Chinese Society of Allergy and Chinese Society of Otorhinolaryngology-Head and Neck Surgery Guideline for Chronic Rhinosinusitis

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.

Expression of SerpinB2 and SerpinB4 genes in nasal brushings in allergic rhinitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the expression of SerpinB2 and SerpinB4 genes in cells from the nasal brushings in allergic rhinitis(AR) patients, and their relationships with eosinophil numbers in nasal brushings, serum total IgE level and severity of AR. METHODS Twenty nine control subjects and 59 AR patients[29 specific IgE positive AR(sIgE-P-AR) patients, 30 specific IgE negative self reported AR(sIgE-N-SR-AR) patients] were recruited. The samples of nasal brushings and peripheral blood were collected to detect SerpinB2 and SerpinB4 gene expression and eosinophil numbers in nasal brushings, and total IgE and allergen-specific IgE level in peripheral blood. RESULTS Expression of SerpinB2 and SerpinB4 genes in cells from nasal brushings were significantly higher in sIgE-P-AR [5.17(2.33-18.96), 0.6(0.355-1.08), respectively] and sIgE-N-SR-AR [3.27(1.59-13.4), 0.75(0.42-1.64), respectively] than that in control subjects[1.21(0.1-3.285), 0.29(0.165-0.505)] (sIgE-P-AR:P=0.013; sIgE-N-SR-AR:P=0.002). Expression level of SerpinB2 and SerpinB4 had no relationships with eosinophil numbers in nasal brushings and serum total IgE level. Expression of SerpinB2 in moderate/severe AR[4.74(2.68-47.5)] was significantly higher than that in mild AR[(1.333-5.603)](P=0.025); while expression of SerpinB4 in mild AR[3.95(2.6-7.59)] was significantly higher than that in moderate/ severe AR[2.83(0.715-5)](P=0.042). CONCLUSION SerpinB2 and SerpinB4 genes might be involved in the pathogenesis of AR, and their diagnostic values in AR deserve to be evaluated with larger samples.