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1.
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
2.
Biomed Res Int ; 2019: 7150942, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31534961

RESUMO

To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper airways (UA). Recently, topical administration of ectoine has just been recognized as adjuvant treatment in the Allergic Rhinitis (AR) and Rhinosinusitis (ARS). The aim of this work is to review the published literature regarding all the potential therapeutic effects of ectoine in the acute and chronic inflammatory diseases of UA. Pertinent studies published without temporal limitation were selected searching on MEDLINE the following terms: "ectoine" and "nasal spray," "oral spray," "upper respiratory tract infections," "rhinosinusitis," "rhinitis," "rhinoconjunctivitis," "pharyngitis," and "laryngitis." At the end of our selection process, six relevant publications were included: two studies about the effect of ectoine on AR, one study about ARS, one study about rhinitis sicca anterior, and two studies about acute pharyngitis and/or laryngitis. Due to its moisturizing and anti-inflammatory properties, topical administration of ectoine could play a potential additional role in treatment of acute and chronic inflammatory diseases of UA, in particular in the management of sinonasal conditions improving symptoms and endoscopic findings. However, these results should be viewed cautiously as they are based on a limited number of studies; some of them were probably underpowered because of their small patient samples.


Assuntos
Diamino Aminoácidos/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Doença Aguda , Administração Tópica , Doença Crônica , Humanos , Inflamação/tratamento farmacológico , Inflamação/patologia , Laringite/tratamento farmacológico , Laringite/patologia , Sprays Orais , Infecções Respiratórias/patologia , Rinite/tratamento farmacológico , Rinite/patologia , Sinusite/tratamento farmacológico , Sinusite/patologia
3.
Acta Otolaryngol ; 139(10): 881-889, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31438745

RESUMO

Background: Olfactory dysfunction in eosinophilic chronic rhinosinusitis (ECRS) is poorly understood. Objective: To compare olfactory mucosal injury due to eosinophil infiltration in ECRS with postoperative olfactory function. Methods: Seventeen ECRS patients (ECRS group) and 18 bilateral rhinosinusitis (non-ECRS group) patients were compared. At 3 and 12 months post-endoscopic sinus surgery (ESS), all patients were evaluated for subjective symptoms (nasal obstruction, nasal discharge and olfactory dysfunction), endoscopic nasal findings, CT score and T&T olfactometer recognition threshold test. The eosinophil count, OMP-positive cells and epithelial erosion in olfactory mucosa collected during ESS were compared with the postoperative olfactory function. Results: The non-ECRS group showed significant improvement in all clinical findings at 3 and 12 months, but the ECRS group showed worsening of the olfactory dysfunction symptoms and T&T olfactometer recognition threshold at 12 months because of recurrence of sinusitis. The groups differed significantly in the ΔT&T value (i.e. pre-ESS T&T recognition threshold - post-ESS T&T recognition threshold) at both 3 and 12 months, and the degree of olfactory improvement differed. Histologically, the ECRS group showed significantly more eosinophils, fewer OMP-positive cells and greater epithelial erosion than the non-ECRS group. Conclusions: Eosinophilic inflammation was thought to cause olfactory mucosal injury/dysfunction.


Assuntos
Endoscopia , Eosinofilia/complicações , Transtornos do Olfato/etiologia , Transtornos do Olfato/patologia , Rinite/cirurgia , Sinusite/cirurgia , Adolescente , Adulto , Doença Crônica , Eosinofilia/patologia , Feminino , Humanos , Masculino , Mucosa Olfatória/patologia , Estudos Retrospectivos , Rinite/complicações , Rinite/patologia , Sinusite/complicações , Sinusite/patologia , Resultado do Tratamento , Adulto Jovem
4.
Eur Arch Otorhinolaryngol ; 276(11): 3123-3130, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31468129

RESUMO

OBJECTIVE: Rhinitis medicamentosa is drug-induced rhinitis which occurs by prolonged and overdose usage of topical nasal decongestants. There is not much of treatment choice rather than nasal steroids. In this pathological study, we have been aimed to represent the healing effects of xylitol on damaged nasal mucosa due to rhinitis medicamentosa. METHOD: 30 Wistar rats were separated into 5 groups. During 2 months, oxymetazoline was given to the first group, and saline was given to second group intranasally. First and second group animals were examined at the end of 2 months and rhinitis medicamentosa was detected. Oxymetazoline was given to the third, fourth, and fifth groups during 2 months. Then xylitol solution, mometasone, and saline were applied, respectively, for 15 days. After the experiment, rats' nasal mucosas were evaluated histopathologically. RESULTS: Xylitol and mometasone were found to be more effective than the control group in terms of histopathological changes. Effectivity of xylitol and mometasone was compared and not a significant value was determined. CONCLUSIONS: According to the results, xylitol solution is effective as mometasone, usable and well-priced in the treatment of rhinitis medicamentosa. More comprehensive and ultrastructural studies on animals and human studies with rhinometric evaluation should be performed.


Assuntos
Furoato de Mometasona/administração & dosagem , Descongestionantes Nasais/efeitos adversos , Mucosa Nasal , Oximetazolina/efeitos adversos , Rinite , Xilitol/administração & dosagem , Administração Intranasal , Animais , Anti-Inflamatórios/administração & dosagem , Modelos Animais de Doenças , Masculino , Descongestionantes Nasais/administração & dosagem , Mucosa Nasal/efeitos dos fármacos , Mucosa Nasal/patologia , Ratos , Ratos Wistar , Rinite/induzido quimicamente , Rinite/patologia , Rinite/terapia , Edulcorantes/administração & dosagem , Tempo , Resultado do Tratamento
5.
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
11.
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
12.
J Otolaryngol Head Neck Surg ; 48(1): 23, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31142355

RESUMO

BACKGROUND: Chronic rhinosinusitis (CRS) is a complex disease that incorporates many different conditions. Currently, primary CRS is considered a disease of broad airway inflammation, however, the previous classification of CRS with and without nasal polyposis fails to adequately classify patients based upon their etiology of illness. Our aim with this review is discuss the clinical presentation, radiology, endoscopy, histopathology, and treatment algorithm of three different phenotypes of primary CRS: central compartment atopic disease, eosinophilic CRS, and non-eosinophilic CRS. METHODS: A narrative review of a tertiary rhinology center's research themes and how they are applied to clinical protocols and practice was assessed. DISCUSSION: Diagnosis and treatment of upper and lower airway conditions become increasingly important as phenotypes and endotypes are being described. There are well-described therapies to treat the different phenotypes of CRS, based upon the presumed underlying cause of the inflammatory process. Research continues to shed more light on different endotypes and phenotypes of airway inflammation, however, clinical differentiation of CRS can be applied in clinic practice with three simple phenotypes of CRS. Understanding these different phenotypes and their etiologies allows for further management beyond the 'maximum medical therapy and then surgery' approach that has often been used in the management of CRS.


Assuntos
Corticosteroides/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Rinite , Sinusite , Doença Crônica , Endoscopia , Humanos , Fenótipo , Radiografia , Rinite/diagnóstico , Rinite/patologia , Rinite/terapia , Sinusite/diagnóstico , Sinusite/patologia , Sinusite/terapia
19.
Medicina (Kaunas) ; 55(4)2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30959833

RESUMO

Chronic rhinosinusitis (CRS) is a heterogeneous chronic inflammatory condition of the paranasal sinuses and nasal passage. It is characterized as inflammation of the sinonasal passage, presenting with two or more symptoms (nasal blockage, secretions, facial pain and headaches) for more than 12 weeks consecutively. The disease is phenotypically differentiated based on the presence of nasal polyps; CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). Traditionally, CRSwNP has been associated with a type 2 inflammatory profile, while CRSsNP has been associated with a type 1 inflammatory profile. Extensive work in characterizing the inflammatory profiles of CRS patients has challenged this dichotomy, with great variation both between and within populations described. Recent efforts of endotyping CRS based on underlying pathophysiology have further highlighted the heterogeneity of the disease, revealing mixed inflammatory profiles coordinated by a number of inflammatory cell types. This review will highlight the current understanding of inflammation in CRS, and discuss the importance and impact of refining this understanding in the development of appropriate treatment options for CRS sufferers.


Assuntos
Inflamação/classificação , Inflamação/imunologia , Rinite/classificação , Rinite/patologia , Sinusite/classificação , Sinusite/patologia , Biomarcadores/análise , Doença Crônica , Citocinas/análise , Humanos , Microbiota , Terapia de Alvo Molecular , Pólipos Nasais , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Linfócitos T Auxiliares-Indutores/imunologia
20.
Artigo em Alemão | MEDLINE | ID: mdl-31013526

RESUMO

OBJECTIVE: Retrospective evaluation of the diagnostic value of bacterial culture of nasal mucosal swabs and histopathologic assessment of nasal mucosal biopsies in dogs with nasal discharge. MATERIAL AND METHODS: Medical records of dogs with the predominant clinical sign of nasal discharge that were referred to the ENT Unit of the Small Animal Department between January 2015 and December 2016 were reviewed. RESULTS: Data of 85 dogs were evaluated. On the basis of the results of computed tomography (CT), rhinoscopy, bacterial culture of a nasal mucosal swab and histopathologic examination of nasal mucosal biopsies, dogs were assigned to one of six groups of primary nasal diseases: nasal neoplasia (24/85, 28 %), oronasal defect (22/85, 26 %), idiopathic chronic rhinitis (17/85, 20 %), foreign body (8/85, 10 %), sinonasal aspergillosis (7/85, 8 %) and diseases of the planum nasale (7/85, 8 %). In brachycephalic dogs (14/85, 17 %), oronasal defects (8/14, 57 %) were the most frequent cause of nasal discharge. No cases of a primary bacterial infection of the nasal cavity were observed and, therefore, antibiotic treatment had not been successful. Nevertheless, 72 % of the dogs in this study had received prior antibiotic treatment. Secondary bacterial infec tions diagnosed via nasal mucosal swabs were not diagnostic for the underlying primary nasal diseases. Targeted biopsies of tumors obtained under endoscopic visualization may lead to a definitive diagnosis, whereas biopsies of the nasal mucosa and the type of the inflammatory infiltrate were not diagnostic. CONCLUSIONS: Nasal discharge in dogs is frequently an indicator of an underlying severe primary nasal disease possibly leading to mortality of the affected dogs. Further diagnostics under anesthesia should be performed early in the diagnostic evaluation. Rhinoscopy as the central diagnostic is supported by CT and biopsy. Bacterial culture of the nasal discharge does not provide a diagnosis for the primary nasal disease process. CLINICAL RELEVANCE: Without further diagnostics, antibiotic treatment of dogs presenting with nasal discharge is considered as not appropriate and can be harmful in dogs with nasal tumors or sinonasal aspergillosis. When an intranasal malignant neoplasia is suspected, endoscopic-guided biopsies of the nasal mass should be obtained, because blind nasal biopsies are associated with a high rate of false-negative results.


Assuntos
Doenças do Cão/microbiologia , Doenças do Cão/patologia , Mucosa Nasal/microbiologia , Mucosa Nasal/patologia , Doenças Nasais/veterinária , Animais , Aspergilose/microbiologia , Aspergilose/patologia , Aspergilose/veterinária , Doença Crônica/veterinária , Cães , Endoscopia/veterinária , Corpos Estranhos/patologia , Corpos Estranhos/veterinária , Doenças Nasais/microbiologia , Doenças Nasais/patologia , Neoplasias Nasais/patologia , Neoplasias Nasais/veterinária , Estudos Retrospectivos , Rinite/microbiologia , Rinite/patologia , Rinite/veterinária , Tomografia Computadorizada por Raios X/veterinária
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