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Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (12): 338-343, 2023.
Article in Chinese | WPRIM | ID: wpr-982745


〓 Objectives: To analyze the pathological and clinical features of nasal respiratory epithelial adenomatoid hamartoma(REAH), and summarize the diagnostic points, to improve the experience of diagnosis and treatment. Methods:The clinical data of 16 patients with REAH were analyzed retrospectively. The clinical manifestations, pathological features, imaging features, surgical treatment and prognosis were summarized. Results:16 cases of REAH were studied, 10 cases(62.50%) were associated with sinusitis, 1 case(6.25%) was associated with inverted papilloma, 1 case(6.25%) was associated with hemangioma. 5 cases(31.25%) had a history of nasal sinus surgery, including 1 case with 3 times of nasal sinus surgery, 1 case with 2 times of nasal sinus surgery, 3 cases with 1 time of nasal sinus surgery; 10 cases(62.50%) occurred in the bilateral olfactory cleft, 2 cases(12.50%) in the unilateral olfactory cleft, 3 cases(18.75%) in the unilateral middle turbinate, 1 case(6.25%) in the nasopharynx. All 16 patients were pathologically diagnosed as REAH. In the patients with lesions located in bilateral olfactory fissures, symmetrical widening of olfactory fissures and lateral displacement of middle turbinate were observed on preoperative sinus CT. The average width of bilateral olfactory fissures was (9.9±2.70) mm. The ratio of wide to narrow olfactory cleft was 1.21 ± 0.19. There was no significant difference in Lund-Mackay score between the two sides(P>0.05). All patients underwent surgery under general anesthesia and nasal endoscopy. The follow-up period ranged from 1 to 66 months, and no recurrence occurred. Conclusion:Preoperative diagnosis of REAH is facilitated by the combination of clinical manifestations and endoscopic and imaging features. Endoscopic complete resection can achieve a good therapeutic effect.

Humans , Nasal Polyps/complications , Retrospective Studies , Paranasal Sinuses/pathology , Adenoma , Endoscopy/methods , Hamartoma/surgery
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (12): 871-885, 2023.
Article in Chinese | WPRIM | ID: wpr-1011092


Objective:To analyze the influencing factors and perform the prediction of olfactory disorders in patients with chronic rhinosinusitis(CRS) based on artificial intelligence. Methods:The data of 75 patients with CRS who underwent nasal endoscopic surgery from October 2021 to February 2023 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. There were 53 males and 22 females enrolled in the study, with a median age of 42.0 years old. The CRS intelligent microscope interpretation system was used to calculate the proportion of area glands and blood vessels occupy in the pathological sections of each patient, and the absolute value and proportion of eosinophils, lymphocytes, plasma cells and neutrophils. The patients were grouped according to the results of the Sniffin' Sticks smell test, and the clinical baseline data, differences in nasal mucosal histopathological characteristics, laboratory test indicators and sinus CT were compared between the groups. Determine the independent influencing factors of olfactory disorders and receiver operating characteristic curves(ROC) were used to evaluate the performance of the prediction model. Statistical analysis was performed using SPSS 25.0 software. Results:Among the 75 CRS patients, 25 cases(33.3%) had normal olfaction and 50 cases(66.7%) had olfactory disorders. Multivariate Logistic regression analysis showed that tissue eosinophils percentage(OR=1.032, 95%CI 1.002-1.064, P=0.036), Questionnaire of olfactory disorders-Negative statement(QOD-NS)(OR=1.079, 95%CI 1.004-1.160, P=0.040) and Anterior olfactory cleft score(AOCS)(OR=2.672, 95%CI 1.480-4.827, P=0.001) were independent risk factors for olfactory disorders in CRS patients. Further research found that the area under the ROC curve(AUC) of the combined prediction model established by the tissue eosinophil percentage, QOD-NS and AOCS was 0.836(95%CI 0.748-0.924, P<0.001), which is better than the above single factor prediction model in predicting olfactory disorders in CRS. Conclusion:Based on pathological artificial intelligence, tissue eosinophil percentage, QOD-NS and AOCS are independent risk factors for olfactory disorders in CRS patients, and the combination of the three factors has a good predictive effect on CRS olfactory disorders.

Male , Female , Humans , Adult , Retrospective Studies , Artificial Intelligence , Rhinosinusitis , Rhinitis/complications , Nasal Polyps/complications , Sinusitis/complications , Olfaction Disorders/etiology , Smell , Chronic Disease
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (12): 878-885, 2023.
Article in Chinese | WPRIM | ID: wpr-1011064


Objective:To compare the perioperative efficacy and safety of postoperative oral glucocorticoid and glucocorticoid stent implantation in patients with chronic rhinosinusitis with nasal polyps(CRSwNP) undergoing functional endoscopic sinus surgery(FESS). Methods:Sixty patients with bilateral CRSwNP with similar degree of lesions were selected and divided into three groups: conventional surgical treatment group(20 cases), glucocorticoid stent group(20 cases), and oral glucocorticoid group(20 cases). All three groups underwent routine FESS, patients in the sinus glucocorticoid stent group receiving sinus glucocorticoid stent placed in the ethmoid sinuses(one on each side) during surgery, and patients in the oral glucocorticoid group received postoperative oral methylprednisolone at a dose of 0.4 mg/kg per day for 7 days, followed by a tapering of 8 mg per week to 8 mg followed by maintenance therapy for 1 week, for a total of 3-4 weeks. Visual analog scale(VAS) scores were used to evaluate nasal congestion, rhinorrhea, olfaction, and facial pressure symptoms before surgery, as well as at 2, 4, 8, and 12 weeks after surgery. Nasal endoscopic Lund-Kennedy scores were recorded, and adverse reactions such as stent detachment, stent-related allergic reactions, sleep disorders, edema, gastrointestinal symptoms, rash/acne, behavioral/cognitive changes, weight gain, limb pain, and infection risk were documented. Results:The nasal congestion symptom scores at 2, 4, 8, and 12 weeks after surgery were significantly lower than those before operationin all three groups, and the differences were statistically significant(P<0.05). The sinus glucocorticoid stent group exhibited significantly lower nasal congestion symptom scores at 4 and 8 weeks after surgery compared to the conventional surgical treatment group. The rhinorrhea symptom scores at 2, 8, and 12 weeks after surgery were significantly lower than preoperative scores in all three groups. Additionally, the sinus glucocorticoid stent group had significantly lower rhinorrhea scores than the conventional surgical treatment group at 2 weeks postoperatively. Concerning olfaction, the sinus glucocorticoid stent group showed a significant reduction in scores at 12 weeks postoperatively, while the oral glucocorticoid group exhibited significant improvement starting from 8 weeks after surgery. There were no statistically significant differences in nasal congestion, rhinorrhea, facial pressure, and olfaction scores between the sinus glucocorticoid stent and oral glucocorticoid groups at 2, 4, 8, and 12 weeks postoperatively. Nasal endoscopy scores revealed lower polyp scores and edema at 2, 4, 8, and 12 weeks postoperatively for all three groups compared to preoperative scores. The conventional surgical treatment group exhibited a significant reduction in nasal secretion scores starting from 8 weeks after surgery, while both the sinus glucocorticoid stent and oral glucocorticoid groups showed significant reductions starting from 2 weeks postoperatively, with scores significantly lower than those of the conventional surgical treatment group at 2 weeks. Scab/scar scores in the conventional surgical treatment group significantly decreased from 8 weeks after surgery, while both the sinus glucocorticoid stent and oral glucocorticoid groups exhibited significant reductions starting from 4 weeks. No statistically significant differences were observed in endoscopy scores(including polyps, edema, nasal secretion, scars, and scabs) between the sinus glucocorticoid stent and oral glucocorticoid groups at 2, 4, 8, and 12 weeks postoperatively. Regarding adverse reactions, no postoperative complications related to sinus glucocorticoid stent were observed in the sinus glucocorticoid stent group. In the oral glucocorticoid group,1 patient experienced irritability, and 1 patient experienced weight gain. Conclusion:The glucocorticoid stent implantation has comparable effects to oral glucocorticoid in improving postoperative nasal symptoms, reducing nasal mucosal edema, scar formation, and nasal secretion in patients with CRSwNP undergoing FESS, with a better safety profile.

Humans , Nasal Polyps/complications , Glucocorticoids/therapeutic use , Cicatrix/complications , Sinusitis/complications , Postoperative Period , Endoscopy , Rhinorrhea , Edema/complications , Weight Gain , Chronic Disease , Rhinitis/complications , Treatment Outcome
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (12): 864-870, 2023.
Article in Chinese | WPRIM | ID: wpr-1011063


Objective:To investigate whether changes in postoperative symptoms and signs in patients can predict the recurrence of ECRS after nasal endoscopic sinus surgery. Methods:A total of 70 adult patients with ECRS were enrolled for ESS surgery from June 2020 to March 2022 in a single center. There were 50 males and 20 females, with an average age of (46.9±14.5) years. Follow-up after ESS was at least 52 weeks. Patients undergo peripheral blood tests, CT of the sinuses, olfactory T&T test, visual analogue scale of symptoms(VAS), and endoscopic scoring. Results:VAS scores and endoscopic scores were analyzed at preoperative and 6th week, 12th week, 24th week and 52th week postoperative. After 12th week postoperatively, there was a clear correlation between symptom scores and endoscopic scores. Moreover, olfactory disorder and nasal discharge were the two most obvious symptoms. There were differences in the expression of multiple preoperative clinical inflammatory indicators between the symptom-controled group and the symptom-uncontrolled group(previous surgical history, concomitant asthma, nasal smear eosinophil, serum EOS%, total IgE, CT score, olfactory score, and symptom score, all with P<0.05), while there was no difference in baseline endoscopic score(P>0.05). At 12th week postoperative, the two groups of patients showed significant differences in both symptom scores and endoscopic scores. The symptoms and endoscopic score at the 12th week point of follow-up were used as predictive indicators for recurrence, with sensitivity and specificity of 62.5% and 83.3%, respectively. Conclusion:The changes in postoperative symptom score and endoscopic score in ECRSwNP patients indicated that the recurred ECRS. In the symptom-uncontrolled group, symptomatic and endoscopic scores showed consistent increased scores; In the symptom-controlled group, conflicting results between increased endoscopic scores and stable symptoms suggest that the presence of asymptomatic recurrence must be considered. The changes in symptoms and signs at the 12th week point of follow-up can serve as clinical indicators for preventing disease recurrence.

Male , Adult , Female , Humans , Middle Aged , Nasal Polyps/complications , Self Report , Rhinitis/complications , Sinusitis/complications , Paranasal Sinuses/surgery , Endoscopy , Chronic Disease
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (12): 856-863, 2023.
Article in Chinese | WPRIM | ID: wpr-1011062


Objective:To investigate the correlation between FCER2(2206A>G) gene polymorphism and the efficacy of inhaled corticosteroids(ICS) in patients with chronic rhinosinusitis(CRS). Methods:A total of 208 CRS patients were routinely treated with functional endonasal sinus surgery and postoperative ICS. DNA extraction, PCR amplification and gene sequencing were performed to observe the FCER2(2206A>G) gene polymorphism and calculate the allele frequency. The visual analog scale(VAS) score, Lund-Kennedy score, and computed tomography(CT) Lund-Mackay score were determined 6 months after surgery among patients with different genotypes. Moreover, the polymorphism frequency was compared among different subgroups(chronic rhinosinusitis with nasal polyps versus chronic rhinosinusitis without nasal polyps, eosinophilic chronic rhinosinusitis versus non-eosinophilic chronic rhinosinusitis). Results:There were FCER2(2206A>G) gene polymorphism in patients with CRS, and the phenotypes included 3 genotypes, AA, AG and GG, with distribution frequencies of 68(32.7%), 116(55.8%) and 24(11.5%) cases, respectively. No significant differences were found in age, VAS score, nasal endoscopic Lund-Kennedy score and CT imaging Lund-Mackay score among patients with CRS of each genotype before surgery. In patients with the AA genotype, the changes in VAS score(5.74±1.10), Lund Kennedy score(5.92 ± 1.14), and CT imaging Lund-Mackay score(13.26±4.26) were significantly higher than in patients with the AG(4.37±0.86, 5.37±1.24, 10.82±3.77) and GG(4.26±0.80, 5.18±1.56, 10.10±3.53) genotype(P<0.05). However, there were no marked difference between patients with the AG genotype and those with the GG genotype(P>0.05). Compared with patients with non-eosinophilic sinusitis, Among them, the differences between the GG genotype and AG /AA genes were more significant in eosinophilic sinusitis compared to non-eosinophilic sinusitis(P<0.01). Conclusion:The FCER2(2206A>G) gene in patients with CRS has genetic polymorphism and is associated with the recovery of CRS patients after surgery, individual corticosteroid sensitivity, and subgroup variability.

Humans , Nasal Polyps/complications , Rhinitis/complications , Sinusitis/complications , Adrenal Cortex Hormones/therapeutic use , Polymorphism, Genetic , Endoscopy/methods , Chronic Disease , Receptors, IgE , Lectins, C-Type
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 142-152, 2022.
Article in Chinese | WPRIM | ID: wpr-936187


Objective: To detect the percentages of CD8+Treg cells in the nasal mucosa and peripheral blood of chronic rhinosinusitis (CRS) and to explore their correlation with eosinophilic infiltration. Methods: Thirty-three chronic rhinosinusitis with polyp (CRSwNP), 26 chronic rhinosinusitis without polyp (CRSsNP) and 27 control patients who were collected with the nose mucosal tissue and peripheral blood in the Third Affiliated Hospital of Sun Yat-sen University from March 2017 to October 2018 were selected, including 59 males and 27 females, aging from 18 to 72 years. Hematoxylin and eosin (HE) staining was used to observe the number of eosinophils in the nasal tissues and to classify the CRS into eosinophilic CRS (ECRS) and non-eosinophilic CRS (Non-ECRS). Flow cytometry was used to detect the percentages of CD4+ and CD8+T cells in lymphocytes of nasal mucosa and peripheral blood. The percentages of CD8+Foxp3+Treg cells, CD8+Foxp3-IL-10+Treg cells, CD8+IFN-γ+T cells (Tc1), CD8+IL-4+T cells (Tc2) and CD8+IL-17A+T cells (Tc17) in lymphocytes of nasal mucosa and peripheral blood were also tested. Besides, the percentages of Foxp3+TGF-β+Treg cells and Foxp3+IL-10+Treg cells in CD8+T cells were determined. All data were represented by M (IQR). GraphPad 7.0 and SPSS 16.0 were used for illustration and statistical analysis. Results: The percentage of CD8+T cells (37.75%(17.35%)) was higher than that of CD4+T cells (4.72%(4.29%)) in nasal mucosa (Z=-5.70, P<0.001), while lower (23.60%(9.33%)) than that of CD4+T cells (44.05% (10.93%)) in peripheral blood (t=9.72, P<0.001). CRSwNP patients possessed the highest Tc2 (1.82% (1.22%)) and Tc17 (1.93% (2.32%)) percentages than CRSsNP (Tc2: 0.84% (0.79%); Tc17: 0.54% (1.04%)) and control (Tc2: 1.09% (0.92%); Tc17: 0.47% (0.51%), both P<0.05) patients. While, CRSwNP patients possessed the lowest CD8+Foxp3+Treg cells percentage (0.10% (0.32%)) than CRSsNP (0.43% (1.45%)) and control (0.48% (0.83%), Z value was -2.24, -2.22, respectively, P value was 0.025, 0.027, respectively). The percentages of Foxp3+TGF-β+Treg cells and Foxp3+IL-10+Treg cells of CD8+T cells in nasal mucosa in CRSwNP were also lower than controls (Z value was 1.46, 0.49, respectively, both P=0.001). Moreover, the percentage of CD8+Foxp3-IL-10+Treg cells of CD8+T cells was decreased in nasal mucosa of CRSwNP patients (0.14% (0.28%)) when compared with that of CRSsNP (0.89% (0.81%), Z=0.61, P=0.03). ECRS patients had the lower percentages of CD8+Foxp3+Treg cells (0.07% (0.44%)) and CD8+Foxp3-IL-10+Treg cells (0.13% (0.21%)) than Non-ECRS patients (CD8+Foxp3+Treg cells: 0.53% (0.75%); CD8+Foxp3-IL-10+Treg cells: 0.29% (0.76%), t value was 2.14, 2.78, respectively, both P<0.05). The percentage of CD8+Foxp3+Treg cells and the ratio of CD8+Foxp3-IL-10+T per CD8+T cells were negatively correlated with the percentage of eosinophils in CRS patients(R2 value was 0.56, 0.78, respectively, both P<0.001). There was no significant difference in the distribution of CD8+Fxop3+Treg cells and CD8+Fxop3-IL-10+Treg cells in peripheral blood among different groups. Conclusion: The percentages of CD8+Treg cells decrease in CRSwNP patients, especially in ECRS patients, which are opposite to that of Tc2 and Tc17, and negatively correlate with the eosinophils percentage. This indicates that the decrease in the ratio of CD8+Treg cell may be associated with the immune-imbalance and eosinophilic infiltration in nasal mucosa of CRS patients.

Female , Humans , Male , CD8-Positive T-Lymphocytes , Chronic Disease , Nasal Polyps/complications , Rhinitis/complications , Sinusitis/complications , T-Lymphocytes, Regulatory
Braz. j. otorhinolaryngol. (Impr.) ; 87(3): 298-304, May-Jun. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1285695


Abstract Introduction The antiinflammatory effects of macrolides, especially clarithromycin, have been described in patients with chronic rhinosinusitis without polyps and also other chronic inflammatory airway diseases. There is no consensus in the literature regarding the effectiveness of clarithromycin in patients with chronic rhinosinusitis with sinonasal polyposis and the national literature does not report any prospective studies on the efficacy of clarithromycin in chronic rhinosinusitis in our population. Objective To evaluate the effect of clarithromycin in the adjunctive treatment of recurrent chronic rhinosinusitis with sinonasal polyposis refractory to clinical and surgical treatment. Methods Open prospective study with 52 patients with chronic rhinosinusitis and recurrent sinonasal polyposis. All subjects received nasal lavage with 20 mL 0.9% SS and fluticasone nasal spray, 200 mcg / day, 12/12 h for 12 weeks; and clarithromycin 250 mg 8/8 h for 2 weeks and, thereafter, 12/12 h for 10 weeks. The patients were assessed by SNOT 20, NOSE and Lund-Kennedy scales before, immediately after treatment and 12 weeks after treatment. The patients were also evaluated before treatment with paranasal cavity computed tomography (Lund-Mackay) and serum IgG, IgM, IgA, IgE and eosinophil levels. The outcomes evaluated were: SNOT-20, NOSE and Lund-Kennedy. Results Most patients were women, aged 47 (15) years (median / interquartile range), and 61.5% (32/52) had asthma. All patients completed the follow-up after 12 weeks and 42.3% (22/52) after 24 weeks. Treatment resulted in a quantitative decrease in the SNOT-20 [2.3 (1.6) vs. 1.4 (1.6); Δ = −0.9 (1.1); p < 0.01]; NOSE [65 (64) vs. 20 (63); Δ = −28 (38), p < 0.01] and Lund-Kennedy [11 (05) vs. 07 (05); Δ = −2 (05); p < 0.01] scores. SNOT-20 showed a qualitative improvement (>0.8) in 54% (28/52, p < 0.04) of patients, a group that showed lower IgE level [108 (147) vs. 289 (355), p < 0.01]. The group of patients who completed follow-up 12 weeks after the end of treatment (n = 22) showed no worsening of outcomes. Conclusion Long-term adjuvant use of low-dose clarithromycin for chronic rhinosinusitis patients with recurrent sinonasal polyposis refractory to clinical and surgical treatment has resulted in improved quality of life and nasal endoscopy findings, especially in patients with normal IgE levels. This improvement persisted in the patient group evaluated 12 weeks after the end of the treatment.

Resumo Introdução Os efeitos anti-inflamatórios dos macrolídeos são reconhecidos, principalmente da claritromicina para os pacientes com rinossinusite crônica sem pólipos e outras doenças inflamatórias crônicas das vias aéreas em outras populações. Não existe consenso na literatura quanto a sua prescrição para os pacientes de rinossinusite crônica com polipose nasossinusal e a literatura nacional não dispõe de estudos prospectivos sobre a eficácia da claritromicina na rinossinusite crônica em nossa população. Objetivo Avaliar o efeito da claritromicina no tratamento adjuvante da rinossinusite crônica recorrente com polipose nasossinusal refratária ao tratamento clínico e cirúrgico. Método Estudo prospectivo aberto, com 52 pacientes, portadores de rinossinusite crônica com polipose nasossinusal recorrente. Todos os indivíduos receberam lavagem nasal com SF 0,9% 20 mL e fluticasona spray nasal, 200 mcg/dia, 12/12 horas por 12 semanas; e claritromicina 250 mg, de 8/8 horas, por 2 semanas e posteriormente 12/12 horas, por 10 semanas. Os pacientes foram avaliados através do SNOT 20, do NOSE e Lund-Kennedy antes, pós-tratamento imediato e 12 semanas após o tratamento. Os pacientes também foram avaliados antes do tratamento por tomografia computadorizada das cavidades paranasais (Lund-Mackay) e dosagem sérica de IgG, IgM, IgA, IgE e eosinófilos. Os desfechos avaliados foram: SNOT-20, NOSE e Lund-Kennedy. Resultados A maioria dos pacientes era mulher, idade de 47 (15) anos (mediana/intervalo interquartílico) e 61,5% (32/52) portadores de asma. Todos os pacientes completaram o seguimento após 12 semanas e 42,3% (22/52) após 24 semanas. O tratamento resultou em uma diminuição quantitativa do SNOT-20 [2,3 (1,6) vs. 1,4 (1,6); Δ = -0,9 (1,1); p< 0,01]; do NOSE [65 (64) vs. 20 (63); Δ = -28 (38), p< 0,01] e do Lund-Kennedy [11 (05) vs. 07 (05); Δ = -2 (05); p< 0,01]. O SNOT-20 mostrou uma melhoria qualitativa (> 0,8) em 54% (28/52, p< 0,04) dos pacientes, grupo que evidenciou menor nível de IgE [108 (147) vs. 289 (355), p< 0,01]. O grupo de pacientes que completou o seguimento 12 semanas após o término do tratamento (n = 22) não mostrou uma pioria dos desfechos. Conclusão O uso prolongado adjuvante da claritromicina em baixas doses para pacientes com rinossinusite crônica com polipose nasossinusal recorrente refratária ao tratamento clínico e cirúrgico resultou em melhoria na qualidade de vida e endoscopia nasal, principalmente em pacientes com níveis de IgE normal. Essa melhoria se sustentou no grupo de pacientes avaliado 12 semanas após o término do tratamento.

Rhinitis/drug therapy , Nasal Polyps/complications , Nasal Polyps/drug therapy , Quality of Life , Chronic Disease , Prospective Studies , Treatment Outcome , Clarithromycin , Endoscopy
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 824-829, 2021.
Article in Chinese | WPRIM | ID: wpr-942530


Objective: To assess the efficacy of a bioabsorbable steroid-eluting sinus stent in improving surgical outcomes when placed in the frontal sinus ostium (FSO) following full endoscopic sinus surgery (ESS) in patients with whole group chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients with whole group CRSwNP who had similar lesions on bilateral sinus between September 2019 and March 2020 in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital were chosen. Patients with CRSwNP who underwent extended ESS were randomly assigned to receive a steroid-eluting sinus stent in one FSO whereas the contralateral side received surgery alone. Endoscopic evaluations recorded at 30, 90 days postoperative were graded by an independent assessment panel to assess the need for interventions in the FSO. Semi-quantitative data with CT and endoscopic score were performed by rank sum test. The need for postoperative intervention and the patency rate of FSO were analyzed using the McNemar test. Results: Thirty-one patients with whole group CRSwNP met all eligible criteria, including 17 males and 14 females, with the age of (44.5±11.8) years(x¯±s). Stents were successfully placed in one FSO of all patients. At 30 days post-ESS, the assessment panel reported that steroid-eluting stents reduced the need for postoperative interventions by 41.0% (χ2=5.314,P=0.021), the need for oral steroid interventions by 40.0% (χ2=4.133,P=0.042) and the need for surgical interventions by 74.8% (χ2=4.292,P=0.038) compared to control sinuses with no stents. Clinical surgeons also reported greater diameter of FSO compared to control sinuses at 30 days post-ESS (74.2% vs 48.4%, χ2=4.351, P=0.037). These results at 90 days post-ESS were consistent with those at 30 days post-ESS. Conclusion: Bioabsorbable steroid-eluting sinus stents in the FSO can reduce polyp formation, adhesion, and the need for postoperative interventions in FSO of CRSwNP patients and improve the early postoperative outcomes.

Adult , Female , Humans , Male , Middle Aged , Absorbable Implants , China , Chronic Disease , Endoscopy , Frontal Sinus/surgery , Nasal Polyps/complications , Paranasal Sinuses , Rhinitis/complications , Stents , Steroids , Treatment Outcome
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 743-747, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142588


Abstract Introduction: Chronic rhinosinusitis with nasal polyps, a prevalent disease affecting around 2% of the world population, is characterized by symptomatic inflammation of the nasal mucosa and impairment of quality of life. Chronic rhinosinusitis with nasal polyps has a multifactorial etiology, involving a dysfunctional host response to environmental factors. Thus, inflammatory models may be useful to shed light on the pathophysiology of this disease. Micronucleus count has been used to screen DNA damage in various tissues. Objective: To investigate the association between frequency of micronucleus in exfoliated cells from the nasal cavity of patients with chronic rhinosinusitis with nasal polyps and disease severity. Methods: This cross-sectional study included 21 patients with chronic rhinosinusitis with nasal polyps and 19 controls without disease. None of the participants were smokers. Results: Mean micronucleus count was 3.690 per 1000 cells (±2.165) in individuals with vs. 1.237 per 1000 cells (±0.806) in controls; (Student's t test = 4.653, p< 0.001). Nasal surgery in the past 5 years and aspirin-exacerbated respiratory disease were not associated with nicronucleus count (p= 0.251). Conclusion: Micronucleus count seems to be linked to chronic rhinosinusitis with nasal polyps, providing a new perspective for the evaluation of this disorder.

Resumo Introdução: A rinossinusite crônica com pólipos nasais, doença prevalente que afeta cerca de 2% da população mundial, é caracterizada por inflamação sintomática da mucosa nasal e comprometimento da qualidade de vida. A rinossinusite crônica com pólipos nasais tem etiologia multifatorial, envolvendo resposta disfuncional do hospedeiro a fatores ambientais. Assim, modelos inflamatórios podem ser úteis para esclarecer a fisiopatologia dessa doença. A contagem de micronúcleos tem sido usada para rastrear danos no DNA em vários tecidos. Objetivo: Investigar a associação entre a frequência de micronúcleos em células esfoliadas da cavidade nasal de pacientes com rinossinusite crônica com pólipos nasais e a gravidade da doença. Método: Estudo transversal que incluiu 21 pacientes com rinossinusite crônica com pólipos nasais e 19 controles sem doença. Nenhum dos participantes era fumante. Resultados: A contagem média de micronúcleos foi de 3,690 por 1.000 células (± 2,165) nos indivíduos doentes e 1,237 por 1.000 células (± 0,806) nos controles (teste t de Student = 4,653; p < 0,001). A cirurgia nasal nos últimos 5 anos e a doença respiratória exacerbada por aspirina não foram associadas à contagem de micronúcleos (p = 0,251). Conclusão: A contagem de micronúcleos parece estar ligada à rinossinusite crônica com pólipos nasais, proporcionando uma nova perspectiva para a avaliação dessa doença.

Humans , Sinusitis/complications , Rhinitis/complications , Nasal Polyps/complications , Quality of Life , Chronic Disease , Cross-Sectional Studies , Epithelial Cells
Rev. otorrinolaringol. cir. cabeza cuello ; 78(2): 157-160, jun. 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-961608


RESUMEN El síndrome de Churg-Strauss (SCS) es una vasculitis necrotizante sistémica de etiología desconocida, que afecta vasos sanguíneos de pequeño y mediano tamaño. Característicamente se definen tres estadios: prodrómico, hipereosinofílico y una etapa de vasculitis sistémica. Dentro del prodrómico se encuentran manifestaciones del área otorrinolaringológica, que suelen preceder por años a las manifestaciones propias de las vasculitis. Entre ellas destacan la otitis media crónica, rinitis alérgica y rinosinusitis crónica poliposa. Reportamos el caso de un paciente de sexo masculino de 64 años con poliposis nasosinusal bilateral, con biopsia compatible con SCS, encontrándose en estado prodrómico de la enfermedad. Además, presentamos una revisión de la literatura sobre esta patología.

ABSTRACT Churg-Strauss syndrome (CSS) is a necrotizing systemic vasculitis of unknown etiology, which involves small and medium-sized vessels. It is characterized by three stages: prodromic, hypereosinophilic and systemic vasculitis. In the prodromal stage we can find otolaryngological manifestations (including chronic otitis media, allergic rhinitis, chronic rhinosinusitis with polyps) that usually precede the proper manifestations of the vasculitis by years. Here, we report a 64-year old male patient with sinonasal polyps and biopsy compatible with CSS, being in the prodromal stage of the illness. Also, we present a review of this disease.

Humans , Male , Middle Aged , Churg-Strauss Syndrome/drug therapy , Churg-Strauss Syndrome/diagnostic imaging , Nasal Polyps/complications , Sinusitis/drug therapy , Vasculitis , Tomography, X-Ray Computed , Rhinitis/drug therapy , Diagnosis, Differential
Braz. j. otorhinolaryngol. (Impr.) ; 83(6): 677-682, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-889333


Abstract Introduction: Nasal polyposis is often found in patients with cystic fibrosis. Objective: To assess the incidence of nasal polyposis, the response to medical treatment, recurrence and the need for surgical intervention in children and adolescents with cystic fibrosis during a three-year follow-up. Methods: Clinical symptoms (pulmonary, pancreatic insufficiency, malnutrition, nasal obstruction), two positive sweat chloride tests, and genotype findings in 23 patients with cystic fibrosis were analyzed. All patients underwent nasal endoscopy every 12 months from January 2005 to December 2007, to assess the presence and grade of Nasal Polyps. Nasal polyposis, when present, were treated with topical corticosteroids for 6-12 months, with progress being evaluated within the 3 years of follow-up. Results: In the first evaluation, nasal polyposis was diagnosed in 30.43% of patients (3 bilateral and 4 unilateral), recurrent pneumonia in 82.6%, pancreatic insufficiency in 87%, and malnutrition in 74%. The presence of nasal polyposis was not associated with chloride values in the sweat, genotype, clinical signs of severity of cystic fibrosis, or nasal symptoms. In the three-year period of follow up, 13 patients (56.52%) had at least one event of polyposis, with the youngest being diagnosed at 32 months of age. Only one patient underwent surgery (polypectomy), and there was one diagnosis of nasopharyngeal carcinoma. Conclusion: The study showed a high incidence of nasal polyposis. Monitoring through routine endoscopy in patients with cystic fibrosis, even in the absence of nasal symptoms, is highly recommended. The therapy with topical corticosteroids achieved good results. Thus, an interaction between pediatricians and otolaryngologists is necessary.

Resumo Introdução: A polipose nasal é frequentemente encontrada em pacientes portadores de fibrose cística. Objetivo: Avaliar a incidência de polipose nasal, a resposta ao tratamento clínico, a recorrência e a necessidade de intervenção cirúrgica em crianças e adolescentes com fibrose cística durante um seguimento de 3 anos. Método: Os sintomas clínicos (pulmonar, insuficiência pancreática, desnutrição, obstrução nasal), duas pesquisas de cloro no suor positivas e genótipo de 23 pacientes com fibrose cística foram descritos. Todos os pacientes foram submetidos à endoscopia nasal a cada 12 meses de janeiro de 2005 a dezembro de 2007, para avaliação de presença e grau de polipose nasal. A polipose nasal, quando presente, foi tratada com corticosteroide tópico de 6 a 12 meses e avaliada a evolução nos 3 anos de seguimento. Resultados: Na primeira avaliação, a polipose nasal foi diagnosticada em 30,43% dos pacientes (três bilaterais e quatro unilaterais), pneumonia recorrente em 82,6%, insuficiência pancreática em 87% e a desnutrição em 74%. A presença de polipose nasal não se associou aos valores de cloro no suor, genótipo, sinais clínicos de gravidade da fibrose cística ou sintomas nasais. Nos três anos de seguimento, 13 pacientes (56,52%) apresentaram pelo menos um evento de polipose, o mais jovem foi diagnosticado aos 32 meses. Apenas um paciente foi submetido à cirurgia (polipectomia) e houve um diagnóstico de carcinoma da nasofaringe. Conclusão: O estudo mostrou alta incidência de polipose nasal. O acompanhamento por meio de exames endoscópicos de rotina em pacientes fibrocisticos, mesmo na ausência de sintomas nasais, é altamente recomendado. A terapia com corticoide tópico mostrou bons resultados. Assim, faz-se necessária a interação entre pediatras e otorrinolaringologistas.

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Young Adult , Nasal Polyps/epidemiology , Cystic Fibrosis/epidemiology , Recurrence , Time Factors , Severity of Illness Index , Brazil/epidemiology , Nasal Polyps/complications , Nasal Polyps/pathology , Nasal Polyps/drug therapy , Incidence , Prospective Studies , Follow-Up Studies , Treatment Outcome , Adrenal Cortex Hormones/therapeutic use , Cystic Fibrosis/complications , Natural Orifice Endoscopic Surgery/methods , Nasal Cavity/pathology , Nasal Cavity/diagnostic imaging
Braz. j. otorhinolaryngol. (Impr.) ; 83(1): 66-72, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-839397


Abstract Introduction Eosinophilic and noneosinophilic Nasal polyps (NPs) are different subtypes of NPs and require different treatment methods. Objective To compare the histologic characteristics, mRNA and protein expression between Nasal Polyps with and without eosinophilia. Methods NPs tissues were obtained from eighty-six NPs patients during surgery. Eosinophilic and noneosinophilic NPs were distinguished according to immunochemical results of the specimen. The histological, mRNA and protein expression features were compared between the two groups. Results In eosinophilic NPs, we observed a significantly higher GATA-3, IL-5, IL-4, IL-13 mRNA and protein expression. In noneosinophilic NPs, IL-17, IL-23 and RORc mRNA and protein expression were increased. Immunohistochemistry tests showed, more mast cells and less neutrophils in eosinophilic NPs compared with noneosinophilic NPs. Eosinophilic NPs patient presented more severe symptom scores when compared to noneosinophilic NPs. Conclusion We demonstrate for the first time that Th2 is the predominant reaction in eosinophilic NPs while Th17 is the predominant reaction in noneosinophilic NPs. Our study may provide new treatment strategy for NPs.

Resumo Introdução Pólipos nasais (PNs) eosinofílicos e não eosinofílicos são diferentes subtipos de PNs e requerem diferentes métodos de tratamento. Objetivo Comparar as características histológicas e a expressão de mRNAs e proteínas entre PNs com e sem eosinofilia. Método Amostras de PNs foram obtidos de 86 pacientes durante a cirurgia. PNs eosinofílicos e não eosinofílicos foram diferenciados segundo os resultados imunoistoquímicos de cada amostra. As características histológicas e de expressão de mRNAs e de proteínas foram comparadas entre os dois grupos. Resultados Em PNs eosinofílicos, observamos uma expressão significativamente maior dos mRNAs e proteínas GATA-3, IL-5, IL-4 e IL-13. Nos PNs não eosinofílicos, aumentou a expressão dos mRNAs e das proteínas IL-17, IL-23 e RORc. Nos testes imunoistoquímicos, observamos maior número de mastócitos e menor número de neutrófilos nos PNs eosinofílicos, em comparação com PNs não eosinofílicos. Os pacientes com PNs eosinofílicos obtiveram escores de sintomas mais graves vs. PNs não eosinofílicos. Conclusão Demonstramos, pela primeira vez, uma reação Th2 predominante em PNs eosinofílicos e uma reação Th17 predominante em PNs não eosinofílicos. Nosso estudo pode proporcionar novas estratégias terapêuticas para a rinossinusite crônica.

Humans , Male , Female , Adult , Sinusitis/immunology , Rhinitis/immunology , Nasal Polyps/immunology , Eosinophils/immunology , Sinusitis/complications , Transcription Factors , Severity of Illness Index , RNA, Messenger/metabolism , Immunohistochemistry , Rhinitis/complications , Nasal Polyps/complications , Nasal Polyps/metabolism , Nasal Polyps/pathology , Chronic Disease , Cytokines/immunology , T-Lymphocytes, Helper-Inducer/immunology , Eosinophilia/complications , Eosinophilia/metabolism , Eosinophilia/pathology , Real-Time Polymerase Chain Reaction
Braz. j. otorhinolaryngol. (Impr.) ; 80(3): 202-207, May-June/2014. tab, graf
Article in English | LILACS | ID: lil-712980


INTRODUCTION: Establishing a diagnosis in patients with olfactory disturbances has always been challenging for physicians.One reason for this is the rarity of some of the diseases that affect this sense, such as Kallmann's syndrome and post-viral olfactory loss. OBJECTIVE: To identify the major causes of olfactory disturbances and to describe the diagnostic evaluation in outpatients attended to at an ambulatory clinic specialized in olfaction disorders. METHODS: A retrospective analysis was performed in outpatients with primary olfactory complaint attended to between June 1, 2011 and September 30, 2013 in a center specialized in olfactory disorders. Patient history, nasofibroscopy, and the University of Pennsylvania Smell Identification Test (UPSIT) comprised the examination. RESULTS: Sixty-two patients were evaluated. The major causes were chronic rhinosinusitis (31%); rhinitis, primarily the allergic type (19%); post-viral olfactory loss (13%); and post-traumatic loss (8%). UPSIT scores were statistically different among different etiologies (p = 0.01). CONCLUSIONS: The major diagnoses that should be part of the physician assessment when a patient complains of olfactory disturbance are chronic rhinosinusitis with and without polyps, allergic rhinitis, post-viral olfactory loss, and post-traumatic loss. .

INTRODUÇÃO: Estabelecer um diagnóstico em pacientes com distúrbios olfatórios foi sempre um desafio aos médicos. Uma das razões para isso é a raridade de algumas doenças que afetam esse sentido como a Síndrome de Kallmann e a perda olfatória pós-viral. OBJETIVO: Identificar as principais causas das doenças olfatórias e descrever sua condução diagnóstica em um ambulatório direcionado a esses distúrbios. MÉTODO: Análise retrospectiva de pacientes ambulatoriais com queixa olfatória primária atendida entre 1º de junho de 2011 e 30 de setembro de 2013 em centro especializado. História clínica, nasofibroscopia e o Teste de Identificação do Olfato da Universidade da Pensilvânia (UPSIT) compuseram a avaliação. Sempre que necessário, foram solicitadas tomografia de seios paranasais e ressonância magnética de crânio. RESULTADOS: Sessenta e dois pacientes foram avaliados. As causas mais comuns encontradas foram respectivamente: rinossinusite crônica (31%), rinites (19%), principalmente a rinite alérgica, perda olfatória pós-viral (13%) e pós-traumática (8%). As pontuações no UPSIT foram estatisticamente diferentes entre as cinco principais causas (p = 0,01). CONCLUSÕES: Os principais diagnósticos que devem fazer parte na investigação médica diante de um paciente com queixa olfatória são: rinossinusite crônica com e sem polipose nasal, rinite alérgica, perda olfatória pós-viral e pós-traumática. .

Adult , Female , Humans , Male , Olfaction Disorders/diagnosis , Olfaction Disorders/etiology , Craniocerebral Trauma/complications , Nasal Polyps/complications , Retrospective Studies , Respiratory Tract Infections/complications , Respiratory Tract Infections/virology , Rhinitis/complications , Sinusitis/complications
Yonsei Medical Journal ; : 1683-1690, 2014.
Article in English | WPRIM | ID: wpr-180225


PURPOSE: To analyze the outcome of endoscopic sinus surgery (ESS) after preoperative systemic steroid (PSS) treatment for chronic rhinosinusitis (CRS) with nasal polyposis (NP) and to investigate and compare clinicopathological factors associated with the outcome. MATERIALS AND METHODS: We performed a retrospective chart review of 468 patients with CRS with NP who underwent primary ESS between January 2005 and October 2011. 124 patients who met the inclusion criteria were included. Beginning from 2008, our clinic administered steroid preoperatively in patients of CRS with NP, thus there were 84 patients with preoperative systemic steroid (PSS group) and another 40 patients without such regimen (no PSS group). To evaluate the outcome after ESS, poor outcome and complication were analyzed according to the following parameters: age, sex, follow-up duration, eosinophilic infiltration, atopy, asthma, Lund-Mackay score, and polyp grade. RESULTS: There was no significant difference in poor outcome rates between the PSS and no PSS group (35.0% vs. 47.6%, p=0.185). There was no significant difference in complication rates between the PSS and no PSS group (10% vs. 6%, p=0.468). As with the multivariate analysis of the clincopathological factors to the poor outcome rate, presence of asthma and eosinophilic infiltration were significantly related (odds ratio as 6.555 and 4.505, respectively), whereas PSS was confirmed as less likely related (odds ratio 0.611). CONCLUSION: Low dose PSS administration does not seem to have an effect on the outcome after ESS in patients who have CRS with NP. Eosinophilic infiltration and presence of asthma are important predictors of surgical outcome.

Adult , Aged , Female , Humans , Male , Middle Aged , Asthma/complications , Chronic Disease , Endoscopy/methods , Inflammation , Nasal Polyps/complications , Odds Ratio , Otorhinolaryngologic Surgical Procedures/methods , Paranasal Sinuses/pathology , Prednisone/administration & dosage , Retrospective Studies , Rhinitis/complications , Sinusitis/complications , Treatment Outcome
Braz. j. otorhinolaryngol. (Impr.) ; 79(5): 616-619, Sep-Oct/2013. graf
Article in Portuguese | LILACS | ID: lil-688616


Polipose nasossinusal (PNS) é uma afecção inflamatória crônica das cavidades nasais/paranasais que afeta 1%-4% da população. Pólipos parecem ser uma manifestação inflamatória crônica da mucosa do seio nasal/paranasal em indivíduos alérgicos e não alérgicos; porém, a patogênese da PNS permanece desconhecida. A interleucina-17A (IL-17A) é uma citocina chave em muitas doenças inflamatórias. Pouca atenção tem sido dada ao papel da IL-17A em distúrbios inflamatórios crônicos. OBJETIVO: Investigar a expressão da IL-17A na PNS e verificar se ela é um marcador de bom ou mau prognóstico. MÉTODO: Estudo prospectivo de 25 pacientes com PNS foram submetidas à técnica de imuno-histoquímica. Após realizarem teste cutâneo, todos os pacientes foram divididos em grupos atópicos e não atópicos e classificados em asmáticos ou não asmáticos. RESULTADOS: A expressão de IL-17A foi observada nos pacientes atópicos e não atópicos; porém, o número de células positivas com IL-17A foi maior nos pólipos nasais de pacientes atópicos que nos não atópicos (p = 0,0128). CONCLUSÃO: Os resultados indicam que a IL-17A pode desempenhar papel importante na patologia da PNS. Considerando as propriedades inflamatórias da IL-17A, este estudo sugere que a IL-17A pode aumentar a susceptibilidade a atopia e asma. .

Sinonasal polyposis (SNP) is a chronic inflammatory pathology of the nasal/paranasal cavities which affects from 1%-4% of the population. Although polyps seem to be a manifestation of chronic inflammation of nasal/paranasal sinus mucosa in both allergic and non-allergic subjects, the pathogenesis of nasal polyposis remains unknown. Interleukin-17A (IL-17A) is a key inflammatory cytokine in many disorders. Little attention has been paid to the role of IL-17A in chronic inflammatory disorders. OBJECTIVE: To investigate the expression of IL-17A in the SNP and verify if this expression is a marker of good or bad prognosis. METHOD: Prospective study with 25 patients presenting with SNP were subjected to the immunohistochemistry technique. After a skin prick test, all patients were divided into atopic and nonatopic groups, and asthmatic or non-asthmatic. RESULTS: The IL-17A expression was observed in both atopic and nonatopic patients. The numbers of IL-17A positive cells were greater in nasal polyps of atopic patients than nonatopic (p = 0.0128). CONCLUSION: These results indicate that IL-17A may play an important role in the pathology of SNP. Considering the inflammatory properties of IL-17A, this study suggests that it could increase susceptibility to atopy and asthma. .

Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Asthma/metabolism , /metabolism , Nasal Polyps/metabolism , Asthma/complications , Biomarkers/metabolism , Case-Control Studies , Immunohistochemistry , Nasal Polyps/complications , Prognosis , Prospective Studies
Tehran University Medical Journal [TUMJ]. 2013; 71 (8): 524-529
in Persian | IMEMR | ID: emr-143041


Nasal polyp [NP] is a benign mucosal mass located in both sinuses and nares which is mostly seen in association with cystic fibrosis, asthma or oversensitivity to aspirin. The prominent histological feature of NP is inflammatory cell infiltration with eosinophil predominance. Superantigens role in causing NP complications is already proven. Superantigens, which are mostly originated from Streptococci and Staphylococci, activate T cells strongly and increase the process of production and release of cytokines, and secretion of IgE from B cells, which in turn directly affects proinflammatory cells such as eosinophils, both in their tissues infiltration and functions. The samples are collected from patients referring to ENT clinic in Rasoul Akram training Hospital in Tehran after thorough clinical and paraclinical examinations. For control group the samples collected from patients undergoing rhinoplasty. All the samples kept frozen and sent to immunology lab. The DNA of the excised tissues extracted and amplified by using the superantigens specific primers and PCR product detected by gel electrophoresis. The date analyzed by using mean and SD and CHI[2] analytical tools. Fifteen healthy individuals, 25 patients with rhinosinusitis and 24 with polyposis entered this trial. Group A Streptococcus toxin detection was significantly more frequent in those with nasal polyp and rhinosinusitis compared to healthy individuals [P=0.001 and 0.005, respectively], but the results were almost the same for those with nasal polyp and rhinosinusitis [P=0.4]. Streptococci may play an important role in induction or clinical exacerbation of polyposis and group A Streptococcus pyogenes exotoxin [SPEs] with superantigenic effects may have a crucial role in etiology and pathogenesis of polyps with or without rhinosinusitis. It is postulated that, T cells polyclonal activation by SPEs may cause recruitment of inflammatory cells in nasal mucosa. These inflammatory cells include IgE producing B cells leading to allergic and inflammatory reactions in NP.

Humans , Male , Female , Nasal Polyps/complications , Streptococcus pyogenes/immunology , Sinusitis/immunology , Nasal Mucosa/pathology , Polymerase Chain Reaction , Allergy and Immunology , Immunoglobulin E , Exotoxins/immunology , Chronic Disease
Acta cir. bras ; 27(9): 645-649, Sept. 2012. ilus
Article in English | LILACS | ID: lil-646732


PURPOSE: To compare gene expression of the chemokines RANTES and eotaxin-2, its receptor, CCR-3, adhesion molecule ICAM-1 and its receptor LFA-1 in eosinophilic polyps and in control normal nasal mucosa. METHODS: Gene expression was quantified by Real Time PCR in polyps (n=35) and in healthy nasal mucosa (n=15). RESULTS: Eosinophilic polyps showed a higher expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa. CONCLUSION: Eosinophilic polyps present greater expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa.

OBJETIVO: Comparar a expressão gênica das quimiocinas RANTES e eotaxina-2, do seu receptor CCR-3, da molécula de adesão ICAM-1 e do seu receptor LFA-1 entre pólipos nasais eosinofílicos (PE) (n=35) e mucosa nasal controle (n=15). MÉTODOS: Quantificou-se a expressão gênica dos mediadores citados pela técnica de PCR em tempo real em PEs e em mucosas de concha média de pacientes sem doenças nasais ou alteração endoscópica. RESULTADOS: Pólipos eosinofílicos apresentam maior expressão de eotaxina-2 e RANTES, mas não de CCR-3, ICAM-1 e LFA-1, quando comparados as mucosas nasais controles. CONCLUSÃO: Pólipos eosinofícios apresentaram maior expressão de eotaxin-2 and RANTES, mas não de CCR-3, ICAM-1 ou LFA-1,comparada à mucosa nasal controle.

Humans , Nasal Polyps/metabolism , Rhinitis/metabolism , Sinusitis/metabolism , Case-Control Studies , Chronic Disease , /genetics , /metabolism , /genetics , /metabolism , Gene Expression , Intercellular Adhesion Molecule-1/genetics , Intercellular Adhesion Molecule-1/metabolism , Lymphocyte Function-Associated Antigen-1/genetics , Lymphocyte Function-Associated Antigen-1/metabolism , Nasal Mucosa , Nasal Polyps/complications , Polymerase Chain Reaction , /genetics , /metabolism , Rhinitis/complications , Sinusitis/complications
Braz. j. otorhinolaryngol. (Impr.) ; 76(1): 25-28, jan.-fev. 2010. tab
Article in English, Portuguese | LILACS | ID: lil-541432


Embora o perfil das citocinas na polipose nasossinusal seja bem documentado, pouco se sabe sobre estas proteínas quando associadas à Fibrose Cística. Objetivos: Avaliar a expressão das citocinas IL¬4, IL¬5, IL¬6, IL¬8, GM¬C-SF e IFN--y analisada pela RT¬-PCR, nos pólipos de pacientes com Fibrose Cística. Material e método: Estudo transversal, prospectivo, de 24 pacientes, 13 com Fibrose Cística e polipose nasossinusal (Grupo Fibrose Cística) e 11 com exame otorrinolaringológico normal (Grupo Controle). A média de idade foi de 21 anos (3¬-57), 12 eram do sexo masculino e 12 do sexo feminino. O perfil das citocinas foi pesquisado nos fragmentos de mucosa (Grupo Controle) ou pólipo nasal (Grupo Fibrose Cística) através da RT-¬PCR. Foram estudadas as transcrições para as citocinas IL¬4, IL¬5, IL¬6, IL¬8, IFN¬y e GM¬-CSF ajustadas pelo valor da β¬ actina. Resultados: As interleucinas 5, 6, 8 e GM¬-CSF foram semelhantes nos dois grupos (p>0,05). Menores valores de IFNy¬ (p=0,03) e forte tendência de aumento de IL¬4 (p=0,06) foram observados no grupo Fibrose Cística. Conclusão: As células inflamatórias e estruturais podem produzir RNA mensageiro para IL¬4, bloqueando a produção de outras citocinas com IFN-y¬, sugerindo a participação destes mecanismos na formação dos pólipos da Fibrose Cística.

Although the cytokine profile in nasal polyposis is well documented, little is known about cytokines associated to cystic fibrosis. AIM: Assess the expression of cytokines IL¬4, IL¬5, IL¬6, IL¬8, GM¬-CSF and IFN¬-y, analyzed through RT-PCR, in the polyps of patients with cystic fibrosis. Materials and methods: A cross-sectional, prospective study was carried out with 24 patients, 13 of whom had cystic fibrosis and nasal polyposis (Cystic Fibrosis Group) and 11 had normal otorhinolaryngological exams (Control Group). The average age was 21 years (3¬57); 12 participants were males and 12 were females. The cytokine profile was studied in mucosal fragments (Control Group) or nasal polyps (Cystic Fibrosis Group) through RT¬PCR. Transcriptions were studied for cytokines IL¬4, IL¬5, IL¬6, IL¬8, IFN¬y and GM¬CSF, adjusted for the β¬-actin value. Results: Interleukins 5, 6, 8 and GM¬CSF were similar in both groups (p>0.05). There were lower values of IFN-y¬ (p=0.03) and a strong tendency toward an increase in IL¬4 (p=0.06) in the Cystic Fibrosis Group. Conclusion: Inflammatory and structural cells may produce messenger RNA for IL¬4, blocking the production of other cytokines such as IFN-y, suggesting the participation of this mechanism in the formation of polyps in cystic fibrosis.

Adolescent , Child , Female , Humans , Male , Middle Aged , Young Adult , Cystic Fibrosis/immunology , Cytokines/blood , Nasal Polyps/immunology , Biomarkers/blood , Case-Control Studies , Cross-Sectional Studies , Cystic Fibrosis/complications , Nasal Polyps/complications , Prospective Studies , Reverse Transcriptase Polymerase Chain Reaction , RNA, Messenger/analysis , Young Adult