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Abstract Objectives The aim of this study was to explore the differences in the pattern of allergen sensitization in CR individuals without or with asthma, according to asthma severity. Methods A total of 1066 adults were evaluated. Asthma and chronic⁄allergic rhinits were identified by specialists, questionnaries and skin-prick test. The phenotypic characterization was avaliable from skin-prick test to an aeroallergen extended panel, total IgE and pulmonary function. Using questionnaires and clinical evaluation, participants were classified into the groups: chronic rhinitis alone (CRA) and chronic rhinitis + asthma, the latter subdivided into CR + mild asthma (CRMA) and CR + moderate to severe asthma (CRMSA). Aerollergen sensitization was defined by a positive prick test to one or more allergens associated with nasal symptoms and/or asthma. The association between CR and asthma was evaluated by multivariable logistic regression. The evidence of effect modification of pattern of sensitization in CR on the association with asthma severity and outcomes was examined by introducing interactions terms in the logistic regression models adjusting for confounders. Results Frequency of sensitization to aeroallergens was higher in association with asthma in comparison to CRA (CRMA 70.4%; CRMSA 65.0%; CRA 47.0%; p= 0.000). Similarly, the presence of asthma was associated to aeroallergen multiple sensitization (51.5%) (OR = 2.10, 95% CI 1.27-3.50). Additionally, the sensitization to mites, cockroaches, animal epithelium, grasses, and molds, were higher in asthma (56.8%, 24.3%, 12%, 7.13% and 10.3%, respectively). Sensitization to Alternaria alternata, Cladosporium herbarum and dog epithelium was exclusive in asthma groups. A concomitant asthma diagnosis was directly associated with a positive allergen sensitization at least one allergen (62.7%, OR = 2.45, 95% CI 1.80-3.34) and polissensitization (51.5%, OR = 2.10, 95% CI 1.27-3.50). Conclusion Asthma is associated with multiple allergen sensitization among patients with CR. Some unique profiles of aeroallergen sensitization were observed in patients with CR and asthma. Nevertheless, no difference was found in the sensitization in relation to asthma severity, which suggest atopy is not the main underlying mechanism for asthma severity among patients with CR. Level of evidence: Level 3.
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Objective To investigate the relationship between the epidemiology of chronic rhinitis and atmospheric environmental factors in Wuhan. Methods A total of 3 371 patients with chronic rhinitis in Wuhan seventh hospital from January 2017 to January 2020 were enrolled. The incidence of chronic rhinitis in different years and seasons was compared. Then the influence of atmospheric environmental factors such as air pollution index (API), fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), diurnal patterns of relative humidity, wind speed, air temperature, air pressure wind speed and temperature range on occurrence of chronic rhinitis was analyzed. Results The incidence of chronic rhinitis in Wuhan showed an annual decreasing trend from 2017 to 2020, so the incidence rate was the highest in 2017 (38.83%, 1309/3371) and was the lowest in 2020 (28.98%, 977/3371). In terms of different seasons, the incidence rate was the highest in winter (33.67%, 1135/3371), and was the lowest in summer (16.11%, 543/3371). The main factors affecting the incidence of chronic rhinitis were API, PM2.5, and PM10 in spring, which were NO2, SO2, and daily average relative humidity in summer, those were API, PM2.5, PM10, NO2, and SO2 in autumn, and were API, PM2.5, PM10, NO2, SO2, and daily range of air temperature in winter. The lag response of patients with chronic rhinitis to atmospheric environmental factors was 2-5 days in spring, 1-6 days in summer, 0-5 days in autumn and 3-6 days in winter. Patients with chronic rhinitis have the fastest response to API and PM2.5 in spring, the fastest response to API in summer, and the fastest response to API and PM2.5 in autumn, respectively. Conclusion The incidence of chronic rhinitis in Wuhan is decreasing year by year, and the incidence is related to environmental and meteorological factors, and the disease onset has the characteristics of lag due to seasonal factors.
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Objective:To compare the effects of different surgical treatment of chronic rhinitis-sinusitis difference,and its impact on transport function of maxillary sinus mucociliary,provide a clinical-surgical sinusitis preferably reference about the treatment of chronic nasal formulation for.Methods:From 2013.9-2014.12,otorhinolaryngology clinic in our hospital,160 cases were diagnosed as chronic nose-as research subjects were randomly divided into four groups of patients with sinusitis were treated from 1 to 4,60 cases in each group;treatment groupl receiving the maxillary sinus ostium augmentation,treatment group 2 received fenestration,treatment group 3 through tears crypt before maxillary sinus surgery,treatment 4 group receiving the maxillary sinus balloon dilatation;after covering the nasal mucosa observed and compared four groups of patients about edema,vesicle formation,bone exposure,scarring,etc.,as well as internal maxillary sinus secretions traits,volume situation,and compared patients after four groups line maxillary sinus cavity and perioral saccharin test biopsy cases three months and six months.Results:The four groups were made after surgery better clinical efficacy,and group efficacy 4 with the other three groups,the effect is most significant (all P ＜0.05),the difference was statistically significant,and after three months and six months,group 4 compared with other surgical group,the Lund-Kernedy score were also lower,MMT time were also lower,the difference was more significant (all P ＜0.05);in the maxillary sinus biopsy aspects:the number of postoperative inflammatory cells and dendritic cells and glandular cell morphology and submucosal edema improved submucosal structures also in the group of four most significant (P＜0.05).Conclusion:Maxillary sinus balloon dilatation treatment chronic nasal sinusitis curative effect is higher,which can effectively improve the cell and submucosal gland cell morphology and sinus mucosa edema,sinus unobstructed drainage effect,and high safety.
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Objective To investigate the expression of the vascular endothelial growth factor (VEGF) and mucin MUC5AC in nasal mucosa before and after chronic rhinitis - sinusitis and nasal polyps - endoscopic sinus surgery.Methods 75 cases chronic rhinitis - sinusitis and nasal polyps - endoscopic sinus surgery patients were selected as nasal polyps group and 75 cases of nasal bone fracture or epistaxis patients as the control group from January 2012 to January 2015. Took the samples of nasal polyps before surgery and the maxillary sinus mucosa specimens after surgery six weeks of nasal polyps’ patients and on the edge of the inferior turbinate mucosa specimens of the control group to detect eosinophil count by HE staining, and detect the expression of VEGF and mucin MUC5AC by immunohistochemical staining.Results The specimens eosinophils of preoperative nasal polyp group and postoperative nasal polyp group were higher than that of control group (P < 0.05), the nasal eosinophils of postoperative nasal polyp group was lower than that of preoperative nasal polyp group (P < 0.05). The expression of specimens VEGF and mucin MUC5AC area percentages in preoperative nasal polyp group and postoperative nasal polyp group were higher than that in control group (P < 0.05), the expression of nasal VEGF and mucin MUC5AC area percentages in the postoperative nasal polyp group was lower than that of preoperative nasal polyp group (P< 0.05).Conclusion Eosinophil count and the expression levels of VEGF and mucin MUC5AC of nasal mucosa in chronic rhinitis - sinusitis and nasal polyps - endoscopic sinus surgery preoperative are higher, and reduce at postoperative six weeks, VEGF and mucin MUC5AC may be involved nasal repair.
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This study was aimed to explore the tic disorders ( TD ) pathogenesis induced by chronic rhinitis . A total of 400 TD children were all investigated with self-made TD general questionnaire , Yale Global Tic Severity Scale ( YGTSS ) , TD diagnostic criteria by DSM-IV , chronic rhinitis diagnostic criteria by Zhu-Fu-Tang Textbook of Pediatrics ( 7th edition ) . A total of 258 TD children accompanied with chronic rhinitis were screened . Levels of peripheral blood T lymphocyte subsets , immunoglobulins , IL-6 , TNF-α and other related immunological indexes were detected to analyze pathogenesis. The results showed that the nose movement symptom scores of TD children with rhinitis were higher than the score of TD children without rhinitis . The score of arm-lifting and hand movement in TD children with rhinitis was lower than the score in the TD children without rhinitis . And the YGTSS score of TD children with rhinitis was higher than TD children without rhinitis. Compared with TD children without rhinitis, the level of peripheral blood T lymphocyte subsets in TD children with rhinitis was obviously reduced ( P < 0 . 05 ) . Compared with TD children without rhinitis , the level of immunoglobulins in TD children with rhinitis was slightly reduced . The level of IL-6 in TD children with rhinitis tended to increase , but the level of TNF-α tended to reduce . It was concluded that chronic rhinitis is one of the factors to induce TD .
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A study of mediator cells by nasal scraping method was performed for the first time in Thai population i.e. 154 chronic rhinitis patients and 43 healthy volunteer with no nasal symptoms. There were 67 males and 87 females, ages ranged from 8 – 70 years old with the average of 35.5 in the chronic rhinitis group. In the normal volunteer group, there were 21 males and 22 females, ages ranged from 17 – 74 years old with the average of 35. All chronic rhinitis were skin tested by intracutaneous method to a panel of common inhalants. The result of the skin test we graded into 0 – 4+ If the patients had 2+ – 4+ skin test result, they were classified as having allergic rhinitis (AR), while patients who had 0 – 1 were classified as non-allergic rhinitis (NAR). The average number of basophilic metachromatic cells (BMC) in normal volunteers, AR and NAR patients were 2.35 + 10.73 (0 – 57), 121.74 + 198.73 (0 – 1,177) and 11.33 + 32.05 (0 – 117) cells respectively. This findings confirm that AR patients have more BMC on their nasal surface than NAR patients and normal people. When comparing the average number of BMC according to the skin test result in chronic rhinitis patients we found that the average number of BMC in patients with 0, 2+, 3+ and 4+ skin test results were 11.33 + 32.05, 54.54 + 100.49, 110.00 + 84.68 and 135.71 + 212.54 cells respectively. Statistical analysis showed that the number weaker positive and negative results. The sensitivity of nasal scraping method in diagnosing AR was found to be 61.27 percent with the specificity of 90.91 percent, the positive predictive value was 94.56 percent and the efficiency of test was 69.54 percent. We concluded that the study of BMC by nasal scraping method is easy to perform with minimal trauma to the patient, the instrument used is simple and less expensive, the interpretation of result is also accurate and can be repeated. Therefore this method should be considered as another tool to diagnose AR especially in the place where skin test is not available.