Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 175
Filtrar
1.
Life Sci ; 236: 116901, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31610206

RESUMO

AIMS: Allergic rhinitis is a global cause of disability, characterized by airway inflammation. Sumatriptan is a 5-hydroxytryptamine 1B/1D (5HT1B/1D) agonist used as a treatment for migraine headaches. Activation of 5HT1B/1D receptors can inhibit the release of neuropeptides and inhibit the inflammation cascades. This study investigated the effect of sumatriptan on ovalbumin-induced allergic rhinitis model in mice and the role of nitric oxide. METHODS: Female Balb/c mice were sensitized by intraperitoneal ovalbumin and challenged by intranasal ovalbumin. Mice received sumatriptan in doses 3, 10, 30 µg/kg intraperitoneally, 30 min before the last ovalbumin challenge. KEY FINDINGS: Intraperitoneal injection of sumatriptan significantly decreased the nasal scratching, IL-4 and serum IgE levels of allergic mice, but it increased IFNγ levels. Histopathological analysis showed that the number of eosinophils was significantly elevated in nasal mucosa of ovalbumin-induced allergic mice, while sumatriptan treatment significantly reduced the number of eosinophils. GR-127935, a selective 5-HT1B/1D-receptor antagonist, reversed the anti-allergic effects of sumatriptan. Acute administration of l-NAME, a non-specific inhibitor of nitric oxide synthase, along with sumatriptan attenuated the anti-allergic effects of sumatriptan but chronic administration of l-NAME did not affect the influences of sumatriptan. Furthermore, sumatriptan decreased the inducible nitric oxide synthase (iNOS) protein expression in allergic mice, but it did not change the concentration of eNOS protein. SIGNIFICANCE: This study shows that sumatriptan administration is associated with anti-allergic effects which are through 5HT1B/1D receptors. Decrease in iNOS expression and changes in T-helper 1&2 cytokines levels may indicate the involvement of inducible NOS and inflammation.


Assuntos
Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico/metabolismo , Ovalbumina/toxicidade , Rinite Alérgica/prevenção & controle , Agonistas do Receptor 5-HT1 de Serotonina/farmacologia , Transdução de Sinais/efeitos dos fármacos , Sumatriptana/farmacologia , Animais , Modelos Animais de Doenças , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Rinite Alérgica/induzido quimicamente , Rinite Alérgica/metabolismo , Rinite Alérgica/patologia
3.
Eur Arch Otorhinolaryngol ; 276(11): 3247-3249, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31363902

RESUMO

PURPOSE: The pathogenesis of persistent allergic rhinitis with chronic and refractory nasal obstruction is still unknown. Inflammation and tissue remodeling are known to play a role, but this has not been studied thoroughly. The purpose of this study is to identify the profile of gene expression of inflammatory and remodeling markers in nasal mucosa of patients with PAR and chronic obstruction. METHODS: After informed consent, we obtained nasal mucosa tissue from five aeroallergen-sensitized PAR patients undergoing anterior turbinectomy, and control non-sensitized individuals undergoing cerebrospinal fluid fistula repair or rhinoplasty. We assessed the expression of 34 genes related to inflammation and tissue remodeling using the real-time polymerase chain reaction (qPCR) to quantify each mRNA. RESULTS: IL-4 mRNA was upregulated in nasal mucosa of all five patients; CCR3, CCR8 and Eotaxin-2 were upregulated in four out of five patient samples; while IL-5 and IL-13 were upregulated in two of them. TGF-ß1 was not upregulated in PAR samples. mRNA from metalloproteinases MMP-7, MMP13 and MMP15 were upregulated in three out of five samples. Our results indicate a typical mRNA expression profile of the infiltrating inflammatory Th2 cells and eosinophils, combined with altered gene expression of remodeling-related proteins in stromal cells from the mucosa. CONCLUSION: Prolonged allergen challenge can lead to persistent upregulation of genes for inflammatory mediators such as IL-4 Th2/eosinophil cytokines, chemokines and receptors, which may play an important role in maintaining PAR with chronic nasal obstruction. Our findings may have therapeutic implications, including the use of anti-IL4, -CCR3 or -MMP therapy to ameliorate the condition.


Assuntos
Mediadores da Inflamação , Interleucina-4/análise , Metaloproteases/análise , Mucosa Nasal/imunologia , Obstrução Nasal , Receptores CCR3/análise , Rinite Alérgica/imunologia , Adulto , Biomarcadores/análise , Feminino , Perfilação da Expressão Gênica , Humanos , Mediadores da Inflamação/análise , Mediadores da Inflamação/classificação , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Obstrução Nasal/imunologia , Rinite Alérgica/complicações , Rinite Alérgica/patologia , Tempo , Regulação para Cima
4.
Int Arch Allergy Immunol ; 180(2): 120-127, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31256157

RESUMO

BACKGROUND: Allergen immunotherapy (AIT) is the only etiological and potentially curative therapy for allergic rhinitis (AR). OBJECTIVES: We sought to investigate the role of epigenetic regulator enhancer of zeste homolog 2 (EZH2) in the activation of dendritic cells (DCs) in AIT. METHOD: In this study, EZH2 expression in circulating myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) were evaluated using flow cytometry. Clinical information from 56 AR patients receiving AIT was collected, including 30 subjects with subcutaneous immunotherapy (SCIT) and 26 subjects with sublingual immunotherapy (SLIT). In vitro, the effect of EZH2 inhibitor, 3 Deazaneplanocin A (DZNep), on the phenotypic and functional activation of monocyte-derived DCs (moDCs) was evaluated. RESULTS: EZH2 expression in circulating mDCs and pDCs were both negatively correlated to treatment time of AIT (r = -0.39, p = 0.003 and r = -0.47, p = 0.0002, respectively). Furthermore, there was a higher correlation between EZH2 expression and AIT treatment time in the SCIT group compared to that of the SLIT group in mDCs (r = -0.42, p = 0.02 vs. r = -0.23, p = 0.26)and pDCs (r = -0.52, p = 0.003 vs. r = -0.33, p = 0.10). In vitro, the co-stimulatory molecules on moDCs, such as CD80, CD86, and CD83, were significantly inhibited by DZNep in a dose-dependent manner. The -DC-driven T-cell proliferation was suppressed by DZNep (MD = 22.88, 95% CI 7.809-37.96, p < 0.05). CONCLUSIONS: Our study shows that EZH2, which is required in the activation of DCs, mediates the epigenetic modification in AIT and stresses the importance of patient adherence during AIT.


Assuntos
Adenosina/análogos & derivados , Células Dendríticas/imunologia , Dessensibilização Imunológica/métodos , Proteína Potenciadora do Homólogo 2 de Zeste/antagonistas & inibidores , Proteína Potenciadora do Homólogo 2 de Zeste/imunologia , Rinite Alérgica/imunologia , Adenosina/uso terapêutico , Adulto , Proliferação de Células/efeitos dos fármacos , Proteína Potenciadora do Homólogo 2 de Zeste/genética , Epigênese Genética/genética , Epigênese Genética/imunologia , Feminino , Humanos , Interleucina-10/análise , Interleucina-6/análise , Masculino , Cooperação do Paciente , Rinite Alérgica/patologia , Adulto Jovem
5.
Artigo em Chinês | MEDLINE | ID: mdl-31327201

RESUMO

Objective:The aim of this study is to screen the targeting chemokine receptor 3-RNA interference (CCR3-RNAi) lentiviral expression vector, infect mouse mast cells,observe the expression of this gene in mast cells and the interference efficiency of the virus vector.The pathogenesis of allergic rhinitis lays the foundation.Method:Three pairs of CCR3-shRNA sequences were constructed,and three pairs of double-stranded shRNA oligo were inserted into shRNA lentiviral vectors to construct three shRNA lentiviral recombinant plasmids.The recombinant vector and virus-packed auxiliary plasmids were co-transfected into 293T cells to obtain lentiviral plasmids.The lentiviral plasmids were then transfected into mouse bone marrow-derived mast cells in vitro and purified. The expression level of CCR3 mRNA in mast cells was verified by qRT-PCR,and the expression level of CCR3 protein in mast cells was detected by Western Blot.Result: It was confirmed by sequencing that the lentiviral vector of CCR3 shRNA was successfully constructed, transfected into 293T cells and packaged with virus. Finally the high purity PDSO19-PL-CCR3 lentiviral plasmid was obtained with a virus titer of 3.7×108TU/ml.The lentiviral plasmid was used to infect mouse mast cells.RT-PCR and Western Blot detection assay showed that CCR3shRNA reduced the expression of CCR3 gene in mouse mast cells at the level of mRNA and protein.Conclusion: The CCR3 gene RNAi lentivirus expression vector was successfully constructed.It was found that it downregulated the expression level of CCR3 gene mRNA and protein in mouse mast cells,which laid the foundation for further research on its role in the pathogenesis of allergic rhinitis.


Assuntos
Vetores Genéticos , Mastócitos/citologia , Interferência de RNA , Receptores CCR3/genética , Animais , Lentivirus , Camundongos , RNA Interferente Pequeno , Rinite Alérgica/patologia , Transfecção
6.
APMIS ; 127(10): 688-695, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31344274

RESUMO

Acetylshikonin has long been known as an anti-inflammatory and antioxidative reagent. However, the anti-allergic effect has not been studied. The aim of this study was to evaluate the effect of acetylshikonin on allergic rhinitis (AR) in mice. Mice were sensitized by intraperitoneal injection of OVA and aluminum hydroxide and challenged with intranasal instillation of OVA. Acetylshikonin was administered orally after nasal cavities challenge. Severity of allergic rhinitis was assessed according to nasal symptoms; serum OVA-specific immunoglobulin E (IgE), IgG1, and IgG2a level; and interleukin (IL)-4, IL-10, IL-5, IL-13, TNF-α, IL-12, and interferon (INF)-γ levels in nasal lavage fluid (NALF). Additionally, the histological change and the release of histamine in serum and nasal lavage fluid were evaluated by acid-Schiff stain and ELISA. Acetylshikonin attenuated manifestation of nasal symptoms in sensitized mice and inhibited production of Th2-related OVA-specific IgE, IgG1, and Th2 cell-produced IL-4, IL-5, IL-13, and mast cell produced histamine; however, it had no effect on Th1 cell-produced cytokines, like INF-γ. In addition, the degree of inflammatory cell infiltration and goblet cell hyperplasia was attenuated by acetylshikonin treatment. Our results suggest that acetylshikonin effectively reduces allergic inflammation in a mouse model of allergic rhinitis by its anti-allergic and anti-inflammatory properties.


Assuntos
Antraquinonas/administração & dosagem , Citocinas/antagonistas & inibidores , Liberação de Histamina/efeitos dos fármacos , Fatores Imunológicos/administração & dosagem , Mastócitos/efeitos dos fármacos , Rinite Alérgica/tratamento farmacológico , Células Th2/efeitos dos fármacos , Administração Oral , Alérgenos/administração & dosagem , Animais , Modelos Animais de Doenças , Injeções Intraperitoneais , Camundongos , Ovalbumina/administração & dosagem , Rinite Alérgica/induzido quimicamente , Rinite Alérgica/patologia , Resultado do Tratamento
8.
Drug Dev Ind Pharm ; 45(9): 1547-1555, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31216904

RESUMO

Chinese herbs such as Flos magnoliae (FM) and Centipeda minima (CM) can be effective in treating allergic rhinitis (AR). However, there is little research on the therapeutic mechanism of these two drugs acting on AR at the same time. In order to systematically understand the mechanism of action of two drugs acting on AR at the same time, we searched various databases to obtain 31 components and 289 target proteins of FM, 25 components and 465 target proteins of CM. The interaction networks of FM, CM, and AR proteins were constructed by Cytoscape-v3.2.1 software. The core protein of two network intersections was obtained by using Venny 2.1.0. The R platform was used for the core target protein gene ontology (GO) comment analysis and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis. Thirteen common targets and seven acting pathways were obtained. The results of animal experiments showed that FM and CM volatile oil could effectively improve the symptoms of AR by regulating the common targets. In summary, this study successfully explained the potential therapeutic mechanism of FM and CM in the treatment of AR. At the same time, it indicates that the two drugs can be compatible as a new application.


Assuntos
Asteraceae/química , Medicamentos de Ervas Chinesas/farmacologia , Magnoliaceae/química , Óleos Voláteis/farmacologia , Rinite Alérgica/tratamento farmacológico , Animais , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Quimioterapia Combinada/métodos , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Masculino , Mucosa Nasal/efeitos dos fármacos , Mucosa Nasal/imunologia , Mucosa Nasal/patologia , Óleos Voláteis/uso terapêutico , Ovalbumina/administração & dosagem , Ovalbumina/imunologia , Mapas de Interação de Proteínas/efeitos dos fármacos , Mapas de Interação de Proteínas/imunologia , Ratos , Rinite Alérgica/diagnóstico , Rinite Alérgica/imunologia , Rinite Alérgica/patologia , Resultado do Tratamento
11.
Medicine (Baltimore) ; 98(20): e15247, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096432

RESUMO

The aim of the current study was to investigate the expression of long non-coding RNA (lncRNA) antisense non-coding RNA in the INK4 locus (ANRIL) in allergic rhinitis (AR) patients, and to further explore the association of lncRNA ANRIL expression with AR risk, severity, and inflammation.In this case-control study, 96 AR patients and 96 non-atopic obstructive snoring patients who underwent adenoid surgery were consecutively recruited. Disease severity of AR patients was assessed via individual nasal symptom score (INSS) and total nasal symptom score (TNSS). Nasal mucosa samples were collected from AR patients and controls, then lncRNA ANRIL and inflammatory cytokine levels were assessed via quantitative polymerase chain reaction.LncRNA ANRIL expression was increased in AR patients (3.605 [1.763-4.981]) compared with controls (1.183 [0.438-2.985]), and it well distinguished AR patients from controls with an area under curve of 0.746 (95% CI: 0.679-0.814). Correlation analyses revealed that lncRNA ANRIL expression was positively associated with itching score and congestion score, while it was not associated with nasal rhinorrhea score or sneezing score. Besides, lncRNA ANRIL was also positively correlated with TNSS, tumor necrosis factor α, interleukin (IL)-4, IL-6, IL-13, and IL-17, while negatively associated with IL-10 and interferon-γ. And no association of lncRNA ANRIL expression with IL-1ß, IL-5, or IL-8 expression was discovered.LncRNA ANRIL expression correlates with increased AR risk, severity, and inflammation, implying that lncRNA ANRIL might be involved in the pathogenesis of AR.


Assuntos
Loci Gênicos/genética , Inflamação/metabolismo , Mucosa Nasal/metabolismo , RNA Longo não Codificante/genética , Rinite Alérgica/genética , Adolescente , Adulto , Estudos de Casos e Controles , Citocinas/metabolismo , Suscetibilidade a Doenças , Feminino , Humanos , Inflamação/patologia , Interleucina-1beta/metabolismo , Interleucina-5/metabolismo , Interleucina-8/metabolismo , Masculino , Mucosa Nasal/patologia , Fragmentos de Peptídeos/metabolismo , Rinite Alérgica/patologia , Rinite Alérgica/cirurgia , Índice de Gravidade de Doença , Fator de Necrose Tumoral alfa/metabolismo , Adulto Jovem
14.
Int J Pediatr Otorhinolaryngol ; 122: 133-137, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31022683

RESUMO

OBJECTIVE: Rhinitis is an acute or chronic inflammatory condition due to several causes (i.e. infections, allergens). There are controversial results that point out the role of nasal inflammation in primary snoring and obstructive sleep apnoea syndrome (OSAS). METHODS: The aim of the present investigation is to study the nasal cytology in 58 children aged from 1 to 15 affected by sleep disordered breathing. RESULTS: Inflammation of the nasal mucous was found in 88% of children. The most frequent problems were infectious rhinitis (36%), followed by non-allergic rhinitis (28%) and allergic rhinitis (21%). Infectious rhinitis was found in 31% of children with primary snoring and 41% with OSAS. Allergic rhinitis was found in 35% of children with primary snoring, and 6% with OSAS. Non-allergic rhinitis was found in 19% of children with primary snoring, and 34% with OSAS. Bacteria was found in 59% of children with OSAS and 46% in children with primary snoring. CONCLUSION: the most prevalent forms of rhinitis in primary snoring were the allergic rhinitis, and in OSAS group were the non-allergic rhinitis. Bacteria were equally distributed in primary snoring and OSAS children. The nasal cytology provided interesting information that can be used to plan possible treatment strategies.


Assuntos
Mucosa Nasal/patologia , Rinite Alérgica/patologia , Apneia Obstrutiva do Sono/patologia , Ronco/etiologia , Ronco/patologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Rinite Alérgica/complicações , Apneia Obstrutiva do Sono/microbiologia
16.
Biochim Biophys Acta Mol Basis Dis ; 1865(6): 1642-1650, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30951821

RESUMO

BACKGROUND: Allergic rhinitis is characterized by a remodeling of nasal epithelium. Since the Notch and TGF-ß signaling pathways are known to be involved in cell differentiation and remodeling processes and leptin adipokine has already been identified as a marker for homeostasis in human bronchial and nasal epithelial cells of asthmatics, roles played by these pathways have been investigated for chronic allergic rhinitis. METHODS: The leptin/leptin receptor expression has been investigated in a study with 40 biopsies from allergic (AR, n = 18) and non-allergic (C, n = 22) inferior turbinates, using immunohistochemistry, immunofluorescence staining and RT-PCR. In addition, extracts from in vitro samples prepared from primary cells of inferior turbinates as well as in vitro cultured human nasal epithelial RPMI 2650 cells (ATCC-CCL-30) were also tested for leptin expression and activation of the Notch-1 pathway. RESULTS: With regards to AR, in vivo expression levels of both leptin and its receptor significantly decreased in comparison to C. Furthermore, leptin receptor mRNA was significantly reduced in AR as compared to C. Immunofluorescence showed an apparent co-expression of leptin receptor with Notch-1, which was not seen with TGF-ß. In vitro, in primary turbinate epithelial cells, the expression of leptin receptor and Notch-1 significantly decreased in AR as compared to C. Moreover, in RPMI 2650 cells, leptin receptor expression was shown to be induced by Notch-1 ligand signaling. CONCLUSION: Thus, both the leptin and Notch-1 pathways appear to represent markers for epithelial homeostasis in allergic rhinitis.


Assuntos
Leptina/genética , Mucosa Nasal/metabolismo , Receptor Notch1/genética , Receptores para Leptina/genética , Rinite Alérgica/genética , Adulto , Biópsia , Estudos de Casos e Controles , Linhagem Celular , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Feminino , Regulação da Expressão Gênica , Homeostase/genética , Humanos , Leptina/metabolismo , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/patologia , Cultura Primária de Células , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptor Notch1/metabolismo , Receptores para Leptina/metabolismo , Rinite Alérgica/metabolismo , Rinite Alérgica/patologia , Transdução de Sinais , Fator de Crescimento Transformador beta1/genética , Fator de Crescimento Transformador beta1/metabolismo , Conchas Nasais/metabolismo , Conchas Nasais/patologia
17.
Ir Med J ; 112(2): 874, 2019 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-30875167

RESUMO

Aim Report successful application of UV endonasal phototherapy as a treatment for severe rhinitis medicamentosa and allergic rhinitis. Methods Allergic rhinitis confirmed by history and skin prick testing; rhinitis medicamentosa based on history. Both confirmed at nasendoscopy. Symptom score before & after treatment. Introduction of Rhinolight endonasal u/v phototherapy for allergic rhinitis. Single patient report. Results Successful remission of Rhinitis Medicamentosa confirmed with patient after eight sessions Rhinolight endonasal phototherapy. Use of nasal decongestant dropped from 2 bottles/daily x 4 years to zero. Symptoms reduced from 25 pre-treatment to 6 post-treatment. Rhinitis medicamentosa is clinically characterized by nasal congestion without rhinorrhea, postnasal drip, or sneezing that begins after using a nasal decongestant for more than 3 days. Treatment involves discontinuation of the offending drug. Discussion Rhinolight endonasal phototherapy is a new treatment for allergic rhinitis and offered as last resort for a patient with untreated allergic rhinitis and overuse of topical decongestants. Patient reports a significant improvement in symptoms with cessation of topical decongestant. Report a successful application of UV endonasal phototherapy as a treatment for severe rhinitis medicamentosa against a background of long standing allergic rhinitis.


Assuntos
Descongestionantes Nasais/efeitos adversos , Rinite Alérgica/induzido quimicamente , Rinite Alérgica/radioterapia , Terapia Ultravioleta/métodos , Adulto , Humanos , Masculino , Descongestionantes Nasais/administração & dosagem , Mucosa Nasal/patologia , Sprays Nasais , Rinite Alérgica/patologia , Índice de Gravidade de Doença , Resultado do Tratamento
20.
Am J Rhinol Allergy ; 33(3): 310-316, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30674195

RESUMO

BACKGROUND: Allergic fungal rhinosinusitis (AFRS) is characterized by higher revision endoscopic sinus surgery (ESS) rates and unique radiographic features when compared to chronic rhinosinusitis with nasal polyposis (CRSwNP) or chronic rhinosinusitis without nasal polyposis (CRSsNP). OBJECTIVE: We hypothesized that an increased frequency of concha bullosa in AFRS or other radiographic nuances might allow for accumulation of allergic mucin and contribute to increased ESS revision rates. METHODS: A retrospective cohort study was performed. Patient diagnosis (AFRS, CRSwNP, and CRSsNP), basic demographics, and prior ESS rates were collected. RESULTS: A total of 210 consecutive patients were included (AFRS = 70, CRSwNP = 70, and CRSsNP = 70). Pediatric AFRS patients had more unilateral disease (38.1% vs 4.4%; P = .007) and anterior ethmoid skull base erosion (23.8% vs 6.7%; P = .047) than adult AFRS patients. AFRS patients were more likely to be younger (24.9 ± 10.1 years vs 45.6 ± 14.4 years vs 48.7 ± 18.2 years; P < .001), African American (70% vs 14.3% vs 11.4%; P < .001), and have undergone prior ESS (54.3% vs 45.7% vs 31.4%; P = .02) than CRSwNP or CRSsNP patients. Concha bullosa were more prevalent in AFRS patients than CRSwNP or CRSsNP patients across the population (42.9%, 18.6%, and 14.3%; P < .001) and in the setting of no previous surgery (53.1%, 31.6%, and 16.7%; P < .001). CONCLUSION: In this cohort, pediatric AFRS patients had more unilateral disease and anterior ethmoid skull base erosion. Concha bullosa prevalence was significantly higher in AFRS as compared to those with CRSwNP or CRSsNP, despite prior ESS. Surgeons should consider concha bullosa as a potential anatomical subsite to harbor recurrent or residual disease.


Assuntos
Rinite Alérgica/diagnóstico por imagem , Sinusite/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Doença Crônica , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico por imagem , Micoses/patologia , Micoses/cirurgia , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/patologia , Pólipos Nasais/cirurgia , Seios Paranasais/diagnóstico por imagem , Seios Paranasais/patologia , Seios Paranasais/cirurgia , Reoperação , Estudos Retrospectivos , Rinite Alérgica/microbiologia , Rinite Alérgica/patologia , Rinite Alérgica/cirurgia , Fatores de Risco , Sinusite/microbiologia , Sinusite/patologia , Sinusite/cirurgia , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA