Comparison of Allergen Immunotherapy Alone and in Conjunction With Turbinate Surgery for Nasal Obstruction in Perennial Allergic Rhinitis Patients.

BACKGROUND: Nasal obstruction, triggered by allergic rhinitis, often does not resolve with allergen-specific immunotherapy (AIT) alone, thus inferior turbinate reduction surgery (ITR) may be required. This study aims to investigate the impact of combined treatment on nasal obstruction, as evidence is currently limited. METHODOLOGY/PRINCIPAL: A retrospective cohort study of perennial allergic rhinitis patients experiencing nasal obstruction and undergoing ≥12 months AIT was conducted. Two groups were derived, those undergoing AIT-with or without an ITR. Patient reported nasal obstruction (evaluated with questionnaires) and nasal airway function (Nasal Peak Inspiratory Flow [NPIF] and Nasal Airflow Resistance [NAR]) were monitored. The change from baseline to 12 months post-treatment in each group were compared. RESULTS: A total of 118 patients (33.71 ± 14.43 years, 41.5% female) were recruited, 72% had AIT and 28% AIT&ITR. At baseline, the AIT&ITR group had a higher level of nasal obstruction (>moderate%; 63.6% vs 52.9%, P = .048). Post treatment, AIT&ITR group reported greater reduction in nasal obstruction (>1 category change: 75.8% vs 48.2%, P = .002). Similarly, the AIT&ITR group had greater improvement in nasal function by NPIF (-13.9 ± 110.3 L/minute vs -3.4 ± 78.1 L/minute, P = .049) and NAR (-0.120 ± 0.342 Pa/cm³/second vs -0.093 ± 0.224 Pa/cm³/second, P = .050). CONCLUSIONS: Allergic rhinitis patients, with moderate to severe nasal obstruction, who undergo combined AIT&ITR have greater relief of nasal obstruction and improved airflow analysis compared to AIT alone.

Assessment of taste functions in allergic rhinitis patients undergoing allergen-specific immunotherapy.

BACKGROUND: We evaluated taste functions of patients with perennial allergic rhinitis (AR) before and after allergen-specific immunotherapy (AIT). METHODS: The study was designed as a prospective clinical study in our tertiary care hospital. Patients (n = 21) who were diagnosed with perennial AR on the basis of physical examination, skin prick test of at least 3* for HDM allergen and treated with AIT were enrolled in this study. A control group (n = 21) was selected from patients who were given intranasal steroids (INS) for perennial AR. Both groups had self-reported hyposmia and subjective loss of the sense of taste before treatment. Taste strips (Burghart, Wedel, Germany) were used for the taste identification scores before and after 6 months treatment. RESULTS: A total of 42 subjects were included, with a mean age of 24.1 ± 7.9 years (range 15-43 years). Overall, the AIT group showed more of an improvement of taste function, observed in the total average test scores, compared to the INS group (p < 0.05), but no change was detected between the groups before treatment. No difference was found for the bitter taste scores between the study groups (p = 0.053). CONCLUSION: Subcutaneous allergen immunotherapy resulted in more of an improvement in taste function than intranasal steroids. Further studies are needed.

Combination of mometasone furoate and oxymetazoline for the treatment of adenoid hypertrophy concomitant with allergic rhinitis: A randomized controlled trial.

In the clinic, approximately 30% of children with adenoid hypertrophy (AH) concomitant with allergic rhinitis (AR) report poor responses to intranasal steroids. To determine whether the combination of mometasone furoate (MF) and oxymetazoline (OXY) is more effective than either agent alone, we performed a two-stage, parallel, randomized, double-blind, double-dummy, clinical trial with 240 AH children with concomitant perennial AR. During the first stage, all children were randomly assigned to the MF or control group for six weeks of treatment. During the second stage, the non-responders from stage one were randomly assigned to 4 groups for 8 weeks of treatment that involved receiving the following treatments: MF/OXY, MF/placebo, placebo/OXY, or placebo/placebo. During the first stage of treatment, 39% of the responders treated with MF achieved greater reductions in total and individual symptom scores than did those on placebo. During the second stage of treatment, the nasal congestion scores of the MF/OXY group significantly decreased. The adenoid/choana ratio of the MF/OXY-treated group decreased and the nasal volume increased significantly. Our results suggest that the combination of OXY and MF is effective and safe for the treatment of AH children with concomitant AR and has a rapid onset of action.

[Clinical features of ocular symptom in patients with allergic rhinitis].

OBJECTIVE: To investigate the clinical characteristics of ocular symptoms in patients with allergic rhinitis (AR) and the impact of the ocular symptoms on patients' quality of life. METHOD: AR patients' history and clinical data were collected and analyzed. One hundred cases were extracted from adult patients with and without ocular symptoms in each group and their quality of life were evaluated using rhino-conjunctivitis quality of life questionnaire (RQLQ). RESULT: Totally 1119 cases were collected and 859 cases had ocular symptoms. Of the patients with ocular symptoms, 582 cases were mild, 234 cases were moderate, 43 cases were severe. Eye itching was the most common symptom, followed by tears, hyperemia and swelling. Patients with ocular symptoms had longer disease history than non ocular symptom group (P < 0.05). There was a positive correlation between ocular and nasal symptoms (P < 0.01); patients with ocular symptoms had more severe nasal symptoms than patients without ocular problems; while patients with moderate to severe AR had more severe ocular symptoms than mild AR patients (P < 0.01). Female patients had higher incidence (P < 0.05) and ocular symptoms score (P < 0.05) than male. Children less than 10 years old had a relative lower incidence and score of ocular symptoms. While the incidence and score had an increasing trend for patients older than fifty. There was no difference regarding the type and number of allergen in the patients with and without ocular symptom. Moreover, patients with ocular symptoms had higher scores in the domains of non-nose/eye symptoms, practical problems, ocular symptoms, emotional function and total score in RQLQ than patients without ocular symptom. CONCLUSION: It was common for the AR patients to have ocular symptoms, and ocular symptoms had obvious influence on the patients' quality of life. So controlling of the ocular symptoms should not be ignored during the diagnosis and treatment of AR.

Does the type of rhinitis influence development of otitis media with effusion in children?

Otitis media with effusion (OME) is characterized by the presence of fluid in the middle ear cavity behind an intact eardrum and is considered a multifactorial condition with Eustachian tube dysfunction as the underlying pathophysiologic condition. One of the most debated causes of OME is allergy, in particular allergic rhinitis. The aim of this paper is to review the role of rhinitis in the development of OME and in particular the role of both allergic (AR) and non-allergic rhinitis (NAR). Most of the recent literature confirms the role of AR in the development of OME, while there are few reports on the role of NAR. In non-allergic children affected by obstructive adenoid hypertrophy, the presence of mast cells in the nasal smear was associated with a high risk of developing a chronic OME.

[The effect of two surgical method on treatment of allergic rhinitis complicated with nasal septum deviation].

OBJECTIVE: To evaluate the effect of two surgical methods on treatment of allergic rhiniti complicated with nasal septum deviation. METHOD: Eighty-seven cases of allergic rhiniti complicated with nasal septum deviation were divided into 2 groups according to the degree of mucosal hypertrophy and hyperplasia of bone in inferior turbinate. They were treated by resection of nasal septum deviation combined with temperature-controlled radio-frequency, or combined with partial submucoperiosteous resection of inferior turbinate bone. The Lanzhou standard (2004) and nasal airway resistance were used to evaluate the efficacy. RESULT: After one year follow-up time, the nasal resistance was significantly decreased and the effective rates were greater than 88% in each group. CONCLUSION: Both of the two surgical methods can significantly depress the nasal resistance and improve the allergic symptoms, which shows good effect.

Risk of cancer in patients with medically diagnosed hay fever or allergic rhinitis.

Data on allergic conditions as risk or protective factors for cancer are controversial probably because most studies have used self-reported data on mixed groups of allergies in a case-control setting. We define cancer risks in medically diagnosed hay fever/allergic rhinitis patients in a nationwide cohort study. A total of 138,723 hay fever/allergic rhinitis patients were identified from three Swedish health care databases and standardized incidence ratios (SIRs) were calculated for subsequent cancers identified from the Swedish Cancer Registry. Overall cancer risk was not changed (SIR 1.03). For individual cancers, the highest SIR was observed for nasal cancer (SIR 2.63), followed by testicular (1.46) and endocrine tumors (1.42), and kidney (1.31), prostate (1.18) and breast (1.11) cancers. The results were consistent in the three sources of data and all SIRs were above unity, albeit mainly not statistically significant. The SIRs for nervous system tumors were above unity and of borderline significance. SIRs were decreased for esophageal (0.50), liver (0.62) and lung (0.78) cancers, and the three sources of data agreed in the direction of the effect. The increased risks for testicular, renal, prostate and endocrine cancers may be explained by immunological mechanisms. Excess risk for these cancer accounts for a significant population attributable fraction. Nervous system cancers showed a borderline increase and none of the histological types were significantly decreased, providing strong evidence against the published case-control studies, which have reported protective effects. The reasons for the reduced risks for esophageal, liver and lung cancer remain to be explained.

Impact of vitamin D deficiency upon clinical presentation in nasal polyposis.

BACKGROUND: The objective of this work was to determine if specific chronic rhinosinusitis with nasal polyps (CRSwNP) populations are at risk for vitamin D3 (VD3 ) deficiency and if VD3 levels correlate with radiographic measures of disease severity or eosinophilia. METHODS: This study was a retrospective review of an academic rhinology practice. CRSwNP patients who had VD3 levels and CT scan within 6 months of each other were included. CT scans were graded using Lund-Mackay scoring (LMS) and peripheral eosinophil counts were measured. Demographic data including race, gender, age, body mass index, atopic status, and presence of asthma were collected. CRSwNP was subdivided into allergic fungal rhinosinusitis (AFRS), aspirin-exacerbated respiratory disease (AERD), and other CRSwNP. Multivariate analysis was performed to examine correlations and control for confounding factors. RESULTS: Insufficient VD3 levels were found in 55% of all CRSwNP patients. VD3 correlated with African American race because nearly 80% of all African Americans had insufficient VD3 levels. Lower VD3 levels also correlated with more severe mucosal disease on CT scans as measured by LMS. There was no correlation between VD3 levels and age, gender, body mass index, atopy, asthma, or CRSwNP subtype. CONCLUSION: VD3 insufficiency/deficiency is common in CRSwNP patients, especially those of African American race. Lower levels of VD3 are associated with worse LMS on CT. The role of VD3 in CRSwNP warrants further investigation.

Cellular changes in tears associated with keratoconjunctival responses induced by nasal allergy.

BACKGROUND: Allergic keratoconjunctivitis occurs in a primary form, caused by an allergic reaction localized in the conjunctiva, and in a secondary form, induced by an allergic reaction originating in the nasal mucosa. Various hypersensitivity mechanisms involved in the keratoconjunctivitis forms result in different keratoconjunctival response types. PURPOSE: To investigate the cytologic changes in tears during the secondary immediate (SIKCR), late (SLKCR), and delayed (SDYKCR) keratoconjunctival responses. METHODS: In 61 patients, comprising 20 SIKCRs, 23 SLKCRs, and 18 SDYKCRs, nasal provocation tests (NPTs) with allergens and 61 phosphate-buffered control challenges were repeated and supplemented with cell counting in the tears. RESULTS: The SIKCR (P<0.01), appearing 10-120 min after the NPT, was associated with increased eosinophil and mast cell counts in tears. The SLKCR (P<0.01), appearing 5-12 h after the NPT, was accompanied by increased counts of eosinophils, neutrophils, basophils, and conjunctival epithelial and goblet cells. The SDYKCR (P<0.05), appearing 24-48 h after NPT, was associated with increased counts of lymphocytes, neutrophils, monocytes, basophils, conjunctival epithelial, corneal epithelial and goblet cells. CONCLUSIONS: The SIKCR, SLKCR, and SDYKCR, induced by nasal allergy, were associated with different cellular profiles in the tears. The cells, except mast, epithelial and goblet cells, displaying no intracellular changes, migrated probably from the conjunctival capillaries, in response to the factors released during the primary allergic reaction in the nasal mucosa and subsequently penetrating into the conjunctiva. These results demonstrate a causal role of nasal allergy and diagnostic value of NPT combined with recording of ocular features and cellular profiles in tears in some keratoconjunctivitis patients.

Case-control study of rhinoconjunctivitis associated with IL5RA polymorphisms in Japanese women: the Kyushu Okinawa Maternal and Child Health Study.

BACKGROUND: Epidemiological research on the relationship between single nucleotide polymorphisms (SNPs) in the IL5RA gene and allergic disorders is limited. We examined the relationship between IL5RA SNPs and risk of rhinoconjunctivitis in young adult Japanese women. METHODS: Included were 393 women who met the criteria of the International Study of Asthma and Allergies in Childhood (ISAAC) for rhinoconjunctivitis. Controls were 767 women without rhinoconjunctivitis according to the ISAAC criteria who had not been diagnosed with allergic rhinitis by a doctor. Adjustment was made for age, region of residence, presence of older siblings, smoking, and education. RESULTS: Compared with the CC genotype of SNP rs6771148, the CG genotype, but not the GG genotype, was significantly associated with a reduced risk of rhinoconjunctivitis: the adjusted OR for the CG genotype was 0.76 (95% CI: 0.58-0.99). No evident associations were found between SNPs rs17882210, rs3804797, rs334809, rs9831572, or rs17881144 and rhinoconjunctivitis. The ACTAGA haplotype of rs17882210, rs3804797, rs334809, rs9831572, rs6771148, and rs17881144 was significantly inversely associated with rhinoconjunctivitis (crude OR=0.58, 95% CI: 0.37-0.88) while the GTAGCA haplotype was significantly positively related to rhinoconjunctivitis (crude OR=1.74, 95% CI: 1.14-2.65). No significant interactions affecting rhinoconjunctivitis were observed between any of the six SNPs and smoking. CONCLUSION: This is the first study to show significant associations between IL5RA SNP rs6771148, the ACTAGA haplotype, and the GTAGCA haplotype and the risk of rhinoconjunctivitis. We did not find evidence for interactions affecting rhinoconjunctivitis between any of the IL5RA SNPs and smoking.

Association between allergic rhinitis and nasopharyngeal carcinoma: a population-based study.

OBJECTIVES/HYPOTHESIS: Although it is known that inflammatory processes can elevate the risk of cancer, to date the association between allergic rhinitis (AR) and nasopharyngeal carcinoma (NPC) remains unknown. This study aimed to evaluate the association between NPC and AR based on a population-based database in Taiwan. STUDY DESIGN: A case-control study. METHODS: In total, 1,799 NPC cases and 5,397 randomly selected controls without NPC were included. We evaluated the prevalence and risk of prior AR between cases and controls. We also performed a conditional logistic regression analysis to calculate the odds ratio (OR) for having been previously diagnosed with AR between cases and controls. RESULTS: In total, 2,453 of the 7,196 study subjects (34.1%) had previously received an AR diagnosis; 875 (48.6%) were cases and 1,578 (29.2%) were controls (P < 0.001). The conditional logistic regression suggested that the OR of prior AR for cases was 2.29 (95% CI = 2.05-2.56) compared to controls. Even after adjusting for geographic region, monthly income, urbanization level, diabetes, tobacco use disorder, and alcohol abuse, the OR of having previously received an AR diagnosis among cases was 2.25 (95% CI = 2.02-2.59) that of controls. Furthermore, after excluding subjects diagnosed with AR within 1, 2, or 3 years prior to the index date, the respective adjusted ORs were 1.91, 1.61, and 1.35. CONCLUSIONS: This study demonstrated an association between NPC and prior AR. We recommend that physicians and patients with AR keep in mind this potential risk of subsequent NPC development.

Possible pathogenic role of T helper type 9 cells and interleukin (IL)-9 in atopic dermatitis.

T helper type 9 (Th9) cells are a novel identified subset of CD4(+) T helper cells, which could partly contribute to allergic inflammation, while the precise contribution of Th9 cells in atopic dermatitis (AD) remains unknown. We aimed to explore the possible role of Th9 cells in AD pathogenesis. The Th9 cell percentage, transcription factor PU.1 and cytokine interleukin (IL)-9 mRNA levels, as well as IL-9 serum concentration in peripheral circulation, were measured in AD patients, psoriasis patients and healthy controls. The Th9 cell percentage, PU.1 and IL-9 expression levels of AD patients were all increased significantly compared with the other two control groups (P < 0·01), and correlated positively with SCORing Atopic Dermatitis index, serum immunoglobulin (Ig)E and thymus- and activation-regulated chemokine (TARC) levels (P < 0·05). In simple AD patients and AD patients complicated by allergic rhinitis or asthma, there were no significant differences in the Th9 cell percentage, PU.1 and IL-9 expression levels between them. At the same time, IL-9 and vascular endothelial growth factor (VEGF) mRNA levels were detected in AD lesions and normal skin samples, which were both distinctly elevated in AD lesions, and there was a positive association between them (P < 0·01). Keratinocytes were cultured with IL-9 stimulation and the secretion of VEGF was detected. IL-9 can promote the secretion of VEGF by keratinocytes in a time- and dose-dependent manner. In conclusion, the expansion of the Th9 cell subset, up-regulation of the PU.1 transcription factor and increased secretion of the IL-9 cytokine may contribute to the pathogenesis of AD, which may be supported by the increased release of VEGF by keratinocyes after IL-9 stimulation.

The association of asthma, nasal allergies, and positive skin prick tests with obesity, leptin, and adiponectin.

BACKGROUND: Cross-sectional and longitudinal reports show that obese adults have more asthma than non-obese adults. A proposed mechanism is via effects of adipokines (leptin and adiponectin) on the immune system. OBJECTIVE: We wished to measure the associations of asthma and other atopic diseases with serum adipokine levels and to find whether the associations with asthma were strong enough to rule out the possibility that they are secondary to the association of fatness measures with asthma. METHODS: The Global Asthma and Allergy Network of Excellence (GA(2) LEN) clinical follow-up survey is a clinical survey, embedded in a larger multi-centre cross-sectional postal survey, involving, with a case/control design, enrichment of the sample with subjects with asthma and chronic rhinosinusitis (CRS). We recorded serum leptin or adiponectin in 845 men and 1110 women in 15 centres and also anthropometric measures of fatness including body mass index and waist/hip ratio, current asthma, and specific skin prick and IgE sensitisation. We used inverse sampling-probability-weighted rank and regression statistics to measure population associations of disease outcomes with adipokines in males and females, adjusting for confounders (area, age, smoking history, and number of elder siblings) and also mutually adjusting associations with adipokines and fatness measures. RESULTS: One thousand nine hundred and fifty-five subjects aged 16-77 years had information on leptin or adiponectin levels. Leptin and leptin/adiponectin ratio were positively associated with the level of asthma, especially in females (Somers' D of leptin by asthma score, 0.20; 95% CI, 0.08-0.30; P = 0.00079). These associations were attenuated after adjusting for confounders and became non-significant after additionally adjusting for fatness measures and multiple comparisons. CONCLUSIONS AND CLINICAL RELEVANCE: Asthma levels are positively associated with serum leptin. However, we cannot rule out the possibility that this association is secondary to associations of both with fatness measures.

Inconclusive evidence for allergic rhinitis to predict a prolonged or chronic course of acute rhinosinusitis.

OBJECTIVE: To systematically review the evidence on allergic rhinitis as a predictor for a prolonged or chronic course in adult patients with acute rhinosinusitis. DATA SOURCES: Pubmed, EMBASE, and the Cochrane library. REVIEW METHODS: A systematic literature search was performed on March 15, 2013. During screening of title and abstract, 3 authors independently selected studies on allergic rhinitis as a predictor for the course of acute rhinosinusitis in adults. The reported study design was assessed for directness of evidence and risk of bias. We aimed to extract prior and posterior probabilities for a prolonged or chronic course of acute rhinosinusitis. RESULTS: Of 13,202 retrieved articles, 2 articles were eligible for study assessment. They provided a high directness of evidence but carried a high risk of bias. The studies showed an incidence of a prolonged and chronic course of, respectively, .19 (95% confidence interval [CI] .16-.23) and .05 (95% CI, .02-.13). In patients with allergic rhinitis, the incidence was .25 (95% CI, .18-.35) and .14 (95% CI, .04-.34), so the added value of allergic rhinitis to predict a prolonged course is 6% and to predict a chronic course 8%. CONCLUSION AND RECOMMENDATION: While the 2 included studies suggest that allergic rhinitis adds little to the prediction of a prolonged or chronic course in patients with acute rhinosinusitis, they carry a high risk of bias. As the available evidence does not provide grounds for different management of patients with and without allergic rhinitis, namely, according to clinical practice guidelines, both can be managed with expectant observation and symptomatic treatment.

Approaching chronic sinusitis.

Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

Reduction in superoxide dismutase expression in the epithelial mucosa of eosinophilic chronic rhinosinusitis with nasal polyps.

BACKGROUND: Eosinophils generate large amounts of oxidant species. The eosinophil-dominant type of chronic rhinosinusitis (CRS) with nasal polyps is related to more extensive disease and a decreased likelihood of surgical success. Superoxide dismutase (SOD) is the first-line and only antioxidant enzyme that converts superoxide to hydrogen peroxide. METHODS: The patients with CRS with nasal polyps were divided into eosinophilic and noneosinophilic groups. The expression of three isoforms of SOD, intracellular copper-zinc SOD (CuZnSOD), mitochondrial manganese SOD (MnSOD) and extracellular SOD (ECSOD), were examined by enzyme activity assay, immunohistochemistry and quantitative real-time RT-PCR sampled by laser capture microdissection. RESULTS: SOD activity in the eosinophilic and noneosinophilic groups was significantly reduced compared to that of the control groups. Immunostaining of both CuZnSOD and MnSOD in the eosinophilic group was significantly decreased compared with that in the noneosinophilic and control groups. CuZnSOD mRNA of the eosinophilic group was significantly decreased compared with that of the control group, whereas MnSOD mRNA in the eosinophilic group was significantly decreased compared with that in the noneosinophilic and control groups. Neither immunoreactivity nor mRNA of ECSOD was different among the three groups. The degree of epithelial damage and disease severity were inversely correlated with CuZnSOD and MnSOD immunoreactivity. CONCLUSIONS: The reduction in SOD activity and the downregulation of the SOD message are suggested to be related to eosinophil recruitment and epithelial damage of CRS with nasal polyps.

Olfactory dysfunction and asthma as risk factors for poor quality of life in upper airway diseases.

BACKGROUND: The study of olfaction/quality of life (QoL) interaction has not been adequately discussed and remains to be further explored. Determination of clinical predictors for poor QoL may support consultation of respective patients. This study explores QoL of patients with olfactory dysfunction and evaluates associated clinical risk factors for QoL prediction. METHODS: One hundred eight patients suffering from chronic rhinosinusitis (CRS) and allergic rhinitis (AR) and 30 healthy subjects were studied. Olfactory function was evaluated using objective olfactory test. All patients completed six validated questionnaires either specific for olfaction (Questionnaire of Olfactory Deficits [QOD]) and for assessing psychological state (Zung Anxiety Scale [ZAS], State-Trait Anxiety Inventory, Zung Depression Scale, and Beck Depression Inventory [BDI]) or a generic one (Short Form 36). RESULTS: Significantly poorer QoL and more severe anxiety and depression symptoms were observed in anosmic (all p < 0.001) and hyposmic patients compared with controls. Anosmic patients presented significantly worse results compared with hyposmic and normosmic patients. However, higher scores were observed in hyposmic compared with normosmic patients only in the QOD, ZAS, and BDI scale. Patients with CRS presented significantly poorer QoL than patients with AR only. The presence of nasal polyps or concomitant AR in patients with CRS did not show any differentiation in the results. Asthma was associated with significantly worse scores in all the psychometric questionnaires. CONCLUSION: Olfactory dysfunction was found to decrease QoL among patients. Anosmia, CRS disease, and asthma as clinical predictors were proved to be independently correlated with QoL, anxiety, and depression levels.

Interleukin-17A expression in patients with chronic rhinosinusitis and its relationship with clinical features.

OBJECTIVE: To investigate the expression of interleukin (IL) 17A in Chinese patients with chronic rhinosinusitis (CRS) and analyse its correlation with clinical parameters. METHODS: Patients undergoing functional endoscopic sinus surgery and matched controls were included in this retrospective study. Clinical assessments (using a visual analogue scale of symptom severity, Johansson endoscopic score and Lund-Mackay computed tomography score) were performed preoperatively. Mucosal specimens were analysed for inflammatory infiltration and IL-17A expression, using immunohistochemistry. RESULTS: In total, 40 patients undergoing functional endoscopic sinus surgery and 16 controls were included in the study. IL-17A levels were significantly higher in tissues from patients with CRS (with or without nasal polyps) than in control tissues. In CRS, IL-17A expression tended to be higher in tissues with infiltrating neutrophils than in those with infiltrating eosinophils, but this difference was not significant. IL-17A expression in CRS was positively correlated with symptom severity, endoscopic findings and radiological appearance. CONCLUSIONS: Expression of IL-17A was higher in Chinese patients with CRS than in controls, and was associated with infiltrating inflammatory cells, symptom severity, endoscopic findings and radiological appearance. These findings suggest that IL-17A may play a role in CRS pathogenesis and remodelling of nasal polyps.