasal polyps were evaluated for histopathology eosinophil count. Statistical analysis was performed to compare two groups′ pre- and post-operative symptoms of VAS score, sinus computed tomography (CT) scans scores according to the Lund-Mackay system and the outcome of surgery. Both groups′ factors that might have affected their outcome were analyzed by t-test, Chi square, Pearson Correlation Coefficient and Willcoxon rank sum test.@*Results@#Seventy two cases were followed up from 24 to 78 months.The average follow-up time was 56 months. The VAS score in the eosinophilia elevated group (n=16) was higher than that in the non-elevated group(n=56), and the difference was statistically significant (11.44±7.13 vs 4.98±5.64, t=3.726, P<0.05). The control of symptoms in the peripheral blood eosinophilia elevated group was less than that in the non-elevated group, and the difference was statistically significant (Z=-1.979, P<0.05). There was a positive correlation between eosinophil counts in peripheral blood and tissues of 72 cases (r=0.429, P<0.05).@*Conclusion@#There is a significant correlation between tissue and blood eosinophil counts, and eosinophilia group has poorer outcomes.

Short-term efficacy and factors of specific immunotherapy on patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the short-term efficacy and investigate the factors of specific immunotherapy (SIT) efficacy of allergic rhinitis.@*METHOD@#Fifty-seven patients with allergic rhinitis to dermatophagoides pteronysinus were included to receive SIT. Pair t-test was used to compare the symptom scores, visual analogue scores (VAS) and medication scores in patients before SIT and into maintain treatment statement to evaluate the clinical efficacy. T-test and Spearman correlation analysis were used to analyze the correlation between gender, age,reaction condition of skin prick test (SPT) and serum sIgE and the efficacy of SIT.@*RESULT@#SIT was able to significantly reduce the symptom scores, VAS and medication scores. But the correlation between gender, age, SPT, and sIgE and theefficacy of SIT were not significant.@*CONCLUSION@#SIT is effective in the short-term treatment of AR. Further research is needed to investigate the factors that impact the efficacy of SIT.

Expression of AMCase mRNA in nasal mucosa of allergic rhinitis in SD rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To examine AMCase mRNA expression levels in nasal mucosa of allergic rhinitis SD rats.@*METHOD@#Thirty SD rats were chosen and randomly divided into the experimental group and the control group. 20 in experimental group and 10 in the control group. AR model rats were established through repeated intraperitoneal shot of ovalbumin (OVA) for 2 weeks and consequently confirmed by local challenge with OVA for 1 week. The control group was treated by the same method with Physiological saline water instead of OVA. After the last excitation allergic rhinitis was diagnosed according to the accumulation score about nasal symptom. The septal mucosa of all rats were used to diagnose pathologically by HE dyeing. AMCase mRNA in nasal mucosa, obtained from the bilateral nasal mucosa in two groups, were used to do reverse transcriptive polymerase chain reaction. Real-time polymerase chain reaction was used to examine AMCase mRNA expression levels.@*RESULT@#(1) The results showed definitely that there were positive expression of AMCase mRNA in normal nasal mucosa. This expression increase significantly during nasal allergy (P < 0.05). (2) The increased expression of AMCase mRNA in allergic rhinitis are related with the nasal symptoms score (r = 0.411, P < 0.05).@*CONCLUSION@#Increased expression of AMCase mRNA in nasal mucosa in allergic rhinitis model might play roles in the pathogenesis of AR, and Restrain the enzyme activity could become new treatment targets of allergic rhinitis.

Experimental study on the impact of urban inhalable particles on allergic rhinitis of rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#In order to study the effect of inhalable particles on provocation of rat allergic rhinitis model and its possible mechanism.@*METHOD@#After basic sensitizing the experimental rats with OVA by intraperitoneal injection, three groups were provocated by solo OVA, PM10+OVA and solo PM10 through nasal cavity respectively. The control group was sensitized by NS instead of OVA, and then provocated by NS as the method of experimental groups. The symptoms of rat during the provocation were observed and recorded. Then, the rats were sacrificed 24 hours after the last provocation, and the expression of IL-4 in nasal mucosa were detected by immunohistochemical method.@*RESULT@#The groups of OVA and PM10+OVA both had provocated the obvious symptoms of allergic rhinitis, while the groups of PM10 and NS had the symptoms of scratching nose occasionally. By statistical analysis of the amount of IL-4 positive cells, there were significant differences between each experimental group and NS group, and there was significant difference between three experimental groups. The amount of IL-4 positive cells in PM10+OVA group was obviously higher than that in other groups.@*CONCLUSION@#In the period of provocation the rat allergic rhinitis, the inhalable particles play a synergic role with allergen, and it can aggravate the symptoms of allergic rhinitis.

To investigate the effect of pretreatment with budesonide spray in patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effects of prophylactic drugs on allergic rhinitis.@*METHOD@#Thirty patients diagnosed as allergic rhinitis based on mugwort allergen were randomly divided into three groups: budesonide group (n = 10), saline group (n = 10) and control group (n = 10). The patients in budesonide group and saline group respectively received budesonide nasal spray (64 microg per, 256 microg once daily) and saline nasal spray twice daily starting two weeks before the date which the patient onset last year and continuing up to the end of the pollen season. The patients in control group were treated without any processing. The nasal symptom scores and attack times of the three groups was recorded.@*RESULT@#During the pollen season, 2 patients attacked in the budesonide group (20%), and all the patients attacked in saline group and control group (100%). Statistical significance was found among the three groups (P < 0.01), and between budesonide group and the other two groups (P < 0.01). The budesonide group had lower symptom score than the other two groups and a postponed attack time. All the differences had Statistical significance (Value of chi-square statistic = 21. 558, P < 0.01, Fisher exact test P < 0.01).@*CONCLUSION@#Prophylactic administration of budesonide, starting two weeks before the date which the patient onset may release symptom and even avoid the attack of the allergic rhinitis based on mugwort allergen.

Effect of nasal septal suture versus nasal packing after septoplasty / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Patients undergone septoplasty, which is one of the most common procedures, always feel very painful after surgery because of routine nasal packing. The objective of this study was to evaluate the effect of septal suture technique without nasal packing after septoplasty.@*METHOD@#Eighty patients who had undergone septoplasty were included in this study. The patients were allocated into tow groups: packing group, mercel was used for nasal packing after septoplasty and inferior turbinate coblation; suturing group, septal suture and inferior turbinate coblation were performed after septoplasty without nasal packing. Postoperative signs and symptoms(visual analogue scale,VAS) were compared between the two groups.@*RESULT@#The patients of packing group experienced significantly more postoperative nasal pain, headache, dysphagia, sleep disturbance and bleeding after surgery (P < 0.01). No difference of epiphora was found between the two groups. More pain and bleeding were experienced during the pack removal(packing group), compared to that during the clearance of nasal cavity (suturing group ). One patient with postoperative septal hematoma was found in the packing group.@*CONCLUSION@#Nasal septum suture combined with inferior turbinate coblation might be a significantly more comfortable, reliable alternative to nasal packing. Nasal packing is not the necessary application for septoplasty.

Acute injury of inhalable particle matters on nasal mucous membrane of rat / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the mechanism of the nasal mucous membrane inflammation induced by the inhalable particle matter (PM10).@*METHOD@#Three dosage PM10 were instilled in rat nasal cavity of different groups for one week. The morphology of nasal mucosa and the numbers of inflammatory cell were observed in each samples.@*RESULT@#The total numbers of inflammatory cells in PM10-treated groups were increased in a dose-respondent manner and significantly different from that in control group. The results of histopathological and scanning electron microscope (SEM) analysis indicated that PM10 caused nasal mucosa injury and pathological changes, such as the damage of cilia and nasal mucosa epithelium in a dose dependent way. The infiltration of inflammatory cells in nasal mucosa epithelium matrix, especially eosinophilia were observed.@*CONCLUSION@#PM10 can cause rat's nasal mucosa inflammation and epithelial injury.

Endoscopic rhinoplasty of nasal cavity for treatment of structural rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss endoscopic surgical treatment and its effect on structural rhinitis.@*METHOD@#Eighty-four patients with structural rhinitis were treated by endoscopic rhinoplasty of nasal cavity, include: (1) inferior turbinoplasty with three segment method, (2) middle turbinoplasty, (3) functional resection of ostiomeatal complex, (4) endoscopic submucous septoplasty. To achieve organic combination of the above surgery methods according to the patient's symptom and the different results of the CT scan, the surgical procedure were designed individually.@*RESULT@#All patients were followed-up for 8 to 12 months, average 10 months. The rate of fully recovered without serious complication was 95.24%. CONCLUSTION: Structural rhinitis is a sort of functional disease as a result of multi-abnormality of nasal cavity structure. Endoscopic rhinoplasty is an effective treatment by means of reconstructing the balance of bilateral nasal cavity and improving its function.

Impact of inhalable particles on allergic rhinitis of rats / 中国耳鼻咽喉头颈外科

OBJECTIVE In order to study the effect of inhalable particles on evocation of allergic rhinitis in rats and its possible mechanism. METHODS The experimental group rats were basically allergized with OVA from intraperitoneal injection. Three groups were provoked by OVA alone, PM10 plus OVA and PM10 alone through nasal cavity respectively. The Control Group was allergized by NS instead of OVA, while the method of provocation was the same as experimental group. Then, the rats were sacrificed 24 hours after the last provocation. The morphological changes of the rats' nasal mucosa were observed by scanning electron microscope and hematoxylin-eosin (HE). The number of the eosinophile of the rats' nasal mucosa was counted under HE staining. RESULTS The amount of eosinophile in the three experimental groups was significantly different from that in NS group, and there was also a significant difference among three experimental groups. The amount of eosinophile in PM10 plus OVA group was obviously higher than that in other groups. Observed by scanning electron microscope, the cilia of the epithelium of the three experimental groups were significantly reduced, fallen off, fallen down, got enlaced, and adhered by secretion. CONCLUSION In the period of provoking, the inhalable particles may play a synergic role with allergen, and it can aggregate the rats' nasal mucosa injury and the allergic inflammation.

A study of the correlation between serum-specific IgE and IL-13 single nucleotide polymorphism among the patients with allergic rhinitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the correlation between the serum-specific IgE and IL-13 single nucleotide polymorphism (SNP) among patients with allergic rhinitis who were allergic to Dermataphagoides pteronyssinus(Derp1) or Artemisia Pollen. METHODS Sixty nine patients who were allergic to Derp1 and 87 patients who were allergic to pollen were examined for detecting serum-specific IgE by a fluorescent enzyme immunoassay. The IL-13 SNP of the coding sequence (Arg130Gln) and the promoter region -1112(C/T)was measured by polymerase chain reaction /restriction fragment length polymorphism (PCR-RFLP) techniques. RESULTS Among patients who were allergic to Derp1, there was a significant correlation between the IL-13 promoter -1112(C/T)SNP ,but not of Arg130Gln ,and serum-specific IgE. Among patients who were allergic to pollen, there were no significant association both of the IL-13 promoter -1112(C/T)and Arg130Gln SNPs with serum-specific IgE. CONCLUSION The results showed a significant association of the IL-13 promoter -1112(C/T)SNP with serum-specific IgE in patients who allergic to Derp1. That suggested a possible involvement of IL-13 promoter -1112(C/T)SNP in the regulation of serum-specific IgE response to Derp1 allergens.

Linkage of allergic rhinitis with HLA-DRB alleles polymorphism / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate whether susceptibility or resistance to allergic rhinitis associated with HLA-DRB alleles.Method:Using PCR-SSP (sequence-specific primer polymerase chain reaction),we tested the frequency distribution of HLA-DRB alleles in 41 patients with allergic rhinitis (AR) and 41 healthy controls from Beijing China.Result:The frequence of HLA-DRB10301.2 and HLA-DRB 40101 was lower in AR than in controls (2.44% vs 17.07%, P＜0.05;29.27% vs 51.22%, P＜0.05).Conclusion:HLA-DRB10301.2 and HLA-DRB 40101 alleles might confer protection against AR.

A Paired Case-Control Study on Risk Factors of Allergic Rhinitis in Adults / 环境与健康杂志

Objective To understand the risk factors of allergic rhinitis in adults. Methods Using 1:1 paired matching case-control study design, 100 pairs of adults allergic rhinitis patients and the relevant controls from the E.N.T. department of Renmin Hospital of Peking University were recruited. Cases and controls were interviewed face to face using a designed health questionnaire in which the general social demographic characters, disease history, smoking history, occupation, indoor environmental situation and family genetic history were included. The questionnaires were analyzed by signal and multiple regression model of SPSS software. Results Allergic rhinitis was associated with the pollen allergic history (OR=2.04,95%CI: 1.31-3.20), occupational exposure to dust was a risk factor of allergic rhinitis (OR=1.46, 95%CI:0.83-2.57), the mother allergic rhinitis history could increase the risk of their off-springs suffering from allergic rhinitis(OR=2.05, 95%CI:1.03-4.07) and keeping ventilation could significantly decrease the risk suffering from allergic rhinitis(OR=0.70, 95%CI:0.34-1.18). Conclusion The occupational dust exposure, pollen allergy and mother allergic rhinitis history are related to allergic rhinitis in adults. Keeping ventilation may be a protective factor of allergic rhinitis in adults.