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Masuda S, Nagao M, Usui S, Nogami K, Tohda Y, Fujisawa T. Development of allergic rhinitis in early life: A prospective cohort study in high-risk infants. Pediatr Allergy Immunol 2022; 33:e13733. [PMID: 35212053 DOI: 10.1111/pai.13733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is the most common allergic disease in children. The development process of AR in early childhood, however, is not well understood. We prospectively investigated the process in regard to not only the nasal symptoms and sensitization but also the nasal cytology, in relation to recurrent wheeze in a high-risk cohort. METHODS Infants under 2 years of age with atopic dermatitis (AD) and/or food allergy (FA) symptoms were recruited and followed prospectively for 2 years. The phenotype of perennial AR was classified based on the presence/absence of (1) persistent nasal symptoms, (2) nasal eosinophils, and (3) HDM sensitization, the most common allergen for perennial AR in Japan. AR-like phenotypes were defined as positive for at least two of those three categories. High-risk recurrent wheezer was diagnosed based on the Japanese guidelines and Global Initiative for Asthma. Cox proportional hazards regression analyses for high-risk recurrent wheeze and the AR-like phenotype, adjusting for known covariate risk factors for asthma. RESULTS A total of 299 children were enrolled, and 237 subjects (78%) completed the 2-year observation. The prevalence of eosinophilia in nasal secretions increased from 18.5% to 69.9%, while HDM-specific IgE ≥ 0.35 kUA /L increased from 30.6% to 74.8%. AR-like phenotypes increased from 18.4% to 65.0%. The AR-like phenotype at 2 years was associated with development of high-risk recurrent wheezer (HR 2.062; 95% CI 1.005-4.796). CONCLUSIONS The prevalence of an HDM-related AR-like phenotype was markedly increased during infancy in infants with AD/FA and was associated with high-risk recurrent wheezer.
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Affiliation(s)
- Sawako Masuda
- Department of Otorhinolaryngology and Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Mizuho Nagao
- Department of Pediatrics and Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Satoko Usui
- Department of Otorhinolaryngology and Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Kazutaka Nogami
- Department of Pediatrics and Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Yuji Tohda
- Department of Respiratory Medicine and Allergology, Kindai University, Faculty of Medicine, Osaka-Sayama, Japan
| | - Takao Fujisawa
- Department of Pediatrics and Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan
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Choi Y, Jeon H, Yang EA, Yoon JS, Kim HH. Nasal eosinophilia and eosinophil peroxidase in children and adolescents with rhinitis. KOREAN JOURNAL OF PEDIATRICS 2019; 62:353-359. [PMID: 31096743 PMCID: PMC6753315 DOI: 10.3345/kjp.2019.00318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 04/24/2019] [Indexed: 01/21/2023]
Abstract
Background Researchers have shown that eosinophil peroxidase (EPO) is a relatively accurate marker of eosinophilia and eosinophil activity. However, its use as a marker of eosinophilic inflammation in nasal secretions is limited because the diagnostic cutoff values of EPO for use as a one-time test for allergic diseases such as allergic rhinitis have not been established. Purpose To identify the correlation between nasal eosinophil count and EPO in children and adolescents with rhinitis. Methods We recruited patients <18 years of age with rhinitis for more than 2 weeks or more than 2 episodes a year whose nasal eosinophil and EPO were measured at a single allergy clinic. The eosinophil percentage was calculated by dividing the eosinophil count by the number of total cells under light microscopy at ×1,000 magnification. EPO and protein were measured from nasal secretions. We retrospectively analyzed the correlation between nasal eosinophils and protein-corrected EPO (EPO/protein) value. Results Of the 67 patients enrolled, 41 were male (61.2%); the mean age was 8.2±4.0 years. The median nasal eosinophil count was 1 and percentage was 1%. The median protein-corrected EPO value was 12.5 ng/μg (range, 0–31 ng/μg). There was a statistically significant correlation between eosinophil count and percentage (P<0.001). However, the eosinophil percentage and EPO did not correlate. The eosinophil count and EPO had a statistically significant correlation (P =0.01). The EPO cutoff value examined for nasal eosinophil counts of 2, 5, 10, and 20 was 17.57 ng/μg regardless of the reference count. The largest area under the curve value was obtained when the receiver operating characteristic curve was drawn using the eosinophil count of 2. Conclusion Nasal eosinophil count was significantly associated with protein-corrected EPO.
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Affiliation(s)
- Yeonu Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Haeun Jeon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Ae Yang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Seo Yoon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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3
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She W, Yang J, Wang C, Zhang L. Diagnostic Value of Nasal Cytology in Chronic Rhinosinusitis Assessed by a Liquid-based Cytological Technique. Am J Rhinol Allergy 2018; 32:181-187. [PMID: 29660995 DOI: 10.1177/1945892418768581] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Back ground: Nasal cytology has generally been employed as a useful diagnostic tool in the differentiation of rhinopathies. Objective The aim of this study was to assess the extent and diagnostic value of inflammation of nasal and paranasal sinus mucosa in chronic rhinosinusitis patients by employing a combination of nasal brushings and a liquid-based cytological technique. Methods Forty-eight patients with chronic sinusitis and 20 control subjects without any sign of sinusitis undergoing endoscopic surgery, although not all underwent endoscopic sinus surgery, were recruited to the study. Nasal cytology samples were collected from all subjects using nasal brush and processed a liquid-based cytological technique for evaluation of total and differential inflammatory cell counts. Biopsies were also taken from the inferior turbinates from its anterior margin in all subjects and from identical lateral maxillary sinus mucosa in patients with chronic sinusitis during surgery and routinely processed for staining and evaluation of inflammatory cells. Results Total and individual inflammatory cell counts in nasal brushings were significantly correlated with the respective inflammatory cell counts in biopsies obtained from the inferior turbinate (eosinophils: r = .519 and P = .016; neutrophils: r = .540 and P = .012; lymphocytes: r = .540 and P = .011) but not in biopsies obtained from the maxillary sinus. No correlation was observed between the inflammatory cells in biopsies from the inferior turbinate and biopsies from the maxillary sinus. The liquid-based cytological technique showed higher sensitivity (94.1%), specificity (76.9%), and positive predictive value (84.2%) for inflammation in the inferior turbinates than for inflammation in the maxillary sinus (sensitivity = 63.4% and positive predictive value = 63.4%). Conclusion Nasal cytology evaluated by use of nasal brushings processed by a liquid-based cytological technique is likely to have higher diagnostic value for the inflammatory response in noninfectious rhinitis than in chronic rhinosinusitis.
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Affiliation(s)
- Wenyu She
- 1 Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,2 Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,3 Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Jun Yang
- 3 Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Chengshuo Wang
- 1 Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,2 Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,3 Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Luo Zhang
- 1 Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,2 Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,3 Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
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4
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Yang EA, Park YM, Kim KH, Lee HJ, Kim HS, Chun YH, Yoon JS, Kim HH, Kim JT. The association between nasal eosinophilia and aeroallergen sensitization in children and adolescents with rhinitis. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.3.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Eun Ae Yang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu Mi Park
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Hoon Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Jin Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwan Soo Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon Hong Chun
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Seo Yoon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Gelardi M, Iannuzzi L, Quaranta N, Landi M, Passalacqua G. NASAL cytology: practical aspects and clinical relevance. Clin Exp Allergy 2017; 46:785-92. [PMID: 27009397 DOI: 10.1111/cea.12730] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Nasal cytology is a simple and safe diagnostic procedure that allows to assess the normal and pathological aspects of the nasal mucosa, by identifying and counting the cell types and their morphology. It can be easily performed by a nasal scraping followed by May-Grunwald-Giemsa staining and optical microscopy reading. This procedure allows to identify the normal cells (ciliated and mucinous), the inflammatory cells (lymphocytes, neutrophils, eosinophils, mast cells), bacteria, or fungal hyphae/spores. Apart from the normal cell population, some specific cytological patterns can be of help in discriminating among various diseases. Viral infections, allergic rhinitis, vasomotor rhinitis and overlapping forms can be easily identified. According to the predominant cell type, various entities can be defined (named as NARES, NARESMA, NARMA). This implies a more detailed knowledge and assessment of the disease that can integrate the standard diagnostic procedures. Nasal cytology also represents a useful research tool for diagnosis and therapy.
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Affiliation(s)
- M Gelardi
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - L Iannuzzi
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - N Quaranta
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - M Landi
- National Pediatric Healthcare System, Turin, Italy.,Unit Research of Pediatric Pulmonology and Allergy, Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council, Palermo, Italy
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy
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Cho SH, Kim DW, Gevaert P. Chronic Rhinosinusitis without Nasal Polyps. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 4:575-82. [PMID: 27393771 DOI: 10.1016/j.jaip.2016.04.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/30/2016] [Accepted: 04/28/2016] [Indexed: 12/11/2022]
Abstract
Chronic rhinosinusitis without nasal polyps (CRSsNP) is more prevalent than chronic rhinosinusitis with nasal polyps (CRSwNP). Certain diseases predispose to whereas others are associated with CRSsNP. Predisposing diseases include allergic and nonallergic upper and lower airway diseases, epithelial cell disorders, immunodeficiencies, autoimmune diseases, and some infectious diseases. In addition, environmental and host factors, examples of which include smoking, a higher incidence of abnormal biofilms, and innate immune defects, play a role in the pathogenesis of this disease. CRSsNP is characterized by histologic abnormalities, including basement membrane thickening (fibrosis) and goblet cell hyperplasia. Neutrophils and several chemokines, TGF-β and C-X-C motif chemokine ligand (CXCL)-8, play a role in CRSsNP remodeling. However, there are conflicting data about CRSsNP endotypes, for example, whether it is characterized by neutrophilia or eosinophilia or both. In spite of advancements and the understanding of the pathogenesis of this disease, additional study is necessary to better comprehend its underlying mechanisms, endotypes, and evidence-based treatment strategies.
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Affiliation(s)
- Seong Ho Cho
- Division of Allergy-Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla.
| | - Dae Woo Kim
- Division of Allergy-Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla; Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Philippe Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
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Nasal Cytology as a Marker of Atopy in Children. DISEASE MARKERS 2017; 2017:4159251. [PMID: 29038613 PMCID: PMC5605914 DOI: 10.1155/2017/4159251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/24/2017] [Accepted: 08/06/2017] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the cytological picture of nasal mucosa in children with atopic diseases and to determine the diagnostic value of the test for the diagnosis of atopic diseases. The study included 140 children from 4 months to 17 years old. Among children with a history of atopy, there were 30 children with atopic dermatitis, 30 children with asthma, and 46 children with allergic rhinitis. The control group consisted of 34 healthy children. The nasal scraping technique has been used to collect samples from the nasal cavity. The samples were evaluated under light microscope. Epithelial cells as well as infiltrating cells were assessed. The only statistically significant group of cells differentiating children with atopic disease and without atopy were eosinophils, which in children with atopy were significantly more common. Assuming a significant eosinophilia value of at least 5% of all cells in cytogram, the sensitivity of nasal cytology in allergic rhinitis was 52.2%, in asthma 33.3%, and in atopic dermatitis 13.3%. The specificity of the test in atopic diseases was 94.1%. It can be concluded that nasal cytology with eosinophilia assessment can be a useful tool for an early diagnosis of atopic disease in children.
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Enumerating Virus-Like Particles and Bacterial Populations in the Sinuses of Chronic Rhinosinusitis Patients Using Flow Cytometry. PLoS One 2016; 11:e0155003. [PMID: 27171169 PMCID: PMC4865123 DOI: 10.1371/journal.pone.0155003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/25/2016] [Indexed: 01/28/2023] Open
Abstract
There is increasing evidence to suggest that the sinus microbiome plays a role in the pathogenesis of chronic rhinosinusitis (CRS). However, the concentration of these microorganisms within the sinuses is still unknown. We show that flow cytometry can be used to enumerate bacteria and virus-like particles (VLPs) in sinus flush samples of CRS patients. This was achieved through trialling 5 sample preparation techniques for flow cytometry. We found high concentrations of bacteria and VLPs in these samples. Untreated samples produced the highest average bacterial and VLP counts with 3.3 ± 0.74 x 107 bacteria ml-1 and 2.4 ± 1.23 x 109 VLP ml-1 of sinus flush (n = 9). These counts were significantly higher than most of the treated samples (p < 0.05). Results showed 103 and 104 times inter-patient variation for bacteria and VLP concentrations. This wide variation suggests that diagnosis and treatment need to be personalised and that utilising flow cytometry is useful and efficient for this. This study is the first to enumerate bacterial and VLP populations in the maxillary sinus of CRS patients. The relevance of enumeration is that with increasing antimicrobial resistance, antibiotics are becoming less effective at treating bacterial infections of the sinuses, so alternative therapies are needed. Phage therapy has been proposed as one such alternative, but for dosing, the abundance of bacteria is required. Knowledge of whether phages are normally present in the sinuses will assist in gauging the safety of applying phage therapy to sinuses. Our finding, that large numbers of VLP are frequently present in sinuses, indicates that phage therapy may represent a minimally disruptive intervention towards the nasal microbiome. We propose that flow cytometry can be used as a tool to assess microbial biomass dynamics in sinuses and other anatomical locations where infection can cause disease.
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Amin KAM. Allergic Respiratory Inflammation and Remodeling. Turk Thorac J 2015; 16:133-140. [PMID: 29404091 DOI: 10.5152/ttd.2015.4942] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 06/01/2015] [Indexed: 01/22/2023]
Abstract
Asthma and rhinitis are inflammatory diseases of the respiratory tract. Respiratory inflammation of the adaptive and innate immune system is the focus of this review, and chronic inflammation is not limited to the respiratory tissue. The inflammatory response, which consists of phagocytes, eosinophils, mast cells, and lymphocytes, spreads along the respiratory tract, leading to tissue damage. Mast cells and eosinophils are commonly recognized for their detrimental role in allergic reactions on activation through the high- and low-affinity receptors for IgE FcɛRI. These cells rapidly produce and secrete many of the mediators responsible for the typical symptoms of asthma and rhinitis. However, increasing amount of evidence demonstrate that mast cells and leukocytes have vital roles in host defense against pathogenesis. Histological methods are used to study leukocytes and receptor expression pattern in different respiratory tract compartments. The overall aim of this review was to understand the relationship between upper and lower respiratory tract inflammation and remodeling in patients with allergic and non-allergic asthma and rhinitis. In conclusion, this review discusses the relationship between the upper and lower airway in respiratory disease and focuses on the effect of respiratory processes on laryngeal inflammation, remodeling, function, and symptoms; however, they also have a central role in the initiation of the allergic immune response. Our findings suggest that there are differences that contribute to the development of immunopathological mechanisms of these clinically distinct forms of asthma, rhinitis, and chronic obstructive pulmonary disease.
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Affiliation(s)
- Kawa A M Amin
- Department of Medical Science, Respiratory Medicine and Allergology, Clinical Chemistry and Asthma Research Centre, Uppsala University and University Hospital, Uppsala, Sweden.,Department of Microbiology/Immunology, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Sulaimani, Iraq
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10
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Cantone E, Marino A, Ferranti I, Castagna G, Maione N, Di Rubbo V, Iengo M. Nasal cytological assessment after crenotherapy in the treatment of chronic rhinosinusitis in the elderly. Int J Immunopathol Pharmacol 2015; 27:683-7. [PMID: 25572751 DOI: 10.1177/039463201402700427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic rhinosinusitis (CRS) determines irreversible alterations of the nasal mucosa with consequent impairment of ciliary movements and, therefore, mucociliary clearance (MCC). People of all ages can be affected by CRS but the elderly are subjects at the highest risk. CRS in the elderly with an age-related physiological impairment of nasal respiratory function, often accompanied by other chronic diseases, requires additional therapies to be added to the numerous daily medications. Since the currently available therapies for CRS include the use of drugs that can have adverse effects and contraindications, crenotherapy could represent a therapeutic option. Indeed, because the adverse effects and contraindications of crenotherapy are scarce, it can be safely used in elderly patients with comorbidities. The aim of this study is to evaluate the nasal cytological assessment after crenotherapy in elderly subjects with CRS. Two groups, comprising a total of 84 elderly subjects with CRS, were treated with crenotherapy with sodium chloride sulphate hyperthermal water rich in mineral salts (group I, n=49) and saline solution (group II n=35). Cytological assessment for both groups took place at baseline (T0) and 1 month after treatment (T30). At T30 the nasal cytological assessment showed statistically significant improvements in the ciliary motility and in the count of neutrophils and spores in group I, but not in group II. Conversely, there were no significant differences in the count of eosinophils, mast cells, bacteria and biofilm in either group. Our data for the first time focused on the role of crenotherapy in the improvement of cytological assessment of CRS in the elderly.
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Affiliation(s)
- E Cantone
- Department of Neuroscience, Section of ENT Federico II University, Naples, Italy
| | - A Marino
- Department of Neuroscience, Section of ENT Federico II University, Naples, Italy
| | - I Ferranti
- Department of Neuroscience, Section of ENT Federico II University, Naples, Italy
| | - G Castagna
- Department of Neuroscience, Section of ENT Federico II University, Naples, Italy
| | - N Maione
- Department of Neuroscience, Section of ENT Federico II University, Naples, Italy
| | - V Di Rubbo
- Department of Neuroscience, Section of ENT Federico II University, Naples, Italy
| | - M Iengo
- Department of Neuroscience, Section of ENT Federico II University, Naples, Italy
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Pagliuca G, Rosato C, Martellucci S, de Vincentiis M, Greco A, Fusconi M, De Virgilio A, Gallipoli C, Simonelli M, Gallo A. Cytologic and functional alterations of nasal mucosa in smokers: temporary or permanent damage? Otolaryngol Head Neck Surg 2015; 152:740-5. [PMID: 25573681 DOI: 10.1177/0194599814566598] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/11/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Tobacco smoke is a significant risk factor for respiratory diseases. The purpose of this study is to analyze the cytologic and functional features of nasal mucosa in smokers, nonsmokers, and ex-smokers to evaluate if nasal alterations in smokers are permanent or reversible conditions after smoking cessation. STUDY DESIGN Case series with planned data collection. SETTING University medical center. SUBJECTS AND METHODS Ninety healthy volunteers recruited from the staff of Alfredo Fiorini Hospital, Sapienza University of Rome, were enrolled in this prospective study from October to November 2013. We divided the cases according to smoking habits (smokers, nonsmokers, ex-smokers). Each group was composed of 30 subjects. Cytologic features of nasal mucosa and effectiveness of nasal mucociliary clearance were studied, focusing on 4 parameters: (1) nasal mucociliary clearance, assessed by saccharin nasal transit time; (2) ratio between the number of ciliated cells and goblet cells, analyzed by microscopic observation of cytologic specimens of nasal mucosa that had undergone May Grunwald Giemsa staining; (3) evaluation of ciliary motility; and (4) time of ciliary movement of ciliated cells analyzed by phase-contrast microscopy. RESULTS All parameters were significantly reduced in the smokers compared to the nonsmokers. There were no statistically significant differences between the nonsmoker and ex-smoker groups. CONCLUSION Cigarette smoking causes cytologic modifications of nasal mucosa that influence the effectiveness of mucociliary clearance. Our preliminary study suggests that these changes are not permanent and that nasal mucosa of ex-smokers recovers normal cytologic and functional features.
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Affiliation(s)
- Giulio Pagliuca
- Department of Medico-Surgical Sciences and Biotechnologies, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Chiara Rosato
- Department of Medico-Surgical Sciences and Biotechnologies, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Salvatore Martellucci
- Department of Medico-Surgical Sciences and Biotechnologies, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Marco de Vincentiis
- Department of Sensorial Organs, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sensorial Organs, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Massimo Fusconi
- Department of Sensorial Organs, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Armando De Virgilio
- Department of Sensorial Organs, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Camilla Gallipoli
- Department of Medico-Surgical Sciences and Biotechnologies, ENT Section, Sapienza University of Rome, Rome, Italy
| | - Marilia Simonelli
- Speech and Swallowing Rehabilitation Service, Santa Lucia Foundation, Rome, Italy
| | - Andrea Gallo
- Department of Medico-Surgical Sciences and Biotechnologies, ENT Section, Sapienza University of Rome, Rome, Italy
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12
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Pelikan Z. Cytological Changes in Nasal Secretions Accompanying Delayed Nasal Response to Allergen Challenge. Am J Rhinol Allergy 2013. [DOI: 10.2500/ajra.2013.27.3933a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Patients with allergic rhinitis when challenged with allergen develop various types of nasal response, such as an immediate nasal response (INR), late nasal response (LNR), dual late nasal response (DLNR), or delayed nasal response (DYNR), probably because of different hypersensitivity mechanisms. This study was designed to investigate the cytological changes in the nasal secretions (NSs) during the DYNR, beginning 24–32 hours, reaching maximum at 32–36 hours, and resolving within 56 hours after the nasal provocation tests (NPTs) with allergens. Methods In 45 allergic rhinitis patients developing 45 positive DYNRs (p < 0.01), the NPTs and the phosphate-buffered saline (PBS) controls were repeated and supplemented with cytological examination of the NSs and determination of interferon (IFN) γ and IL-4 in nasal lavage fluid (NLF). Results The repeated DYNR (p < 0.001) was accompanied by significant changes (p < 0.05) in the counts of neutrophils, monocytes, lymphocytes, epithelial and goblet cells, and, to a limited extent, of plasma cells and platelets in the NSs and increased concentrations of IFN-γ but not of IL-4, in NLF between 24 and 48 hours after the NPT. No significant cytological changes were found in NSs during the PBS controls (p > 0.1). Conclusion The DYNR is associated with cytological profiles in the NS different from those observed during the INR or LNR. The significant count changes of neutrophils, monocytes, lymphocytes, epithelial and goblet cells in NSs, and increased IFN-γ but not of IL-4 concentrations in the NLF, suggest a possible involvement of the cell-mediated hypersensitivity in the DYNR. These results also emphasize the diagnostic value of NPTs combined with cytological examination of the NSs in patients with nasal allergy.
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13
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Gelardi M, Luigi Marseglia G, Licari A, Landi M, Dell'Albani I, Incorvaia C, Frati F, Quaranta N. Nasal cytology in children: recent advances. Ital J Pediatr 2012; 38:51. [PMID: 23009215 PMCID: PMC3533990 DOI: 10.1186/1824-7288-38-51] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 09/10/2012] [Indexed: 02/07/2023] Open
Abstract
Nasal cytology is a very useful diagnostic tool in nasal disorders, being able to detect both the cellular modifications of the nasal epithelium caused by either allergen exposure or irritative stimuli (that may be physical or chemical, acute or chronic), or inflammation. Over these past few years, nasal cytology has allowed to identify new disorders, such as the non-allergic rhinitis with eosinophils (NARES), the non-allergic rhinitis with mast cells (NARMA), the non-allergic rhinitis with neutrophils (NARNE), and the non-allergic rhinitis with eosinophils and mast cells (NARESMA). The rhinocytogram is actually able to distinguish the different forms of allergic rhinitis and to suggest the appropriate treatment, such as antinflammatory drugs or allergen immunotherapy. The technique is easy to perform and nasal cytology is therefore particularly suitable even for children. Such a consideration suggests the utility of a systematic use of nasal cytology in the diagnostic work-up of nasal disorders in children, in order to reach a proper defined diagnosis and to set a rational therapeutic approach: in facts, these two elements are fundamental in order to prevent from complications and to improve the patient’s quality of life.
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Affiliation(s)
- Matteo Gelardi
- Department of Otolaryngology, University of Bari, Bari, Italy
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14
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Majima Y, Kurono Y, Hirakawa K, Ichimura K, Haruna S, Suzaki H, Kawauchi H, Takeuchi K, Naito K, Kase Y, Harada T, Moriyama H. Efficacy of combined treatment with S-carboxymethylcysteine (carbocisteine) and clarithromycin in chronic rhinosinusitis patients without nasal polyp or with small nasal polyp. Auris Nasus Larynx 2012; 39:38-47. [DOI: 10.1016/j.anl.2011.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 04/26/2011] [Accepted: 04/29/2011] [Indexed: 10/18/2022]
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15
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Carpagnano GE, Resta O, Gelardi M, Spanevello A, Di Gioia G, Giliberti T, Depalo A, Foschino Barbaro MP. Exhaled inflammatory markers in aspirin-induced asthma syndrome. ACTA ACUST UNITED AC 2008; 21:542-7. [PMID: 17999786 DOI: 10.2500/ajr.2007.21.3066] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic inflammation, were analyzed in nasal and oral exhaled breath condensate to understand the inflammation of upper and lower airways in subjects with aspirin-induced asthma (AIA) syndrome, evaluating possible differences between AIA and the single pathological conditions included in AIA syndrome. METHODS Twelve patients with AIA, 17 patients with mild asthma (MA), 12 patients with nasal polyposis (NP), 11 patients with mild asthma + nasal polyposis (MA + NP), and 10 healthy subjects (HSs) were enrolled. Nasal and oral exhaled IL-4 and IL-6 were measured by enzyme immunoassay kit. RESULTS Higher levels of nasal and oral exhaled IL-4 and IL-6 were observed in AIA compared with MA, NP, MA + NP, and HSs. Moreover, a positive correlation was identified between nasal exhaled IL-4 and IL-6 and, respectively, the number of neutrophils and eosinophils and in nasal scraping. CONCLUSION The concentration of eosinophilic and neutrophilic markers in upper and lower airways of subjects with AIA syndrome is higher compared with HS and subjects with MA, NP, and MA + NP.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Foggia, Italy.
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16
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Miman MC, Uzun O, Gurses I, Kuku I, Ozturan O, Akarcay M. The sensitivity of nasal eosinophilia in allergic rhinitis. Eur Arch Otorhinolaryngol 2007; 264:1013-8. [PMID: 17468876 DOI: 10.1007/s00405-007-0310-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Accepted: 03/23/2007] [Indexed: 10/23/2022]
Abstract
Evaluation of nasal epithelial samples is a part of clinical allergy practice. The aim of this study is to reveal the sensitivity of the nasal eosinophilia using Rhino-probe and Wright-Giemsa staining by means of all available nasal eosinophilia scoring systems. In 30 patients (12 males, 18 females; mean age = 31.6 years) with clinical diagnosis of allergic rhinitis, both sides of the nose were sampled. The content of the cupped tip of the probe has been prepared and stained for nasal cytological examination under oil immersion by light microscopy. Nasal eosinophilia has been assessed by scoring systems. The sensitivity of nasal eosinophilia has been revealed. The nasal eosinophilia scores have been compared between nasal sides (right or left nose) and also between the examiners' observations for the same sample. Sensitivity values of nasal eosinophilia according to previously described criteria in the literature have been found to be between 13.33 and 80%. As the agreements for the nasal eosinophilia diagnosis between the sides of the nasal cavity and between the blinded examiners, the criteria of nasal eosinophilia such as the ratio of eosinophils to neutrophils or to all inflammatory cells rendered different diagnoses between the examiners (P < 0.01). The results of nasal cavity sides and Meltzer-scoring yielded no differences (P > 0.05). The substantial intraindividual variations when comparing the results obtained from the nasal sides and low sensitivity reveal that the nasal cytology needs more objective and standardized methods for a better differential diagnosis of chronic rhinitis.
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Affiliation(s)
- Murat Cem Miman
- Otorhinolaryngology Department, Inonu University, Malatya, Turkey
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17
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Abstract
This article reviews the treatment of chronic sinusitis with macrolides. Chronic sinusitis is often the result of bacterial infections that lead to chronic inflammation with thickening of the sinus mucosa and hypersecretion of mucus. In addition to their anti-infective properties, some macrolides possess immunomodulatory effects. These macrolides have been used successfully to treat diffuse panbronchiolitis, a progressive inflammatory lung disease, and may be useful for treatment of asthma, chronic bronchitis, chronic sinusitis, cystic fibrosis, and bronchiectasis. The clinical benefits of macrolides in patients with chronic sinusitis include decreased nasal secretions and postnasal drip, with improvement in nasal obstruction. In vivo and in vitro studies show that some macrolides affect neutrophil chemotaxis and infiltration, inflammatory cytokine production, mucus production, and the transportability of airway secretions. These findings indicate that macrolides are promising agents for treating chronic inflammation of the airways.
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Affiliation(s)
- Yuichi Majima
- Department of Otorhinolaryngology, Mie University School of Medicine, 2-174 Edobashi Tsu, Mie 514-8507, Japan
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18
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Abstract
Two histologic patterns of disease are found in chronic rhinosinusitis. The first is dominated by eosinophilia and polypoid changes. Glandular hyperplasia and hypertrophy characterize the second. We present the evidence supporting the existence of these two patterns of disease and link these histologic patterns to the larger pathophysiologic processes that drive them. This histologic classification should be acknowledged both in the clinical setting and in laboratory research of chronic rhinosinusitis.
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Affiliation(s)
- Sonya Malekzadeh
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University, 1st Floor Gorman Building, 3800 Reservoir Road, NW, Washington, DC 20007-2197, USA.
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19
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Abstract
Airway mucociliary clearance depends on the properties and volume of secreted mucus, ciliary function and mucociliary interactions. In chronic airway diseases, mucus viscoelasticity is higher than the optimal values for mucociliary clearance. The mucous glycoproteins (MGs) are produced by goblet and submucosal gland cells and are the most important determinant of the viscoelasticity of normal respiratory mucus, although with chronic infection and inflammation neutrophil-derived DNA and F-actin assume an important role. The quantities and structures of MGs mainly determine the rheological properties of mucus. Mucolytic agents, such as the thiols with free sulphydryl groups (classic mucolytics) and proteolytic enzymes (peptide mucolytics) change the conformation of mucus and lead to the reduction of viscoelasticity. Mucoregulatory medications such as glucocorticoids and macrolide antibiotics may decrease the hypersecretion of MGs.
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Affiliation(s)
- Yuichi Majima
- Department of Otorhinolaryngology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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20
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Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001; 108:S147-334. [PMID: 11707753 DOI: 10.1067/mai.2001.118891] [Citation(s) in RCA: 2090] [Impact Index Per Article: 90.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- J Bousquet
- Department of Allergy and Respiratory Diseases, University Hospital and INSERM, Montpellier, France
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21
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Bhattacharyya N. Chronic rhinosinusitis: is the nose really involved? AMERICAN JOURNAL OF RHINOLOGY 2001; 15:169-73. [PMID: 11453503 DOI: 10.2500/105065801779954184] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To determine whether chronic rhinitis usually accompanies chronic sinusitis, and critically examine the concept of chronic rhinosinusitis, paired specimens of nasal septal mucosa and ethmoid sinus mucosa were obtained in a prospective cohort of 42 patients undergoing endoscopic sinus surgery for chronic rhinosinusitis. The histopathological degree of inflammation for each specimen was scored using a five-point rating scale. Cell counts for eosinophils and inflammatory cells per high-power field (HPF) were determined. Mean patient age was 40.5 years and mean Lund score was 9.3. The inflammation grade of the septal mucosa was within one point of the ethmoid mucosa in 36 (85.7%) cases, and correlated exactly in 24 patients (57.1%). A statistically significant correlation was found between septal and ethmoid mucosa inflammation grades (p = 0.048). No significant difference in mean non-eosinophilic inflammatory cell count per HPF was noted betmeen ethmoid mucosa and septal mucosa (48.2 versus 54.3 cells/HPF, p = 0.061, power = 0.873). Ethmoid mucosa had a significantly higher mean eosinophil count than septal mucosa (6.6 versus 1.9 cells/HPF, p < 0.001). For combined inflammatoty cell counts, no significant difference in cell counts was noted (54. 7 cells/HPF ethmoid versus 56.1 septal, p = 0.670, power = 0.847). Histopathologic evidence of rhinitis is associated with chronic sinusitis. This supports the concept of rhinosinusitis rather than sinusitis alone. Eosinophils are found in significantly higher numbers in sinus mucosa than in nasal mucosa, suggesting a site-specific role in rhinosinusitis.
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Affiliation(s)
- N Bhattacharyya
- Department of Otology and Laryngology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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22
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Amin K, Rinne J, Haahtela T, Simola M, Peterson CG, Roomans GM, Malmberg H, Venge P, Sevéus L. Inflammatory cell and epithelial characteristics of perennial allergic and nonallergic rhinitis with a symptom history of 1 to 3 years' duration. J Allergy Clin Immunol 2001; 107:249-57. [PMID: 11174190 DOI: 10.1067/mai.2001.112266] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Perennial rhinitis is an inflammatory condition of the mucosal lining of the nose that may be caused by allergic and nonallergic mechanisms. OBJECTIVE We sought to characterize the cellular pattern and structural changes in the nasal mucous membrane of patients with perennial rhinitis and compare them with those of control subjects. METHODS Biopsy specimens were obtained from 27 patients with perennial allergic rhinitis (PAR), from 12 patients with perennial nonallergic rhinitis (PNAR) with eosinophils present in the nasal smear, and from 6 control subjects without rhinitis. In 10 of 27 patients with PAR who were also allergic to pollen, biopsy specimens were taken within the respective season (PARseason). In the other 17 patients, the biopsy was taken outside the pollen season (PARoutside season). Inflammatory cells were identified by using mAbs to their unique granular proteins. RESULTS The characteristic feature of perennial rhinitis was the accumulation of activated (degranulated) mast cells and eosinophils in the nasal mucosa. The tissue eosinophil/neutrophil ratio was higher, and the loss of epithelial integrity was greater in all patient groups compared with the control subjects. The extent of epithelial damage was significantly larger in patients in the PARseason group compared with that in the PARoutside season and PNAR groups, which did not significantly differ from each other in this respect. The number of eosinophils and mast cells was higher in the PNAR group compared with the PAR groups. In all patient groups, the number of eosinophils correlated with the loss of epithelial integrity. The number of mast cells did not correlate with the extent of epithelial damage nor did the number of neutrophils, except in patients in the PARseason group. CONCLUSION The accumulation of eosinophils and mast cells, as well as loss of epithelial integrity, was characteristic for perennial rhinitis. Loss of epithelial integrity in the nasal mucosa may be a consequence of the activity of accumulated eosinophils.
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Affiliation(s)
- K Amin
- Section of Human Anatomy, Department of Medical Cell Biology, University of Uppsala, Uppsala, Sweden
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23
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Shinogi J, Majima Y, Takeuchi K, Harada T, Sakakura Y. Quantitative cytology of nasal secretions with perennial allergic rhinitis in children: comparison of noninfected and infected conditions. Laryngoscope 1998; 108:703-5. [PMID: 9591549 DOI: 10.1097/00005537-199805000-00014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study was performed to quantify the number of inflammatory cells in nasal secretions from pediatric patients with perennial allergic rhinitis under noninfected and infected conditions. Nasal secretions were obtained from seven children under both noninfected and infected conditions with perennial allergic rhinitis to house dust mites, and secondary quantitative cytology was performed on the secretions. The number of neutrophils under infected condition was significantly higher than that under noninfected condition (P < .05), whereas the number of eosinophils in infected condition was significantly lower than that in noninfected condition (P < .05). The ratio of eosinophil count to neutrophil count was more than 0.1 in noninfected condition. The ratio was significantly decreased in infected condition (P < .02). These results suggest that the distribution of inflammatory cells in the nasal mucus of children with allergic rhinitis would be modified under infected condition.
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Affiliation(s)
- J Shinogi
- Department of Otorhinolaryngology, Mie University School of Medicine, Tsu, Japan
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24
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Jirapongsananuruk O, Vichyanond P. Nasal cytology in the diagnosis of allergic rhinitis in children. Ann Allergy Asthma Immunol 1998; 80:165-70. [PMID: 9494449 DOI: 10.1016/s1081-1206(10)62950-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Inflammatory cellular infiltrates of eosinophils and basophilic metachromatic cells are the hallmark of the atopic nasal responses in allergic rhinitis. Nasal cytologic examination for these cells not only establishes the diagnosis of allergic rhinitis but is also useful in the followup of patients with this condition. OBJECTIVES To determine the usefulness of quantitative nasal cytology as an adjunctive diagnostic tool for children with allergic rhinitis in addition to history, physical examination and allergy skin testing. MATERIALS AND METHODS Forty-eight children with allergic rhinitis less than 15 years of age were recruited and evaluated for the following variables: symptoms and signs of allergic rhinitis, skin prick tests to common aeroallergens, paranasal sinus radiographs, and nasal cytology. Forty-one normal and healthy children less than 15 years of age served as controls. Nasal mucosal specimens were obtained by scraping the middle one-third of inferior turbinates with Rhinoprobes and were stained with Wright-Giemsa stain. Nasal cytology was examined under a light microscope and graded according to a previously suggested scoring system. RESULTS There were distinctive differences in the scores for nasal eosinophils and basophilic metachromatic cells between the allergic rhinitis and the control groups (P < .001). The sensitivity for nasal eosinophil scores or nasal basophilic metachromatic cell scores more than 0.5 in the diagnosis of allergic rhinitis was 91.7% with a specificity of 100%, positive predictive value of 100% and a negative predictive value of 91.1%. Presence of polymorphonuclear cells did not correlate with the presence of sinusitis as diagnosed by paranasal sinus radiographs. Nasal eosinophil scores correlated significantly with sign scores (P = .009). House dust mites were the most common allergens sensitized by this group of children (67.4% to 88.4%). CONCLUSION Nasal cytology is a quick, simple, and inexpensive tool not only for the diagnosis of allergic rhinitis but also for serial evaluations of children with this condition as well.
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Affiliation(s)
- O Jirapongsananuruk
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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25
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Majima Y, Masuda S, Sakakura Y. Quantitative study of nasal secretory cells in normal subjects and patients with chronic sinusitis. Laryngoscope 1997; 107:1515-8. [PMID: 9369400 DOI: 10.1097/00005537-199711000-00017] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The contribution of nasal secretory cells to mucus hypersecretion in chronic sinusitis was investigated. The mucosae of the inferior turbinate were obtained from 18 normal control subjects and 65 patients with chronic sinusitis. Histochemical quantitation showed that there was no significant difference in the number of goblet cells between normal controls and chronic sinusitis. On the other hand, the number of submucosal acinar cells in chronic sinusitis was significantly higher than that in normal controls (P < 0.01). The area occupied by the acini in lamina propria was also increased in chronic sinusitis (P < 0.01). There was no significant difference in the distribution of the intra-acinar glycoproteins between normal control subjects and patients with chronic sinusitis. Results suggest that hyperplasia and hypertrophy of nasal acinar cells may have an important role in mucus hypersecretion in chronic sinusitis.
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Affiliation(s)
- Y Majima
- Department of Otorhinolaryngology, Mie University School of Medicine, Tsu, Japan
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26
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Takeuchi K, Ukai K, Lee HS, Majima Y, Sakakura Y. Quantitative cytology of nasal secretions and scrapings in Japanese cedar pollinosis patients. Laryngoscope 1996; 106:1419-23. [PMID: 8914913 DOI: 10.1097/00005537-199611000-00022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
To explore the dynamics of the cellular response to natural allergen exposure, the authors of this study performed quantitative cytology in both the nasal secretions and nasal scrapings of 16 normal control subjects and 23 Japanese cedar pollinosis patients before and during the pollen season. In nasal scrapings, the number of metachromatic cells increased significantly during the pollen season, although there was no significant difference between the normal subjects and the preseason pollinosis patients. The cell differential count in the patients with pollinosis showed that lymphocytes were predominant in scrapings; however, the majority of inflammatory cells in the nasal secretions were neutrophils before the season and eosinophils during the season. The study findings suggest that the appearance of metachromatic cells in nasal scrapings is specific to the pollen exposure and that the cytology in nasal secretions is significantly different from that in nasal scrapings.
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Affiliation(s)
- K Takeuchi
- Department of Otorhinolaryngology, Mie University School of Medicine, Tsu, Japan
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Gibson PG, Stuart JE, Wlodarczyk J, Olson LG, Hensley MJ. Nasal inflammation and chronic ear disease in Australian Aboriginal children. J Paediatr Child Health 1996; 32:143-7. [PMID: 8860389 DOI: 10.1111/j.1440-1754.1996.tb00911.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Chronic middle ear disease is common in Aboriginal children, and may be linked to nasal inflammation and Eustachian tube dysfunction. The pattern of nasal inflammation is unknown. The study reported here was performed to define the role of allergy and infection in causing nasal inflammation in Aboriginal children with chronic middle ear disease. METHODOLOGY Thirty-one Aboriginal children aged between 3 and 7 years underwent clinical assessment, audiometry and allergy skin tests. Nasal swabs for bacterial culture and cytology were performed during the winter and again in spring to identify any seasonal variation. A randomized trial of nasal beclomethasone for 8 weeks was conducted in children with abnormal tympanometry to identify the effect of therapy upon nasal cytology. RESULTS Twenty-six of the 31 children had abnormal tympanograms. Average hearing levels were reduced in nine children. Pathogenic organisms were isolated from most children: Streptococcus pneumoniae (82%), Haemophilus influenzae (79%), Moraxella catarrhalis (39%) and Staphylococcus aureus (29%). Eight of the 31 children (26%) were atopic. Nasal cytology disclosed a marked neutrophil infiltrate (80% of cells) during the winter, which fell significantly in spring to 52% of cells. Only two subjects had nasal eosinophilia of >10%. There was no effect of beclomethasone on nasal cytology. CONCLUSIONS Chronic ear disease in Aboriginal children is associated with nasal inflammation, neutrophil infiltration and the presence of bacteria. These features suggest respiratory infection as the main cause of chronic nasal inflammation in Aboriginal children with middle ear disease. There is a seasonal variation in the severity of the nasal infiltrate, consistent with increased infections during winter. Despite a high prevalence of atopy, allergic nasal disease was uncommon.
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Affiliation(s)
- P G Gibson
- Department of Respiratory Medicine, John Hunter Hospital, New Lambton, Newcastle, Australia
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Abstract
PURPOSE Interleukin-8 (IL-8), a monocyte-derived and macrophage-derived cytokine, displays potent chemotactic activating properties toward neutrophils and thus may contribute to the pathogenesis of chronic sinusitis. The object of this investigation was to show the expression of the IL-8 gene in chronic sinusitis by Northern blot analysis and a reverse transcription-polymerase chain reaction (RT-PCR). MATERIALS AND METHODS For Northern blot analysis, RNAs were extracted from maxillary mucosa and nasal polyps from two patients with chronic sinusitis, respectively, and from the inferior turbinate of a nasal allergy patient. For RT-PCR, RNAs were extracted from 11 patients with chronic sinusitis, 8 patients with allergic rhinitis, and 4 patients with hypertrophic rhinitis. RESULTS Whereas IL-8 mRNA was expressed in the maxillary mucosa, IL-8 transcript was not detected in the inferior turbinate by Northern blot analysis. IL-8 transcripts were detected in 45% of chronic sinusitis RNAs (5/11) and in 50% of allergic rhinitis RNAs (5/10) by RT-PCR. CONCLUSION These data suggest IL-8 may contribute to neutrophil involvement in chronic sinusitis.
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Affiliation(s)
- K Takeuchi
- Department of Otorhinolaryngology, Mie University School of Medicine, Japan
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Wang D, Clement P, Smitz J, de Waele M, Derde MP. Monitoring nasal allergic inflammation by measuring the concentration of eosinophil cationic protein and eosinophils in nasal secretions. Allergy 1995; 50:147-51. [PMID: 7604937 DOI: 10.1111/j.1398-9995.1995.tb05071.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Quantitative measurement of the eosinophil cationic protein (ECP) concentration and the percentage of eosinophils in nasal secretions has greatly improved our understanding of the inflammatory process after natural allergen exposure. ECP and eosinophils were measured in the nasal secretions of 40 symptomatic patients with seasonal allergic rhinitis during the pollen season. Results showed a significant relationship between a high concentration of ECP (median: 410 ng/g, range: 6-2380 ng/g) and a high percentage of eosinophils (median: 13.5%, range: 1-85%). This quantitative study again demonstrated that infiltration by eosinophils and release of ECP play a key role in allergic rhinitis. It also suggests that the combined measurement of the percentage of eosinophils together with the ECP concentration in nasal secretions seems to be a very useful model in monitoring and assessing the condition of chronic nasal inflammation in patients with allergic rhinitis.
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Affiliation(s)
- D Wang
- Department of Otorhinolaryngology, University Hospital, Free University, Brussels, Belgium
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Testa B, Mesolella M, Testa D, Giuliano A, Costa G, Maione F, Iaccarino F. Glutathione in the upper respiratory tract. Ann Otol Rhinol Laryngol 1995; 104:117-9. [PMID: 7857012 DOI: 10.1177/000348949510400205] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Glutathione (GSH), a major extracellular antioxidant, has been found in high concentrations in the epithelial lining fluid of the lower respiratory tract. The GSH concentrations in nasal fluid, in normal and pathologic conditions, were investigated and found to be very low. A GSH aerosol (600 mg daily for 10 days) increased GSH levels in the nasal mucosa and induced a statistically significant improvement in nasal obstruction, rhinorrhea, and ear fullness. Thus, GSH administered by aerosol could be a means of defending the epithelial respiratory cells against a toxic oxidant.
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Affiliation(s)
- B Testa
- Institute of Otolaryngology, II University of Naples, Italy
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