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1.
Eur J Histochem ; 64(1)2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31988531

RESUMO

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent sinonasal mucosa inflammatory disease with still unclear pathophysiologic mechanisms that imply events of tissue repair and structural remodelling. Several cascades seem to have a considerable role in the onset and progression of mucosa hyperproliferation in nasal polyps including transforming growth factor ß/Small mother against decapentaplegic (TGFß/Smads), mitogenactivated protein kinases (MAPKs), advanced glycosylation end-products (AGEs) together with epithelial-tomesenchymal transition (EMT). Since many inflammatory mediators are reported to play important roles in the development of nasal polyps (NP) disease, this study aimed to analyse the correlation between the AGEs/receptor of advanced glycosylation end-products (RAGE)/extracellular signal-regulated kinase (ERK) signalling pathway and the main markers of EMT to better understand the influence that they exert on the remodelling of nasal mucous membranes in patients affected by CRSwNP vs normal controls. A total of 30 patients were enrolled in this study. Immunohistochemical analysis, using AGE, RAGE, p-ERK, MMP-3, TGF-ß1, Smad2/3, Collagen I-III, α-SMA, E-cadherin, IL-6 and Vimentin antibodies, was performed. AGE, RAGE, ERK, p-ERK and MMP3 were also evaluated using western blot analysis. We observed an overexpression of the AGE/RAGE/p-ERK and the main mesenchymal markers of EMT (Vimentin and IL-6) in CRSwNP vs controls whereas the TGF-ß/Smad3 pathway did not show any significant differences between the two groups of patients. These observations suggest a complex network of processes in the pathogenesis of NP, and the AGE/RAGE/ERK pathway and EMT might work together in promoting tissue remodelling in the formation of CRSwNP.


Assuntos
Transição Epitelial-Mesenquimal/fisiologia , Sistema de Sinalização das MAP Quinases/fisiologia , Pólipos Nasais/etiologia , Sinusite/etiologia , Adulto , Doença Crônica , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Feminino , Produtos Finais de Glicação Avançada/metabolismo , Humanos , Imuno-Histoquímica , Interleucina-6/metabolismo , Masculino , Mucosa Nasal/patologia , Pólipos Nasais/patologia , Pólipos Nasais/fisiopatologia , Receptor para Produtos Finais de Glicação Avançada/metabolismo , Sinusite/patologia , Sinusite/fisiopatologia , Vimentina/metabolismo
2.
Isr Med Assoc J ; 22(1): 48-52, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31927806

RESUMO

BACKGROUND: Nasal polyps are three-dimensional structures arising from the mucosa of the upper airway. Due to their complexity, the reliability of single-layer cell cultures and animal systems as research models is limited. OBJECTIVES: To evaluate the feasibility of an ex vivo organ culture of human polyps, preserving tissue structure and function. METHODS: Nasal polyps were excised during routine endoscopic sinus surgery for chronic rhinosinusitis and polyposis. Fresh tissue samples were used for pathological evaluation and for the preparation of 250-500 µm sections, which were incubated in culture media. Tissue viability was assessed by visualisation of cilia motility, measurement of glucose uptake, and an infectivity assay. Cytokine secretion was evaluated by enzyme-linked immunosorbent assay and real-time polymerase chain reaction before and after the introduction of steroids. RESULTS: Polyp tissue viability was retained for 2-3 days as demonstrated by cilia motility, glucose uptake and preserved cellular composition. Tissue samples maintained their capacity to respond to infection by herpes simplex virus 1 and adenovirus. Introduction of dexamethasone to cultured tissue samples led to suppression of interferon-g production. CONCLUSIONS: The ex vivo nasal polyp organ culture reproduces the physiological, metabolic, and cellular features of nasal polyps. Furthermore, it shows a preserved capacity for viral infection and response to drugs. This system is a useful tool for the investigation nasal-polyps and for the development of novel therapies.


Assuntos
Pólipos Nasais/diagnóstico , Técnicas de Cultura de Órgãos/métodos , Adulto , Quimiocinas/metabolismo , Citocinas/metabolismo , Glucose/metabolismo , Humanos , Pólipos Nasais/metabolismo , Pólipos Nasais/patologia , Pólipos Nasais/cirurgia , Reação em Cadeia da Polimerase em Tempo Real
3.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(11): 850-856, 2019 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-31795547

RESUMO

Objective: To explore the expression of amphiregulin (AREG) in nasal polyps patients with different degrees of eosinophil infiltration, and to analyze the correlation between AREG and tissue remodeling. Methods: Forty-eight patients underwent endoscopic sinus surgery in the Department of Otorhinolaryngology Head and Neck Surgery, Remin Hospital, Wuhan University from July 2017 to August 2018 were recruited, including 40 males and 8 females, aged from 16 to 60 years old. The subjects were divided into three groups: control group (n=14), eosinophilic chronic sinusitis with nasal polyps (ECRSwNP) group (n=19) and noneosinophilic chronic rhinosinusitis with nasal polyps (non-ECRSwNP) group (n=15). The relative expression of AREG in nasal mucosa was detected by Western blot assay and immunohistochemical staining. Tissue remodeling was detected by HE staining, AB-PAS staining and Masson staining. Kruskal-Wallis test was used for comparison among multiple groups, and Spearman correlation analysis was conducted between the expression level of AREG and the related indexes of tissue remodeling. Results: The expression of AREG in ECRSwNP group was significantly higher than that in non-ECRSwNP group and control group (median protein expression of Western blot was 1.592 vs 0.617 vs0.582, all P<0.05). The degree of epithelial injury and goblet cell metaplasia in ECRSwNP group was significantly higher than that in control group (all P<0.05), the percentage of collagen fibrosis area in ECRSwNP group was significantly lower than that in control group (P=0.01). In chronic rhinosinusitis with nasal polyps (CRSwNP) patients, the area of mucous glands was negatively correlated with the expression of AREG (r=-0.616, P<0.05), and the percentage of collagen fibrosis area was negatively correlated with the expression of AREG (r=-0.738, P<0.05). Conclusion: The expression of AREG is higher in ECRSwNP patients, which is related to the process of tissue remodeling.


Assuntos
Anfirregulina/biossíntese , Eosinófilos/metabolismo , Mucosa Nasal/metabolismo , Pólipos Nasais/metabolismo , Rinite/metabolismo , Sinusite/metabolismo , Adolescente , Adulto , Doença Crônica , Feminino , Fibrose/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/patologia , Mucosa Nasal/cirurgia , Pólipos Nasais/patologia , Pólipos Nasais/cirurgia , Rinite/patologia , Rinite/cirurgia , Sinusite/patologia , Sinusite/cirurgia , Adulto Jovem
5.
Mol Med Rep ; 20(2): 1952-1958, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257460

RESUMO

Electroacupuncture (EA) has been documented as a form of therapy for chronic sinusitis (CRS). The present study aimed to assess the effects of EA combined with interleukin­10 (IL­10) overexpression on CRS in mice, and to investigate the associated mechanisms. A mouse model of CRS was established by the administration of ovalbumin (OVA), and overexpression of IL­10 was induced using virus­encoded IL­10. The experimental groups were as follows: i) Control group; ii) OVA group; iii) OVA + EA group; iv) OVA + empty vector group; v) OVA + vector + EA group; vi) OVA + IL­10 group; and vii) OVA + IL­10 + EA group. Pathological changes and nasal mucus were analyzed using hematoxylin and eosin staining. Interferon­Î³ (IFN­Î³) and IL­10 were detected via reverse­transcription quantitative PCR and western blot analyses. The pseudostratified epithelium of the mucosa of the nasal sinus was impaired following the induction of CRS. Treatment with EA and/or IL­10 reversed the injury. Combination treatment with EA and IL­10 induced synergistic effects. No infiltration of inflammatory cells was observed in the submucosa following EA and IL­10 treatment. Compared with the control group, the expression of IFN­Î³ and IL­10 in the OVA group was reduced. By contrast, EA or the overexpression of IL­10 inhibited this reduction. Furthermore, the combined application of EA and IL­10 had a significantly more potent inhibitory effect on the reduction of IFN­Î³ expression, but not IL­10. Collectively, EA combined with IL­10 induced specific effects on CRS in mice, likely through the upregulation of IFN­Î³ and IL­10. The current study presented mechanistic implications for the application of EA as an alternative treatment for CRS.


Assuntos
Doença Crônica/terapia , Eletroacupuntura/métodos , Pólipos Nasais/terapia , Sinusite/terapia , Animais , Modelos Animais de Doenças , Humanos , Interferon gama/genética , Interleucina-10/genética , Camundongos , Mucosa Nasal/patologia , Pólipos Nasais/patologia , Sinusite/genética
6.
Artigo em Chinês | MEDLINE | ID: mdl-31327196

RESUMO

Objective:To investigate the clinical characteristics of non-eosinophilic and eosinophilic chronic sinusitis with nasal polyps.Method:Ninty-two patients with chronic sinusitis with nasal polyps were collected and divided into eosinophilic chronic sinusitis with nasal polyps(EOS CRSwNP) and non-eosinophilic chronic sinusitis with nasal polyps(NONEOS CRSwNP) by pathological classification. The clinical characteristics between the two types were compared. Result:NONEOS CRSwNP is more common in northern area of Fujian province(84.8%). NONEOS CRSwNP had the following clinical characteristics: one most nasal discharge was purulent; two more pyocysts can be seen in nasal polyps; three the proportion of eosinophils in the peripheral blood was mostly normal. Four mainly maxillary sinus lesions. EOS CRSwNP had the following characteristics: one most nasal discharge was mucous purulent; two bilateral sinus lesions were more common, mainly ethmoid sinus lesions; three the proportion of blood eosinophilic cells in peripheral blood was often increased. Ouroften accompanied by asthma, postoperative nasal polyps are prone to relapse, systemic steroid hormone is effective in the treatment of recurrent polyps.Conclusion:There are differences in clinical characteristics between eosinophilic and non-eosinophilic chronic sinusitis with nasal polyps. The ratio of eosinophils in peripheral blood, preoperative endoscopy and CT evaluation are helpful for the classification of chronic sinusitis with nasal polyps.


Assuntos
Eosinófilos/citologia , Pólipos Nasais/patologia , Sinusite/patologia , Doença Crônica , Humanos , Contagem de Leucócitos , Pólipos Nasais/diagnóstico , Sinusite/diagnóstico
7.
Artigo em Chinês | MEDLINE | ID: mdl-31327215

RESUMO

Exosomes are nanovesicles secreted by a variety of living cells, which are involved in biological processes such as inflammation,antigen presentation,tumor invasion, and cell differentiation.They are a new mechanism of intercellular communication in the body.Airway chronic inflammatory diseases such as chronic rhinosinusitis,allergic rhinitis, chronic obstructive pulmonary disease,bronchial asthma,etc.are non-specifically involved in airway intrinsic cells,inflammatory cells and inflammatory factors under various internal and external stimuli.Heterotropic inflammatory disease.Exosomes contain a variety of protein,RNA,lipid and other signal transmission media, the are important to chronic inflammation of the airways,and chronic rhinosinusitis,nasal polyps,bronchial asthma,and chronic obstructive pulmonary disease.The occurrence and development of chronic inflammation of the airway is closely related. This article summarizes the current research progress of exosomes and discusses their role in chronic inflammatory diseases of the airways.


Assuntos
Asma/patologia , Dor Crônica/patologia , Exossomos , Pólipos Nasais/patologia , Rinite/patologia , Sinusite/patologia , Humanos
8.
Immun Inflamm Dis ; 7(3): 191-200, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31210032

RESUMO

BACKGROUND: In the clinical setting, chronic rhinosinusitis with nasal polyps (CRSwNP) is usually divided into eosinophilic-CRS (ECRS) and non-ECRS (NECRS) in Japan. Patients with the former are believed to be at risk for postoperative recurrence of CRS. However, some patients have been missed according to these phenotypic classifications due to the low number of infiltrating eosinophils in polyp tissues. OBJECTIVE: In the present study, we attempted to identify cellular or molecular candidate markers to predict nasal polyp recurrence. METHODS: Nasal polyps were collected from 32 patients with CRSwNP who had undergone an endoscopic sinus surgery. These patients were divided into ECRS and NECRS groups in accordance with the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scoring system and the number of eosinophils in polyp tissues. Unclassifiable patients were referred to as the unknown group. RESULTS: Eosinophil infiltration in resected nasal polyps was most evident in the ECRS group. However, the number of mast cells and tryptase-positive cells in nasal polyps were significantly lower in ECRS and unknown groups compared with the NECRS group. A significant positive correlation was detected between the JESREC score and number of eosinophils. The numbers of mast cells and tryptase-positive cells were negatively correlated with the JESREC score in all included samples. Significant positive correlations were detected between the number of transforming growth factor ß1-positive cells and the number of mast cells, tryptase-positive cells, and chymase-positive cells mast cells. CONCLUSIONS AND CLINICAL RELEVANCE: These findings indicated that the enumeration of mast cells in resected polyps may be another approach to predict postoperative polyp recurrence in CRSwNP patients.


Assuntos
Mastócitos/patologia , Pólipos Nasais/patologia , Rinite/diagnóstico , Sinusite/diagnóstico , Doença Crônica , Quimases/metabolismo , Feminino , Humanos , Japão , Contagem de Leucócitos , Masculino , Mastócitos/enzimologia , Pessoa de Meia-Idade , Pólipos Nasais/cirurgia , Período Pós-Operatório , Prognóstico , Recidiva , Rinite/metabolismo , Sinusite/metabolismo , Fator de Crescimento Transformador beta1/metabolismo , Triptases/metabolismo
9.
Mol Med Rep ; 20(2): 863-870, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31173191

RESUMO

CaMKII is a calcium­activated kinase, proved to be modulated by oxidation. Currently, the oxidative activation of CaMKII exists in several models of asthma, chronic rhinosinusitis with nasal polyps, cardiovascular disease, diabetes mellitus, acute ischemic stroke and cancer. Oxidized CaMKII (ox­CaMKII) may be important in several of these diseases. The present review examines the mechanism underlying the oxidative activation of CaMKII and summarizes the current findings associated with the function of ox­CaMKII in inflammatory diseases. Taken together, the findings of this review aim to improve current understanding of the function of ox­CaMKII and provide novel insights for future research.


Assuntos
Asma/enzimologia , Isquemia Encefálica/enzimologia , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/genética , Doenças Cardiovasculares/enzimologia , Diabetes Mellitus/enzimologia , Pólipos Nasais/enzimologia , Neoplasias/enzimologia , Sinusite/enzimologia , Animais , Asma/tratamento farmacológico , Asma/genética , Asma/patologia , Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/genética , Isquemia Encefálica/patologia , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/antagonistas & inibidores , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/metabolismo , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/patologia , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/genética , Diabetes Mellitus/patologia , Ativação Enzimática , Expressão Gênica , Humanos , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/genética , Pólipos Nasais/patologia , Neoplasias/tratamento farmacológico , Neoplasias/genética , Neoplasias/patologia , Oxirredução , Estresse Oxidativo , Inibidores de Proteínas Quinases/uso terapêutico , Espécies Reativas de Oxigênio/antagonistas & inibidores , Espécies Reativas de Oxigênio/metabolismo , Sinusite/tratamento farmacológico , Sinusite/genética , Sinusite/patologia
10.
Allergol Int ; 68(3): 289-295, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31235242

RESUMO

The characteristics in AERD are severe adult-onset asthma, eosinophilic rhinosinusitis with nasal polyposis, and CysLT overproduction. The cause of AERD have remained unclear, however the decrease in the production of PGE2 caused by the reduction in COX-2 activity is considered to main pathological mechanism of AERD. The mast cell activation and the interaction between platelets and granulocytes are lead to the CysLT overproduction and severe eosinophilic inflammation. The ongoing activation of mast cells is important key pathogenesis in not only stable AERD but exacerbated AERD by aspirin and NSAIDs. In recent years, type 2 inflammation caused by ILC2 activation in patients with AERD have been attracting attention. Omalizumab is effective option for AERD via suppression of mast cell activation and CysLT overproduction. Dupilumab improves sinus symptoms especially in patients with AERD. In near future, anti-platelet drug, CRTH2 antagonist, and anti-TSLP antibody may be useful candidates of therapeutic options in patients with AERD.


Assuntos
Antiasmáticos/uso terapêutico , Asma Induzida por Aspirina/tratamento farmacológico , Asma Induzida por Aspirina/patologia , Anti-Inflamatórios não Esteroides/efeitos adversos , Anti-Inflamatórios não Esteroides/imunologia , Aspirina/efeitos adversos , Aspirina/imunologia , Asma Induzida por Aspirina/diagnóstico , Plaquetas/imunologia , Plaquetas/metabolismo , Humanos , Linfócitos/imunologia , Linfócitos/metabolismo , Mastócitos/imunologia , Mastócitos/metabolismo , Pólipos Nasais/patologia , Sinusite/patologia
11.
Neuroradiology ; 61(8): 891-896, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31119344

RESUMO

PURPOSE: Sinonasal angiomatous polyps (SAPs) can be misdiagnosed as malignant tumors due to aggressive clinical behaviors. The purpose of this study was to evaluate the diagnostic accuracy of multiparametric MRI in differentiating SAPs from malignant tumors. METHODS: This retrospective study included 31 patients with pathologically proven SAPs and 36 patients with malignant tumors in maxillary sinus and nasal cavity. All the patients underwent conventional MRI and dynamic contrast-enhanced (DCE) MRI on 3T MR scanners. Diffusion-weighted (DW) MR imaging was performed in 45 patients. All the MR images were retrospectively analyzed independently by two authors. RESULTS: Significant differences were found in T1 homogeneity, T2 signal intensity ratio, peripheral hypointense rim on T2WI, and soft tissue infiltration between SAP and malignant tumors (P = 0.004, < 0.001, < 0.001, and = 0.001, respectively). SAPs usually show heterogeneous signal intensity on T1WI, peripheral hypointense rim on T2WI, and higher T2 signal intensity ratio. The tumor size of SAP (4.01 ± 1.08 cm) was slightly smaller than that of malignant tumors (4.56 ± 1.12 cm) (P = 0.045). There were significant differences in DCE-MRI parameters including Tpeak, CImax, WR, TIC types, and progressive enhancement (P = 0.009, < 0.001, = 0.001, = 0.001, and < 0.001, respectively) between SAPs and malignant tumors. All the 31 SAPs showed progressive enhancement on DCE-MRI, while none of the malignant tumors showed progressive enhancement (accuracy 100%). The mean ADC of SAP (1.75 ± 0.30 × 10-3 mm2/s) was higher than that of malignant tumors (1.18 ± 0.31 × 10-3 mm2/s) (P < 0.001). CONCLUSION: Multiparametric MRI showed high diagnostic performance in differentiating SAPs from malignant tumors. Progressive enhancement on DCE-MRI is the most effective feature of SAP.


Assuntos
Imagem de Difusão por Ressonância Magnética , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/patologia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
12.
Int Forum Allergy Rhinol ; 9(S1): S16-S21, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31087635

RESUMO

BACKGROUND: Intranasal steroids have become part of the mainstay in the long-term management of chronic rhinosinusitis. A long-standing problem remains in efficient and easy-to-use delivery of topical corticosteroids to the nasal mucosa. Currently available means of intranasal steroid delivery include sprays, which are generally limited to treating the anterior nasal cavity, and rinses, which are not FDA-approved for this indication. The exhalation delivery system is a novel method of delivering fluticasone to the deeper areas within the nasal cavities, including the posterior nasal cavity and middle and superior meatuses. METHODS: Comprehensive literature review. RESULTS: Recent large scale studies have suggested its efficacy and safety in the use of patients with both chronic sinusitis with polyposis and without polyps. Specifically, studies have demonstrated decreased Sinonasal Outcome Test scores of 20 points following treatment, as well as improvement of polyp grade by 1 or more point in more than 60% of patients. Furthermore, among patients with nasal polyps, there was approximately 60-70% decreased indication for surgery following EDS-FLU use. CONCLUSION: EDS-FLU is an important adjunct therapy for sinonasal inflammatory disease.


Assuntos
Sistemas de Liberação de Medicamentos , Fluticasona/administração & dosagem , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Administração Intranasal/efeitos adversos , Doença Crônica , Sistemas de Liberação de Medicamentos/efeitos adversos , Expiração , Humanos , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/patologia , Rinite/patologia , Sinusite/patologia , Resultado do Tratamento
13.
Nat Commun ; 10(1): 2162, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31089134

RESUMO

Innate lymphoid cells (ILCs) are crucial for the immune surveillance at mucosal sites. ILCs coordinate early eradication of pathogens and contribute to tissue healing and remodeling, features that are dysfunctional in patients with cystic fibrosis (CF). The mechanisms by which ILCs contribute to CF-immunopathology are ill-defined. Here, we show that group 2 ILCs (ILC2s) transdifferentiated into IL-17-secreting cells in the presence of the epithelial-derived cytokines IL-1ß, IL-23 and TGF-ß. This conversion is abrogated by IL-4 or vitamin D3. IL-17 producing ILC2s induce IL-8 secretion by epithelial cells and their presence in nasal polyps of CF patients is associated with neutrophilia. Our data suggest that ILC2s undergo transdifferentiation in CF nasal polyps in response to local cytokines, which are induced by infectious agents.


Assuntos
Plasticidade Celular/imunologia , Fibrose Cística/imunologia , Inflamação/imunologia , Pólipos Nasais/imunologia , Células Th17/imunologia , Adulto , Animais , Linhagem Celular , Fibrose Cística/sangue , Fibrose Cística/patologia , Feminino , Humanos , Imunidade Inata , Inflamação/sangue , Inflamação/patologia , Interleucina-17/imunologia , Interleucina-17/metabolismo , Interleucina-1beta/imunologia , Interleucina-1beta/metabolismo , Interleucina-23/imunologia , Interleucina-23/metabolismo , Masculino , Camundongos , Pessoa de Meia-Idade , Mucosa Nasal/citologia , Mucosa Nasal/imunologia , Mucosa Nasal/patologia , Pólipos Nasais/sangue , Pólipos Nasais/patologia , Neutrófilos/imunologia , Adulto Jovem
17.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936362

RESUMO

Woakes' syndrome is a rare entity defined as recurrent sinonasal polyposis with a consequent nasal pyramid deformity. Only a few cases are reported in the literature. The goal of this study is to present the features of Woakes' syndrome through a clinical case. A 42-year-old man presented with a history of ASA triad. He started self-medication for 5 years. He returned to the otorhinolaryngology department for the aggravation and persistence of symptoms. CT scans showed the deformity and thinning of the nasal bones. A functional endoscopic sinus surgery and correction of nasal pyramid deformity were performed. At 6 months' follow-up, good functional and aesthetic outcomes were observed. Woakes' syndrome was described more than 130 years ago. Treatment includes endoscopic sinonasal surgery and local treatment. Adequate management and good adherence to the therapeutic protocol could be factors to prevent this syndrome.


Assuntos
Asma Induzida por Aspirina/tratamento farmacológico , Sinusite Etmoidal/tratamento farmacológico , Pólipos Nasais/tratamento farmacológico , Deformidades Adquiridas Nasais/diagnóstico por imagem , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Adulto , Asma Induzida por Aspirina/patologia , Sinusite Etmoidal/patologia , Humanos , Masculino , Pólipos Nasais/patologia , Cirurgia Endoscópica por Orifício Natural , Deformidades Adquiridas Nasais/cirurgia , Rinoplastia , Síndrome , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
Pathology ; 51(3): 268-273, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30837082

RESUMO

Eosinophilic chronic rhinosinusitis (ECRS) is characterised by formation of nasal polyps with prominent eosinophilic infiltration; however, how eosinophils are recruited in this pathological setting remains unclear. In the present study, we carried out quantitative immunohistochemical analysis of nasal polyps associated with ECRS (n=30) and non-ECRS (n=30) to evaluate expression of an L-selectin ligand peripheral lymph node addressin (PNAd) on vascular endothelial cells. We found that PNAd was induced primarily on the luminal surface of venular vessels present in nasal mucosa in both ECRS and non-ECRS, while the number of PNAd-expressing vessels in ECRS significantly exceeded that seen in non-ECRS. Moreover, the number of eosinophils attached to the luminal surface of PNAd-expressing vessels in ECRS was significantly greater than that in non-ECRS, while the number of neutrophils and lymphocytes attached did not differ significantly between conditions. Furthermore, eosinophils, which express cell surface L-selectin, adhered to PNAd-expressing Chinese hamster ovary (CHO) cells in a calcium-dependent manner, and that adhesion was significantly inhibited by pretreatment of eosinophils with DREG-56, an anti-human L-selectin monoclonal antibody. These findings combined suggest that interaction between L-selectin and PNAd plays at least a partial role in eosinophil recruitment in human nasal mucosa with ECRS.


Assuntos
Antígenos de Superfície/metabolismo , Eosinófilos/metabolismo , Proteínas de Membrana/metabolismo , Mucosa Nasal/metabolismo , Pólipos Nasais/metabolismo , Rinite/metabolismo , Sinusite/metabolismo , Animais , Células CHO , Cricetinae , Cricetulus , Eosinófilos/patologia , Humanos , Mucosa Nasal/patologia , Pólipos Nasais/patologia , Rinite/patologia , Sinusite/patologia
20.
Ear Nose Throat J ; 98(2): 89-93, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30884997

RESUMO

BACKGROUND:: There is a medial bulging of the lateral nasal wall in patients with cystic fibrosis (CF). AIMS:: Uncinate process (UP) angulation measurements in patients and controls to objectify this bulging. MATERIALS AND METHODS:: Thirty CF, 17 primary ciliary dyskinesia (PCD), 13 chronic rhinosinusitis with polyps (CRSwp), and 30 controls were included. Angles were measured bilaterally on computed tomography (CT) scans: A, B, C on coronal sections, D and E on axial sections. Angle A was between the UP and the orbit inner wall, whereas the others were between UP and midline. RESULTS:: There was no significant difference between controls, PCD, and CRSwp. However, CF had 3 statistically different angles with controls, 5 with CRSwp, and 4 with PCD. Angle A average value was 126° (±16°) in patients with CF, 138° (±19°) in controls ( P = .007), 145° (±15°) in PCD ( P = .001), and 138° (±14°) in CRSwp ( P = .001). Angle E average value was 35° (±10°) in patients with CF, 20° (±6°) in controls ( P < .001), 21° (±4°) in PCD ( P < .001), and 22° (±6°) in CRSwp ( P < .001). CONCLUSION:: Uncinate process's anatomy is only modified in CF: Angle between UP and inner wall of orbit is closed, and angles between UP and midline are opened. SIGNIFICANCE:: These measures quantify the medial bulging of lateral nasal wall and support nasofibroscopic observations.


Assuntos
Transtornos da Motilidade Ciliar/diagnóstico por imagem , Fibrose Cística/diagnóstico por imagem , Cavidade Nasal/diagnóstico por imagem , Pólipos Nasais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Estudos de Casos e Controles , Transtornos da Motilidade Ciliar/patologia , Fibrose Cística/patologia , Seio Etmoidal/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/patologia , Adulto Jovem
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