ABSTRACT
For >2 years, Japan’s government has been urging the populace to take countermeasures to prevent COVID‐19, including mask wearing. We examined whether these preventive behaviors have affected the rate and degree of sensitization against pollen and house dust antigens in patients with allergic rhinitis. We retrospectively surveyed 2565 patients who had undergone allergy blood testing during the period 2015–2021. We subdivided this period into eras based on the COVID‐19 pandemic: the pre‐COVID (2015–2019, n = 1879) and COVID (2020–2021, n = 686) eras. The positive rates for Japanese cedar and cypress in the 40–59‐year‐olds and those for house dust in the 20–39‐ year‐olds were significantly reduced in the COVID era versus those in the pre‐COVID era. Each group’s mean antigen‐specific CAP scores decreased significantly from the 1st to 2nd era: from 1.98 to 1.57 for cedar (p < 0.01), 1.42 to 0.95 for cypress (p < 0.05), and 2.86 to 2.07 for house dust (p < 0.01). Our survey of the patients’ clinical records indicates that 47.5% of the pollinosis patients reported improvement in nasal symptoms after the three seasons of pollen dispersion in the COVID era. Japan’s quarantine policies designed to combat the spread of COVID‐19 thus coincide with pivotal measures to alleviate allergic reactions. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
ABSTRACT
OBJECTIVE: Severe acute respiratory syndrome coronavirus-2 uses angiotensin-converting enzyme-2 as a primary receptor for invasion. This study investigated angiotensin-converting enzyme-2 expression in the sinonasal mucosa of patients with chronic rhinosinusitis, as this could be linked to a susceptibility to severe acute respiratory syndrome coronavirus-2 infection. METHODS: Ethmoid sinus specimens were obtained from 27 patients with eosinophilic chronic rhinosinusitis, 18 with non-eosinophilic chronic rhinosinusitis and 18 controls. The angiotensin-converting enzyme-2 and other inflammatory cytokine and chemokine messenger RNA levels were assessed by quantitative reverse transcription polymerase chain reaction. Angiotensin-converting enzyme-2 positive cells were examined immunohistologically. RESULTS: The eosinophilic chronic rhinosinusitis patients showed a significant decrease in angiotensin-converting enzyme-2 messenger RNA expression. In the chronic rhinosinusitis patients, angiotensin-converting enzyme-2 messenger RNA levels were positively correlated with tumour necrosis factor-α and interleukin-1ß (r = 0.4971 and r = 0.3082, respectively), and negatively correlated with eotaxin-3 (r = -0.2938). Angiotensin-converting enzyme-2 immunoreactivity was mainly localised in the ciliated epithelial cells. CONCLUSION: Eosinophilic chronic rhinosinusitis patients with type 2 inflammation showed decreased angiotensin-converting enzyme-2 expression in their sinus mucosa. Angiotensin-converting enzyme-2 regulation was positively related to pro-inflammatory cytokines, especially tumour necrosis factor-α production, in chronic rhinosinusitis patients.