Mupirocin Ointment Effect on Polyposis Recurrence After Sinus Surgery.

Introduction: Staphylococcus aureus is an identified pathogen involved in the recurrence of symptoms in patients with chronic rhinosinusitis with nasal polyps. We investigated the effectiveness of a topical ointment of mupirocin applied in the nasal vestibule in lessening symptom recurrence and improving the efficiency of functional endoscopic sinus surgery. Materials and Methods: Patients with chronic rhinosinusitis, nasal polyps, and a positive nostril culture for Staphylococcus aureus were included in a clinical trial. The right nostril was determined as the intervention group (applying mupirocin ointment) and the left as the control group (applying vitamin A ointment). Lund-Mackay radiological scores and Lund-Kennedy endoscopic scores were examined at the time of diagnosis and six months later. Results: Among 60 patients with chronic rhinosinusitis with nasal polyps, 91.6% were positive for nostril Staphylococcus aureus. Comparing the average of the diagnostic radiological and endoscopic scores with the follow-up values in both groups indicated a significant improvement after surgery (P-value=0.001, 0.001). However, there was no significant difference in the radiological and endoscopic score improvements between the study and control groups (P-value > 0.56, 0.74). Conclusion: Nasal mupirocin administration following endoscopic sinus surgery cannot significantly prevent symptom recurrence in chronic rhinosinusitis with nasal polyps.

Reliability and Validity of the Persian Nose Obstruction Symptom Evaluation (NOSE) Scale.

Background: The nasal obstruction symptom evaluation (NOSE) scale is a valid and specific questionnaire for evaluating nasal obstruction. The present study aimed to assess the validity of the Persian version of the NOSE questionnaire. Methods: The present study is a cross-sectional study conducted from December 2018 to April 2019. In the study group, eligible individuals referred to one clinic and Firoozgar Hospital, Tehran, Iran (a tertiary referral center) were asked to complete the questionnaire once on the first visit and once 3 months after the surgery. In the control group, healthy adults (above 18 years old) were selected among staff, students, residents, or relatives of the project executors. The NOSE questionnaire has 5 questions and a quality chart. The results were compared with the short form of the 12-item GHQ-12 questionnaire that had previously been translated and validated. SPSS 20 software was used to calculate Cronbach's alpha and intra-class correlation coefficient and to examine the convergent and discriminative validities. Results: The results obtained are consistent with the results of the primary research when developing the questionnaire and the results of studies conducted with different versions of the questionnaire in different languages and cultures. Analysis of research data showed that the Persian version of the NOSE questionnaire has acceptable internal consistency, repeatability, convergent validity, and discriminant validity. Conclusion: The Persian version of the NOSE questionnaire has good validity and reliability.

Platelet-Rich Fibrin impact on the Diced Cartilage viability in Rhinoplasty.

Introduction: Diced cartilage grafts are well-liked, dependable, and simple-to-use techniques for dorsum camouflage in rhinoplasty. Recent research results demonstrate how effectively PRF increases the survivability of diced cartilage in the nasal dorsum and decreases its absorption. In this study, we intend to investigate the effect of fibrin-rich platelets (PRF) on diced cartilage survival in rhinoplasty surgery. Materials and Methods: This clinical trial included people referred to Rasoul Akram Hospital for rhinoplasty between 2020 and 2021. Patients were divided into two groups: Diced Cartilage alone (DC) and Diced Cartilage + PRF (DC+PRF). Cartilage survival was assessed by ultrasound, photography, and nasal examination, and the two groups were compared six months after rhinoplasty. Patients' satisfaction with surgery was also evaluated using the Utrecht questionnaire. Results: The mean age of the two groups of 20 patients was 29.05 ± 7.02 and 26.65 ± 8.16 years in the DC and DC + PRF groups, respectively (P>0.05). After treatment, the frequency of irregularity on examination and dissatisfaction score was slightly but insignificantly higher in the DC group compared to the DC + PRF group (25% vs. 15% and 12.25 ± 6.45 vs. 10.45 ± 6.74, respectively, and P values>0.05). The total volume decrease, regardless of the injection site, was significant in both groups (P < 0.05), but the magnitude of volume reduction was significantly higher in the DC group compared to the DC + PRF group (-0.060 ± 0.087 vs. - 0.033±0.017, respectively, P<0.05). Conclusion: PRF may slow down the absorption process of diced cartilage.

Suppressor of Cytokine Signaling Proteins 3 and 5 Potentially Delineate Polarization of Th cells in Chronic Rhinosinusitis.

Background: Chronic rhinosinusitis (CRS) is an inflammatory condition classified into chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP). Th cells manage inflammatory cells in CRS. Suppressor of Cytokine Signaling (SOCS) proteins regulate Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway in Th cells by polarizing toward Th1, Th2, and Th17 cells. This study evaluated the levels of SOCS1,3,5 in CRS patients to find associations with Th cells. Methods: In this cross-sectional study, 20 CRSwNP patients, 12 CRSsNP patients, and 12 controls participated. The infiltration of CD4+ T cells was determined using immunohistochemistry. The expression of specific transcription factors and SOCS proteins was assessed using real-time PCR. Cytokine levels were evaluated using ELISA. SOCS protein levels were investigated using western blot analysis. Results: The expression of SOCS3 increased in the CRSwNP group compared to CRSsNP and control groups (p <0.001). SOCS3 protein levels increased in the CRSwNP group compared to CRSsNP (p <0.05) and control (p <0.001) groups. Although there was a significant difference in SOCS5 expression between CRSsNP and control groups, SOCS5 protein levels were significantly different between CRSsNP and control (p <0.001) and CRSwNP (p <0.05) groups. Conclusions: Targeted therapies may be suggested for CRS by modulating SOCS3 and SOCS5 proteins that are responsible for polarization of Th cells toward Th2 or Th1 cells, respectively. JAK-STAT pathway targeting, which encompasses numerous cells, can be limited to SOCS proteins to more effectively orchestrate Th cell differentiation.

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis.

BACKGROUND: Nasal surgeries, addressing anatomical variations for form and function, require careful anesthesia administration, including dexmedetomidine and remifentanil. This meta-analysis evaluates their safety and efficacy variations in nasal surgeries, emphasizing patient comfort and optimal outcomes. METHODS: Four electronic databases (PubMed, Scopus, Web of Science, and CINAHL Complete) were searched for records in English. Studies that measure the effect of dexmedetomidine versus remifentanil on patients underwent nasal surgery were included. The Cochrane Collaboration's tool was used to assess the quality of the included studies. A random-effect model was preferred and statistical analysis was performed by Stata software version 17. RESULTS: Out of an initial pool of 63 articles, five studies were selected for this analysis. All of these chosen studies were Randomized Controlled Trials (RCTs). The meta-analysis involved a total of 302 participants, with 152 in the remifentanil group and 150 in the dexmedetomidine group. The analysis aimed to compare the effects of Dexmedetomidine and Remifentanil on heart rate (HR) and mean arterial pressure (MAP) during surgery. Both groups exhibited similar MAP and HR, with the exception of a slightly lower HR in the remifentanil group at the 15th minute of surgery (Standardized Mean Difference: -0.24 [-0.83, 0.34]). Furthermore, when evaluating the impact of these medications on post-surgery outcomes, including pain levels, the use of pain relief medications, patient-surgeon satisfaction, agitation scores, and recovery time, no significant differences were observed between the two medications in any of these aspects. CONCLUSION: In summary, the study compared Dexmedetomidine and Remifentanil in nasal surgeries anesthesia. No significant differences were found in heart rate, blood pressure, satisfaction, pain, agitation, or recovery time. The study had limitations, and future research should establish standardized protocols and consider various surgical factors.

A systematic review of second-generation FLT3 inhibitors for treatment of patients with relapsed/refractory acute myeloid leukemia.

BACKGROUND: Acute myeloid leukemia (AML) is a complex disease with diverse mutations, including prevalent mutations in the FMS-like receptor tyrosine kinase 3 (FLT3) gene that lead to poor prognosis. Recent advancements have introduced FLT3 inhibitors that have improved outcomes for FLT3-mutated AML patients, however, questions remain on their application in complex conditions such as relapsed/refractory (R/R) disease. Therefore, we aimed to evaluate the clinical effectiveness of second-generation FLT3 inhibitors in treating patients with R/R AML. METHODS: A systematic literature search of PubMed, MEDLINE, SCOPUS and Google Scholar databases was made to identify relevant studies up to January 30, 2024. This study was conducted following the guidelines of the PRISMA. RESULTS: The ADMIRAL trial revealed significantly improved overall survival and complete remission rates with gilteritinib compared to salvage chemotherapy, with manageable adverse effects. Ongoing research explores its potential in combination therapies, showing synergistic effects with venetoclax and promising outcomes in various clinical trials. The QuANTUM-R trial suggested longer overall survival with quizartinib compared to standard chemotherapy, although concerns were raised regarding trial design and cardiotoxicity. Ongoing research explores combination therapies involving quizartinib, such as doublet or triplet regimens with venetoclax, showing promising outcomes in FLT3-mutated AML patients. CONCLUSION: These targeted therapies offer promise for managing this subgroup of AML patients, but further research is needed to optimize their use. This study underscores the importance of personalized treatment based on genetic mutations in AML, paving the way for more effective and tailored approaches to combat the disease.

An overview of anti-Hepatitis B virus flavonoids and their mechanisms of action.

Flavonoids, a diverse group of polyphenolic compounds found in various plant-based foods, have garnered attention for their potential in combating Hepatitis B Virus (HBV) infection. Flavonoids have demonstrated promising anti-HBV activities by interfering with multiple stages of the HBV life cycle, making them promising candidates for novel antiviral agents. Certain plant families, such as Theaceae, Asteraceae, Lamiaceae, and Gentianaceae, are of particular interest for their flavonoid-rich members with anti-HBV activities. Evidences, both in vitro and in vivo, supports the anti-HBV potential of flavonoids. These subsets of compound exert their anti-HBV effects through various mechanisms, including inhibiting viral entry, disrupting viral replication, modulating transcription factors, enhancing the immune response, and inducing autophagy. The antioxidant properties of flavonoids play a crucial role in modulating oxidative stress associated with HBV infection. Several flavonoids like epigallocatechin gallate (EGCG), proanthocyanidin (PAC), hexamethoxyflavone, wogonin, and baicalin have shown significant anti-HBV potential, holding promise as therapeutic agents. Synergistic effects between flavonoids and existing antiviral therapies offer a promising approach to enhance antiviral efficacy and reduce drug resistance. Challenges, including limited bioavailability, translation from preclinical studies to clinical practice, and understanding precise targets, need to be addressed. Future research should focus on clinical trials, combination therapies, and the development of flavonoid derivatives with improved bioavailability, and optimizing their effectiveness in managing chronic HBV infections.

Role of Electrodiagnostic Modalities in Detection of Nasal Septal Deviation.

Nasal Septal Deviation (NSD) is a common sign in otorhinolaryngology that can lead to facial asymmetry. In this case-control observational study, we assessed the role of EMG and NCS in the diagnosis of NSD and its effect on neuromuscular function. Participants were divided into two groups based on paranasal sinus computed tomography scan (PNS CT) results: NSD cases (n = 21) and controls without NSD (n = 13). EMG and NCS were performed on both groups to assess nasal alar muscles at the root of the zygomatic nerve. Our findings showed a significant correlation between NSD and EMG/NCS tests (P-value = 000) and a significant association between septal deviation and nasal alar lateralization (P-value = 000). EMG/NCS can be useful in assessing NSD by providing a better understanding of related neuromuscular structures and neuromuscular function of the nasal alar dilator muscles and aid in the diagnosis of NSD. Nasal Septal Deviation, EMG (electromyography), NCS (nerve conduction studies), Neuromuscular function, Facial asymmetry, Otorhinolaryngology, Paranasal sinus, Computed tomography, Nasal alar muscles, Zygomatic nerve, Nasal Obstruction, Nasal alar lateralization, Diagnosis.

A fragment-based drug discovery developed on ciclopirox for inhibition of Hepatitis B virus core protein: An in silico study.

The Hepatitis B virus (HBV) core protein is an attractive target for preventing capsid assembly and viral replication. Drug repurposing strategies have introduced several drugs targeting HBV core protein. This study used a fragment-based drug discovery (FBDD) approach to reconstruct a repurposed core protein inhibitor to some novel antiviral derivatives. Auto Core Fragment in silico Screening (ACFIS) server was used for deconstruction-reconstruction of Ciclopirox in complex with HBV core protein. The Ciclopirox derivatives were ranked based on their free energy of binding (ΔGB). A quantitative structure affinity relationship (QSAR) was established on the Ciclopirox derivatives. The model was validated by a Ciclopirox-property-matched decoy set. A principal component analysis (PCA) was also assessed to define the relationship of the predictive variable of the QSAR model. 24-derivatives with a ΔGB (-16.56±1.46 Kcal.mol-1) more than Ciclopirox was highlighted. A QSAR model with a predictive power of 88.99% (F-statistics = 9025.78, corrected df(25), Pr > F = 0.0001) was developed by four predictive descriptors (ATS1p, nCs, Hy, F08[C-C]). The model validation showed no predictive power for the decoy set (Q2 = 0). No significant correlation was observed between predictors. By directly attaching to the core protein carboxyl-terminal domain, Ciclopirox derivatives may be able to suppress HBV virus assembly and subsequent viral replication inhibition. Hydrophobic residue Phe23 is a critical amino acid in the ligand binding domain. These ligands share the same physicochemical properties that lead to the development of a robust QSAR mode. The same strategy may also be used for future drug discovery of viral inhibitors.

Ligand-based 3D pharmacophore modeling, virtual screening, and molecular dynamic simulation of potential smoothened inhibitors.

CONTEXT: The Hedgehog (Hh) signaling pathway is a crucial regulator of various cellular processes. Dysregulated activation of the Smoothened (SMO) oncoprotein, a key component of the Hh pathway, has been implicated in several types of cancer. Although SMO inhibitors are important anti-cancer therapeutics, drug-resistant SMO mutants have emerged, limiting their efficacy. This study aimed to discover stable SMO inhibitors for both wild-type and mutant SMOs, using a 12-feature pharmacophore model validated for virtual screening. One lead compound, LCT10312, was identified with high affinity to SMO and showed a significant conformational change in the SMO structure upon binding. Molecular dynamic simulation revealed stable interaction of LCT10312 with SMO and large atom motions, indicating SMO structural fluctuation. The lead compound showed high predicted binding scores to several clinically relevant SMO mutants. METHODS: A ligand-based pharmacophore model was developed from 25 structurally clustered SMO inhibitors using LigandScout v3.12 software and virtually screened for hit identification from a library of 511,878 chemicals. Molecular docking was employed to identify potential leads based on SMO affinities. Molecular dynamic simulation (MDS) with GROMACS v5.1.4 was performed to analyze the structural changes of SMO oncoprotein upon binding lead compound(s) and cyclopamine as the control for 100 ns. The binding affinity of lead compound(s) was predicted on clinical and laboratory SMO mutants.

Biomarkers of endothelial dysfunction are associated with poor outcome in COVID-19 patients: A systematic review and meta-analysis.

Numerous studies have linked coronavirus disease 2019 (COVID-19) with endothelial dysfunction and reported elevated levels of endothelial biomarkers in this disease. We conducted a systematic review and meta-analysis of the published evidence in this respect. A systematic literature search of PubMed and Scopus databases was performed to find studies investigating biomarkers of endothelial dysfunction in COVID-19 patients. Pooled standardized mean differences and their 95% confidence intervals were calculated for each biomarker using random effect model. 74 studies with 7668 patients were included. In comparison to patients with good outcome, those with poor outcome had higher levels of von Willebrand factor (vWF) (SMD: 0.83, 95% CI: 0.59-1.07, p < 0.00001), vWF:ADAMTS13 (1.23, (0.77-1.7), p < 0.00001), angiopoietin-2 (Ang-2) (1.06 (0.6-1.51), p < 0.0001), E-selectin (1.09 (0.55-1.63), p < 0.0001), P-selectin (0.59 (0.24-0.94), p = 0.001), syndecan-1 (0.99 (0.6-1.37), p < 0.00001), mid-regional pro-adrenomedullin (MR-proADM) (1.52 (1.35-1.68), p < 0.00001), vascular endothelial growth factor (0.27 (0.02-0.53), p = 0.03), soluble fms-like tyrosine kinase-1 (sFLT-1) (1.93 (0.65-3.21), p = 0.03) and lower levels of ADAMTS13 antigen (-0.69 (-0.9 to -0.47) p < 0.00001) and activity (-0.84 (-1.06 to -0.61) p < 0.0000). Plasminogen activator inhibitor-1 and tissue plasminogen activator levels were not different between the two groups (p < 0.05). There were elevated levels of endothelial dysfunction biomarkers in COVID-19 patients with poor outcome, indicating their possible role in disease severity and prognosis. In particular, MR-proADM, vWF, syndecan-1 and sFLT-1 showed a significant association with poor outcome in these patients.

Association Between Satisfaction with Nasal Appearance and Olfactory Function in Patients Undergoing Septorhinoplasty Surgery.

BACKGROUND: Any surgery has some complications, and septorhinoplasty is not an exception. The aim of this study was to highlight the relationship between satisfaction with nasal appearance and olfactory function in patients undergoing septorhinoplasty. METHODS: This is a cohort study. In this study, 384 patients aged 18 to 45 years who referred to the Ear, Nose and Throat department at Rasoul Akram hospital and private clinics in 2019 underwent septorhinoplasty. All patients were tested by the Persian Smell Identification Test (PSIT) or Rapid Smell Test (RST) before surgery. They were also reassessed one and three months after surgery. Those patients with dissatisfaction with olfactory function after surgery were also followed up for three months and assessed by PSIT or RST to determine their olfactory dysfunction. RESULTS: One month after surgery, 73.5% of patients who were not satisfied with their nasal appearance also complained about the olfactory sense. In addition, 1.5% of patients who were satisfied with their nasal appearance also complained about the olfactory sense. There was a significant difference regarding complaints of the olfactory sense between patients satisfied with their nasal appearance and those not satisfied with their appearance (P<0.05). Three months after surgery, 78.9% patients who were not pleased with their nasal appearance also had an olfactory complaint. Besides, 0.9% of patients who were pleased with their nasal shape also had an olfactory complaint. There was a significant difference regarding olfactory complaints between patients who were pleased with their nasal shape and those who were not (P<0.05). CONCLUSION: One and three months after septorhinoplasty, most patients who are satisfied with their nasal appearance have no complaints about their olfactory sense, and most patients who are not satisfied with their nasal appearance complain about the olfactory sense. An appropriate outcome of septorhinoplasty with regard to improving olfactory functional status is accompanied by patients' satisfaction level of achieving good nasal appearance.

Viruria of Human BK Virus and John Cunningham Virus among Renal Transplant Recipients and Healthy Control in Southeast of Caspian Sea.

BACKGROUND: Members of the Polyomaviridae family, BK virus (BKV), and John Cunningham virus (JCV) are linked to polyomavirus-associated nephropathy-associated transplant rejection in immunodeficient patients. OBJECTIVE: The aim of the study was to evaluate the prevalence of BKV and JCV in immunocompetent individuals in the north of Iran. METHODS: Ninety-one urine samples were obtained from renal transplant recipients with a mean age of 39.78 ± 11.19 years. A healthy control group of 65 volunteers with an average age of 40.32 ± 10.7 years also contributed. After DNA extraction, positive cases were detected through PCR. Genotyping was done by alignment and phylogenetic tree construction of the VP1 region against all known JCV and BKV genotypes. RESULTS: The prevalence of BKV and JCV was 15.38 and 19.78%, respectively. JCV was detected in 7.69% of the control group. The prevalence of the BKV between the case and control groups was significant (p < 0.0001). There was no significant association between BKV and JCV and duration of dialysis (p > 0.05). Overall, 62.16% of JCV cases were genotype I. Besides, genotype II was dominant within patients with BKV-positive patients. DISCUSSION: The results obtained here show a relatively lower prevalence of BKV and JCV in immunocompromised renal transplant receivers and healthy control than those reported from other areas in Iran. JCV genotyping was evaluated for the first time in Iran. Genotype I for JCV and genotype II for BKV were dominant genotypes in the north of Iran.

The Role of Vesicular Stomatitis Virus Matrix Protein in Autophagy in the Breast Cancer.

BACKGROUND: Breast cancer is one of the most difficult malignancies to treat. Therapeutics is used to target and kill the cancer cells. Non-human oncolytic viruses have the ability to cause cell death directly to cancers. The objective here was to investigate the role of Vesicular Stomatitis Virus (VSV) Matrix (M) protein in autophagy in the breast cancer cell line. METHODS: Two different VSV wild type and mutant (M51R) M protein constructs were produced. Breast cancer cell line BT-20 was transfected by either wild type or mutant vectors. Transfection efficiency was measured using a fluorescent microscopy. Expression of VSV M protein was investigated at protein level. Cell cytotoxicity was measured using an MTT assay. The autophagy pathway was studied by Beclin-1 immunoassay. Data were statistically analyzed between different transfected groups. RESULTS: It has been shown that the VSV M protein induced higher levels of Beclin-1 than the M51R mutant in the BT-20 cell line. Increased levels of Beclin-1 were also associated with VSV M cell-induced cytotoxicity. CONCLUSION: It has been shown here that VSV wild type or mutant M proteins can cause autophagy-induced cell death by increasing Beclin-1 expression. This includes the possible role of VSV to be used as an oncolytic virus in breast cancer treatment. 
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The Effect of Nasal Tip Defatting on Skin Thickness in Rhinoplasty: A Quasi-Experimental Study.

Background: A few studies have been published on the clinical efficacy and safety of nasal tip defatting plus rhinoplasty, particularly among people with bulbous noses. Therefore, the present study aimed to assess the consequences of nasal tip defatting for skin thickness reduction. Methods: This quasi-experimental study was performed on 72 consecutive patients, candidates for aesthetic rhinoplasty. Twenty-seven patients were scheduled for nasal tip defatting with routine open rhinoplasty concomitantly. Besides, 45 patients underwent rhinoplasty without nasal tip defatting method. Tip and supra-tip skin thickness were assessed before and 12 months after the operation using ultrasonography. The patients' and surgeon's satisfaction with aesthetic results after the operation were also evaluated based on visual analog scaling (VAS). SPSS version 16.0 (SPSS Inc., Chicago, IL., USA) was used for the analyses. P values below 0.05 were considered statistically significant. Results: Seventy-two patients (4 men, 68 women; mean age 26.40 ± 4.61 years) entered the study. Twenty-seven candidates underwent rhinoplasty plus nasal tip defatting (group A). Open rhinoplasty alone was performed for the other 45 patients (group B). The mean nasal tip thickness was 3.98±0.84 mm in group A and 3.69±0.64 mm in group B before the surgery (p=0.059). Preoperative nasal supra-tip thickness of the patients was also assessed using ultrasonography (3.54±0.72 mm in group A versus 3.73±0.54 mm in group B; p=0.065). Both preoperative tip and supra-tip thickness did not statistically differ between the two groups. No significant difference in postoperative tip skin thickness was obtained between two groups after 12 months (3.24±1 mm in group A versus 3.25±0.625 mm in group B; p=0.960), while postoperative supra-tip skin thickness differed significantly according to ultrasonography assessments (2.86±0.60 mm in group A versus 3.25±0.71 mm in group B; p=0.016). Postoperative satisfaction of the candidates was obtained using theVAS scoring system 12 months after the operation in both groups (8±1 in group A, 7.5±1 in group B; p=0.021). Surgeon's satisfaction in terms of the aesthetic outcome was also assessed based on the VAS system which did not statistically differ between the two groups as well as the patients' satisfaction (7.84±1.42 in group A, 7±1.61 in group B; p=0.014). Conclusion: Nasal tip skin defatting is the main component in aesthetic rhinoplasty, but its significant effect on the reduction of tip skin thickness is controversial. However, in patients with moderate or thick nasal tip skin, such a procedure can result in higher postoperative satisfaction with the aesthetic outcome compared to rhinoplasty alone.

Investigating Human Papilloma Virus Types in Sinonasal Papilloma Using Polymerase Chain Reaction: Is It Really a Prerequisite for Nasal Papilloma Formation?

Sinonasal papilloma is a relatively rare disease. However, it is prevalent enough for every otorhinolaryngologist to encounter it several times throughout one's medical practice. The aim of this study was to identify the presence of Human Papilloma Virus in sinonasal specimens of patients with sinonasal papilloma. A cross sectional analytical study was performed on fresh tissue samples from 36 patients with sinonasal papilloma. Samples were studied by polymerase chain reaction for of Human Papilloma Virus detection. In conclusion, the majority of patients were of Human Papilloma Virus negative and there was no statistically significant difference in presence of squamous cell carcinoma in of Human Papilloma Virus positive and negative patients. Thus, further studies are needed to assess other potential factors that may influence the development of sinonasal papilloma.

Local eosinophils are associated with increased IgA subclass levels in the sinonasal mucosa of chronic rhinosinusitis with polyp patients.

BACKGROUND: Chronic rhinosinusitis (CRS) describes an inflammatory condition affecting the sinonasal mucosa. As the immune system players such as immunoglobulins play prominent roles in the development of CRS, we aimed to investigate the expression of IgA subclasses and factors involved in IgA class switching in the sinonasal mucosa of CRS patients. METHODS: Specimens were collected from the sinonasal mucosa of the healthy controls and CRS patients. Histological assessments were performed by H&E and immunohistochemistry. Real-time PCR and ELISA methods were applied to measure gene expression and protein levels extracted from tissue samples, respectively. RESULTS: We observed that total IgA and subclass-positive cells were higher in the patient groups than controls. There was a significant correlation between the number of eosinophils and total IgA and subclasses-positive cells (Pv < 0.0001). The expression of CXCL13, BAFF, AID, and germline transcripts were increased in CRSwNP patients. In contrast to IgA2 levels, IgA1 levels were significantly increased in the sinonasal tissue of CRSwNP patients (Pv < 0.01). TGF-ß was significantly elevated in the sinonasal tissue of patients with CRSsNP. CONCLUSIONS: Increased protein levels of IgA subclasses and related antibody-producing cells were associated with elevated eosinophils in CRSwNP patients which may result in eosinophil pathological functions. Several therapeutic approaches might be developed to modulate the IgA production to ameliorate the inflammatory mechanisms in CRSwNP patients.

Non-replicating Newcastle Disease Virus as an adjuvant for DNA vaccine enhances antitumor efficacy through the induction of TRAIL and granzyme B expression.

The potential of non-replicating Newcastle Disease Virus (NDV) as an adjuvant for DNA vaccination remains to be elucidated. To assess the therapeutic effects of DNA vaccine (HPV-16 E7 gene) adjuvanted with NDV, female C57/BL6 mice were inoculated with murine TC-1 cells of human papillomavirus (HPV)-related carcinoma, expressing human papillomavirus 16 (HPV-16) E6/E7 antigens, and immunized with DNA vaccine alone or pretreated with NDV. One week after third immunization, Cytotoxic T lymphocytes (CTLs), splenocyte proliferation, cytokine balance (IFN-γ, IL-4 and IL-12 secretions) and intratumoral expression of cytotoxicity related proteins in tumor lysates were investigated. The results showed that treatment with non-replicating NDV prior to DNA vaccine induced tumor-specific cytolytic and splenocyte proliferation responses. The levels of cytokines IL-12, IL-4 and IFN-γ after treating with combined E7-DNA -non-replicating NDV (NDV-DNA Vaccine) were significantly higher than those of control groups. The intratumoral granzyme B and Tumor Necrosis Factor Related Apoptosis Inducing Ligand (TRAIL)-mediated apoptosis was also significantly increased. Tumor therapeutic experiments showed that the NDV pretreatment could reduce the tumor progression of established E7-expressing TC-tumors. Taken together these data suggest that the significant antitumor responses evidenced during treatment with non-replicating NDV prior to DNA vaccine are due, in part, to strong E7-induced cellular immunity and enhanced expression of cytotoxicity related proteins in the tumor microenvironment. These observations indicated the potential of non-replicating NDV as an adjuvant for enhancing therapeutic DNA vaccines -induced immunity and antitumor responses.

Determining the effect of platelet-rich plasma (PRP) on improving endoscopic sinus surgery: A randomized clinical trial study (RCT).

Background: Rhinosinusitis is an inflammatory disease of the nasal and paranasal sinus mucosa, and it becomes chronic when it lasts longer than 3 months without symptom improvement. The aim of this study was to determine the effect of PRP on improvement of endoscopic sinus surgery. Methods: This was a randomized clinical trial (RCT) designed and implemented on 21 patients with chronic rhinosinusitis in Rasool Akram hospital in Tehran during 2016-2017. In this study, one side of the nose was randomly selected as the control and the other side as the case, and at the end of the surgery, PRP was sprayed onto the surface where the polyp was removed in the side that was intended as the case. The nasal endoscopy findings were graded according to Meltzer's criteria before and after surgery and CT findings were classified according to the Lund-Mackay scoring system. Then, all patients were followed for 6 months. The SNOT-22 questionnaire, charts of Meltzer's criteria, and Lund-Mackay were used for data collection. Kolmogorov-Smirnov test, Wilcoxon Signed Rank test, and Mann-Whitney U test were used to analyze data in SPSS-22 software. P value<0.05 was considered significant. Results: The mean and standard deviation of patients' age were 36.55 and 7.91, respectively. The median Lund-McKay Pre-op CT score before treatment was 10 (9.5-11), and no significant difference was found between the 2 sides of the nose (left and right). The items that showed statistically significant improvement after surgery was SNOT-22 (p<0.05). The mean of Meltzer scores in each side of the nose was significantly different before and after intervention (p<0.05). However, the mean of Meltzer scores in the 2 sides of the nose was not significantly different before and after intervention. Conclusion: The treatment by PRP may be effective in reducing symptoms of patients showing recurrence of CRS symptoms following endoscopic sinus surgery subjectively but not objectively.