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Hellings PW, Klimek L, Cingi C, Agache I, Akdis C, Bachert C, Bousquet J, Demoly P, Gevaert P, Hox V, Hupin C, Kalogjera L, Manole F, Mösges R, Mullol J, Muluk NB, Muraro A, Papadopoulos N, Pawankar R, Rondon C, Rudenko M, Seys SF, Toskala E, Van Gerven L, Zhang L, Zhang N, Fokkens WJ. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy 2017; 72:1657-1665. [PMID: 28474799 DOI: 10.1111/all.13200] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 12/11/2022]
Abstract
This EAACI position paper aims at providing a state-of-the-art overview on nonallergic rhinitis (NAR). A significant number of patients suffering from persistent rhinitis are defined as nonallergic noninfectious rhinitis (NANIR) patients, often denominated in short as having NAR. NAR is defined as a symptomatic inflammation of the nasal mucosa with the presence of a minimum of two nasal symptoms such as nasal obstruction, rhinorrhea, sneezing, and/or itchy nose, without clinical evidence of endonasal infection and without systemic signs of sensitization to inhalant allergens. Symptoms of NAR may have a wide range of severity and be either continuously present and/or induced by exposure to unspecific triggers, also called nasal hyperresponsiveness (NHR). NHR represents a clinical feature of both AR and NAR patients. NAR involves different subgroups: drug-induced rhinitis, (nonallergic) occupational rhinitis, hormonal rhinitis (including pregnancy rhinitis), gustatory rhinitis, senile rhinitis, and idiopathic rhinitis (IR). NAR should be distinguished from those rhinitis patients with an allergic reaction confined to the nasal mucosa, also called "entopy" or local allergic rhinitis (LAR). We here provide an overview of the current consensus on phenotypes of NAR, recommendations for diagnosis, a treatment algorithm, and defining the unmet needs in this neglected area of research.
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Affiliation(s)
- P. W. Hellings
- Clinical division of Otorhinolaryngology Head & Neck Surgery University Hospitals Leuven Leuven Belgium
- Laboratory of Clinical Immunology Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | - L. Klimek
- Center for Rhinology and Allergology Wiesbaden Germany
| | - C. Cingi
- Department of Otorhinolaryngology Head and Neck Surgery University of Eskisehir Osmangazi Eskisehir Turkey
| | - I. Agache
- Department of Allergy and Clinical Immunology Transylvania University Brasov Romania
| | - C. Akdis
- Swiss Institute of Allergy and Asthma Research Christine Kuhne-Center for Allergy Research and Education University of Zurich Davos Switzerland
| | - C. Bachert
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - J. Bousquet
- Hôpital Arnaud de Villeneuve University Hospital of Montpellier Montpellier France
| | - P. Demoly
- Hôpital Arnaud de Villeneuve University Hospital of Montpellier Montpellier France
| | - P. Gevaert
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - V. Hox
- Service d'ORL Cliniques Universitaires St-Luc Brussels Belgium
| | - C. Hupin
- Service d'ORL Cliniques Universitaires St-Luc Brussels Belgium
- Institut de Recherche Expérimentale et Clinique (IREC) Pole de Pneumologie, ORL & Dermatologie Université catholique de Louvain (UCL) Brussels Belgium
| | - L. Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Sestre milosrdnice Zagreb Croatia
| | - F. Manole
- ENT Department Faculty of Medicine University of Oradea Oradea Romania
| | - R. Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology Medical Faculty University of Köln Cologne Germany
| | - J. Mullol
- Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia Hospital Clínic Barcelona Catalonia Spain
| | - N. B. Muluk
- ENT Department Faculty of Medicine Kirikkale University Kirikkale Turkey
| | - A. Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region Department of Mother and Child Health University of Padua Padua Italy
| | - N. Papadopoulos
- Allergy Department 2nd Pediatric Clinic University of Athens Athens Greece
- University of Manchestter Manchester UK
| | | | - C. Rondon
- Allergy Service Carlos Haya Hospital Malaga Spain
| | - M. Rudenko
- London Allergyology and Immunology Center London UK
| | - S. F. Seys
- Laboratory of Clinical Immunology Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | - E. Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery Temple University Philadelphia USA
| | - L. Van Gerven
- Clinical division of Otorhinolaryngology Head & Neck Surgery University Hospitals Leuven Leuven Belgium
- Laboratory of Clinical Immunology Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | - L. Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren Hospital Capital Medical University Beijing China
| | - N. Zhang
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - W. J. Fokkens
- Department of Otorhinolaryngology Head & Neck Surgery Academic Medical Centre (AMC) Amsterdam The Netherlands
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Cingi C, Gevaert P, Mösges R, Rondon C, Hox V, Rudenko M, Muluk NB, Scadding G, Manole F, Hupin C, Fokkens WJ, Akdis C, Bachert C, Demoly P, Mullol J, Muraro A, Papadopoulos N, Pawankar R, Rombaux P, Toskala E, Kalogjera L, Prokopakis E, Hellings PW, Bousquet J. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin Transl Allergy 2017; 7:17. [PMID: 28572918 PMCID: PMC5452333 DOI: 10.1186/s13601-017-0153-z] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022] Open
Abstract
This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.
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Affiliation(s)
- C Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - P Gevaert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - R Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany
| | - C Rondon
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - V Hox
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - M Rudenko
- London Allergy and Immunology Centre, London, UK
| | - N B Muluk
- ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - G Scadding
- Royal National Throat, Nose and Ear Hospital, London, UK
| | - F Manole
- Faculty of Medicine, ENT Department, University of Oradea, Oradea, Romania
| | - C Hupin
- Institut de Recherche Expérimentale et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Centre (AMC), Amsterdam, The Netherlands
| | - C Akdis
- Christine Kuhne-Center for Allergy Research and Education, Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - C Bachert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - P Demoly
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
| | - J Mullol
- Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia Spain
| | - A Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - N Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | | | - P Rombaux
- Service d'ORL, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - E Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery, Temple University, Philadelphia, PA USA
| | - L Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Sestre milosrdnice, Zagreb, Croatia
| | - E Prokopakis
- Department of Otorhinolaryngology, University Hospital of Crete, Crete, Greece
| | - P W Hellings
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - J Bousquet
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
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Gohy ST, Hupin C, Pilette C, Ladjemi MZ. Chronic inflammatory airway diseases: the central role of the epithelium revisited. Clin Exp Allergy 2016; 46:529-42. [PMID: 27021118 DOI: 10.1111/cea.12712] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The respiratory epithelium plays a critical role for the maintenance of airway integrity and defense against inhaled particles. Physical barrier provided by apical junctions and mucociliary clearance clears inhaled pathogens, allergens or toxics, to prevent continuous stimulation of adaptive immune responses. The "chemical barrier", consisting of several anti-microbial factors such as lysozyme and lactoferrin, constitutes another protective mechanism of the mucosae against external aggressions before adaptive immune response starts. The reconstruction of damaged respiratory epithelium is crucial to restore this barrier. This review examines the role of the airway epithelium through recent advances in health and chronic inflammatory diseases in the lower conducting airways (in asthma and chronic obstructive pulmonary disease). Better understanding of normal and altered epithelial functions continuously provides new insights into the physiopathology of chronic airway diseases and should help to identify new epithelial-targeted therapies.
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Affiliation(s)
- S T Gohy
- Université catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT and Dermatology, Brussels, Belgium.,Department of Pneumology, Cliniques universitaires St-Luc, Brussels, Belgium
| | - C Hupin
- Université catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT and Dermatology, Brussels, Belgium
| | - C Pilette
- Université catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT and Dermatology, Brussels, Belgium.,Department of Pneumology, Cliniques universitaires St-Luc, Brussels, Belgium.,Institute for Walloon Excellence in Lifesciences and Biotechnology (WELBIO), Brussels, Belgium
| | - M Z Ladjemi
- Université catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT and Dermatology, Brussels, Belgium.,Institute for Walloon Excellence in Lifesciences and Biotechnology (WELBIO), Brussels, Belgium
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Shen C, Hupin C, Froidure A, Detry B, Pilette C. Impaired ICOSL in human myeloid dendritic cells promotes Th2 responses in patients with allergic rhinitis and asthma. Clin Exp Allergy 2015; 44:831-41. [PMID: 24661627 DOI: 10.1111/cea.12308] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 02/25/2014] [Accepted: 02/27/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND Myeloid dendritic cells (mDCs) and costimulatory molecules such as ICOSL/B7H2 play a pivotal role in murine experimental asthma, while little is known in human allergic disease. The aim of this study was to characterize the phenotype and ICOSL expression of mDCs from allergic rhinitis patients (AR) and their functional correlates on mDC regulation of T cell responses. METHODS Human blood myeloid, CD1c(+) DCs were isolated from AR or healthy controls. Expression of costimulatory molecules inducible costimulatory ligand (ICOSL) and programmed death ligand 1 (PD-L1) was analysed in blood mDCs by flow cytometry and in nasal tissue biopsies by dual immunostaining. Blood mDCs were cocultured with (allogeneic) CD4(+) T cells before immunoassays for cytokine responses. RESULTS mDCs from AR patients expressed a lower level of ICOSL, in both blood and nasal tissue. mDCs from AR were constitutively primed to induce Th2 cytokines and TNF in allogeneic CD4(+) T cells, while no difference was observed for IFN-γ or IL-10. Production of IL-10 and IL-12 did not differ between AR and control mDCs. Blockade of ICOSL in control DCs up-regulated IL-13 but not IFN-γ in cocultures with T cells, while PD-L1 blockade up-regulated both IL-13 and IFN-γ. CONCLUSIONS Our data show that mDCs from patients with AR display impaired expression of ICOSL, and this defect licenses mDCs to promote aberrant IL-13- and IL-5-producing Th2 cell responses.
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Affiliation(s)
- C Shen
- Pôle Pneumologie, ORL & Dermatologie, Institut de Recherche Expérimentale & Clinique (IREC), Université Catholique de Louvain (UCL), Brussels, Belgium; Institute for Walloon Excellence in Life Sciences and Biotechnology (WELBIO), Cliniques Universitaires St-Luc, Brussels, Belgium
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Hupin C, Gohy S, Bouzin C, Lecocq M, Polette M, Pilette C. Features of mesenchymal transition in the airway epithelium from chronic rhinosinusitis. Allergy 2014; 69:1540-9. [PMID: 25104359 DOI: 10.1111/all.12503] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) defines a group of disorders characterized by persistent inflammation of the sinonasal tract. Epithelial changes and structural remodelling are present, but whether epithelial differentiation is altered remains uncertain. METHODS To evaluate the differentiation state of the sinonasal epithelium in CRS, sinonasal biopsies from patients with CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP), or with allergic rhinitis (AR), as compared to controls, were processed by immunohistochemistry and RT-qPCR for terminal differentiation (E-cadherin, high molecular weight cytokeratins (Hmw CK) and CK5, vimentin) and lineage differentiation (ß-tubulin IV+ ciliated cells, MUC5AC+ goblet cells, p63 + basal cells). Findings were correlated with subepithelial fibrosis and clinical CT score. RESULTS Expression of E-cadherin was decreased at protein and mRNA levels in CRSwNP and CRSsNP, as compared to controls. Staining for Hmw CKs was also reduced in CRSwNP and CRSsNP, and CK5 mRNA was decreased in CRSwNP. These features were not due to changes in lineage specification, but associated with increases in vimentin-expressing epithelial cells. In addition, vimentin expression correlated with the basement membrane thickening and with CT score, as well as with tissue eosinophils. CONCLUSION Features of epithelial dedifferentiation towards a mesenchymal phenotype are observed in CRSwNP and CRSsNP and correlate with airway fibrosis and inflammation.
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Affiliation(s)
- C. Hupin
- Pole de Pneumologie, ORL & Dermatologie; Institut de Recherche Expérimentale et Clinique (IREC); Université catholique de Louvain (UCL); Brussels Belgium
| | - S. Gohy
- Pole de Pneumologie, ORL & Dermatologie; Institut de Recherche Expérimentale et Clinique (IREC); Université catholique de Louvain (UCL); Brussels Belgium
- Service de Pneumologie; Cliniques Universitaires St-Luc; Brussels Belgium
| | - C. Bouzin
- Imaging Platform; Institut de Recherche Expérimentale et Clinique (IREC); Université catholique de Louvain (UCL); Brussels Belgium
| | - M. Lecocq
- Pole de Pneumologie, ORL & Dermatologie; Institut de Recherche Expérimentale et Clinique (IREC); Université catholique de Louvain (UCL); Brussels Belgium
| | - M. Polette
- SFR CAP-Santé; INSERM UMR-S 903; University of Reims-Champagne-Ardenne; Reims France
| | - C. Pilette
- Pole de Pneumologie, ORL & Dermatologie; Institut de Recherche Expérimentale et Clinique (IREC); Université catholique de Louvain (UCL); Brussels Belgium
- Service de Pneumologie; Cliniques Universitaires St-Luc; Brussels Belgium
- Institute for Walloon Excellence in Lifesciences & Biotechnology (WELBIO); Wavre Belgium
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Hupin C, Rombaux P, Bowen H, Gould H, Lecocq M, Pilette C. Downregulation of polymeric immunoglobulin receptor and secretory IgA antibodies in eosinophilic upper airway diseases. Allergy 2013; 68:1589-97. [PMID: 24117840 DOI: 10.1111/all.12274] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Immunoglobulin (Ig) A represents a first-line defence mechanism in the airways, but little is known regarding its implication in upper airway disorders. This study aimed to address the hypothesis that polymeric Ig receptor (pIgR)-mediated secretory IgA immunity could be impaired in chronic upper airway diseases. METHODS Nasal and ethmoidal biopsies, as well as nasal secretions, were collected from patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) or without nasal polyps (CRSsNP), allergic rhinitis (AR) and controls, and assayed for IgA1/IgA2 synthesis, pIgR expression, production of secretory component (SC), IgA and relevant IgA antibodies, and correlated with local eosinophils and inflammatory features (IL-12, IL-13 and ECP). RESULTS pIgR expression was decreased in the ethmoidal mucosa in patients with CRSwNP (P = 0.003) and in AR (P = 0.006). This pIgR defect was associated with reduced levels of SC (P = 0.007) and IgA antibodies to Staphylococcus aureus enterotoxin B (SAEB) (P = 0.003) in nasal secretions from patients with CRSwNP, and with increased IgA deposition in subepithelial areas. pIgR downregulation was selectively observed in patients with tissue eosinophilia, whilst no clear relation to smoking history was observed. CONCLUSION Epithelial pIgR expression is decreased in patients with CRSwNP and AR and results in decreased SC and IgA antibodies to certain bacterial antigens (SAEB) in nasal secretions of patients with CRSwNP in parallel to subepithelial accumulation of IgA. This defect in mucosal immunity is associated with eosinophilic, Th2-related inflammation.
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Affiliation(s)
- C. Hupin
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
- Service d'ORL; Cliniques Universitaires St-Luc; Brussels Belgium
| | - P. Rombaux
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
- Service d'ORL; Cliniques Universitaires St-Luc; Brussels Belgium
| | - H. Bowen
- Randall Division of Cell and Molecular Biophysics; MRC/Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London; London UK
| | - H. Gould
- Randall Division of Cell and Molecular Biophysics; MRC/Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London; London UK
| | - M. Lecocq
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
| | - C. Pilette
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
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Durand M, Le Guellec S, Pourchez J, Dubois F, Aubert G, Chantrel G, Vecellio L, Hupin C, De Gersem R, Reychler G, Pitance L, Diot P, Jamar F. Sonic aerosol therapy to target maxillary sinuses. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:244-50. [PMID: 22921302 DOI: 10.1016/j.anorl.2011.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/30/2011] [Accepted: 09/06/2011] [Indexed: 10/28/2022]
Abstract
AIM Intranasal aerosol administration of drugs is widely used by ENT specialists. Although clinical evidence is still lacking, intranasal nebulization appears to be an interesting therapeutic option for local drug delivery, targeting anatomic sites beyond the nasal valve. The sonic nebulizer NL11SN associates a 100Hertz (Hz) sound to the aerosolization to improve deposition in the nasal/paranasal sinuses. The aim of the present study was: to evaluate in vivo the influence of associating a 100Hz sound on sinus ventilation and nasal and pulmonary aerosol deposition in normal volunteers, and; to quantify in vitro aerosol deposition in the maxillary sinuses in a plastinated head model. MATERIAL AND METHODS Scintigraphic analysis of (81m)Kr gas ventilation and of sonic aerosol ((99m)Tc-DTPA) deposition using the NL11SN was performed in vivo in seven healthy volunteers. In parallel, NL11SN gentamicin nebulization was performed, with or without associated 100Hz sound, in a plastinated human head model; the gross amount of gentamicin delivered to the paranasal sinuses was determined by fluorescence polarization immunoassay. RESULTS Associating the 100Hz sound to (81m)Kr gas ensured paranasal sinus ventilation in healthy volunteers. (99m)Tc-DTPA particles nebulized with the NL11SN were deposited predominantly in the nasal cavities (2/3, vs 1/3 in the lungs). In vitro, the use of NL11SN in sonic mode increased gentamicin deposition threefold in the plastinated model sinuses (P<0.002); the resulting antibiotic deposit would be sufficient to induce a local therapeutic effect. CONCLUSION The NL11SN nebulizer ensured preferential nasal cavity aerosol deposition and successfully targeted the maxillary sinuses.
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Affiliation(s)
- M Durand
- Service d'ORL et chirurgie cervico-faciale, centre hospitalier Émile-Roux, Le Puy-en-Velay, France.
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Le Guellec S, Durand M, Pourchez J, Dubois F, Aubert G, Chantrel G, Vecellio L, Hupin C, De Gersem R, Reychler G, Pitance L, Le Pennec D, Diot P, Jamar F. WS24.3 Evaluation of the performance of sonic nebuliser to target maxillary sinuses. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bogaerts M, Deggoujf N, Huart C, Hupin C, Laureyns G, Lemkens P, Rombaux P, Ten Bosch JVDW, Gordts F. Physiology of the mouth and pharynx, Waldeyer's ring, taste and smell. B-ENT 2012; 8 Suppl 19:13-20. [PMID: 23431608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
This paper reviews the contribution of the different parts of the oral cavity and the pharynx to the basic physiology of breathing, phonation, speech, swallowing, and of Waldeyer's ring to the functioning of the immune system. We discuss the development of taste and smell, as well as possibilities for chemosensory testing in children.
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Affiliation(s)
- M Bogaerts
- Department of Otorhinolaryngology, Head and Neck Surgery, Ziekenhuis Oost Limburg, Genk, Belgium
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Deggouj N, Castelein S, Grégoire A, Laroche H, De Graeuwe C, de Toeuf C, Desuter G, Rombaux P, Hupin C. Functional consequences of chronic ENT inflammation on the development of hearing and communicative abilities. B-ENT 2012; 8 Suppl 19:105-115. [PMID: 23431614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Hearing processing and communication abilities development may be influenced by chronic inflammation of the airways in children, especially in case of otitis media and/or adenotonsillar hypertrophy. The present review summarizes the influence of adenotonsillar hypertrophy on speech abilities as well as the consequences of otitis media, with a particular focus on peripheral and central hearing, on the development of language, attention, and memory skills.
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Affiliation(s)
- N Deggouj
- Department of Otorhinolaryngology, Head and Neck Surgery, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium.
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Hupin C, Mahy P, Huart C, Pitance L, de Toeuf C, Rombaux P, Deggouj N. Consequences of chronic inflammation in children on facial growth, growth, behavioural disorders and smell. B-ENT 2012; 8 Suppl 19:117-122. [PMID: 23431615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Adenotonsillar hypertrophy is a common paediatric/otolaryngological disorder that may be associated with secondary growth or facial growth impairment, sleep disturbances, neurocognitive deficits, or smell loss. Surgical removal of the hypertrophic tissue eliminates the mechanical obstacle of the airways and is therefore curative in most cases. The purpose of the present review is to outline the impact of adenotonsillar hypertrophy and adenotonsillectomy on growth, facial growth, sleep, behaviour and smell.
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Affiliation(s)
- C Hupin
- Department of Otorhinolaryngology, Head and Neck Surgery, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium.
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Mayet A, Duron S, Nivoix P, Haus-Cheymol R, Ligier C, Gache K, Dia A, Manet G, Verret C, Pommier de Santi V, Bigaillon C, Martinaud C, Piarroux M, Faure N, Hupin C, Decam C, Chaudet H, Meynard JB, Nicand E, Deparis X, Migliani R. Novel influenza A(H1N1) outbreak among French armed forces in 2009: results of Military Influenza Surveillance System. Public Health 2011; 125:494-500. [PMID: 21767855 DOI: 10.1016/j.puhe.2011.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 12/07/2010] [Accepted: 04/25/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVES An outbreak of novel A(H1N1) virus influenza, detected in Mexico in April 2009, spread worldwide in 9 weeks. The aim of this paper is to present the monitoring results of this influenza outbreak among French armed forces. STUDY DESIGN The period of monitoring by the Military Influenza Surveillance System (MISS) was 9 months, from May 2009 to April 2010. METHODS The main monitored events were acute respiratory infection (ARI), defined by oral temperature ≥38.5 °C and cough, and laboratory-confirmed influenza. Weekly incidence rates were calculated by relating cases to the number of servicepersons monitored. RESULTS In continental France, the incidence of ARI increased from September 2009, with a weekly maxima of 401 cases per 100,000 in early December 2009 according to MISS. Estimations of the incidence of consultations which could be related to novel A(H1N1) influenza ranged from 48 to 57 cases per 100,000. CONCLUSIONS The trends observed by MISS are compatible with French national estimations. The incidence of consultations which could be related to A(H1N1) influenza at the peak of the epidemic (194 cases per 100,000) was much lower than the national estimate (1321 cases per 100,000). This may be due to servicepersons who consulted in civilian facilities and were not monitored. Other explanations are the healthy worker effect and the younger age of the military population.
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Affiliation(s)
- A Mayet
- Department of Epidemiology and Public Health, Northern Sector, Val-de-Grace School of Military Medicine, Paris, France
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Hupin C, Weynand B, Rombaux P. Lymphoepithelial cyst of the nasogenian sulcus: a case report. B-ENT 2010; 6:49-51. [PMID: 20420080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
A rare case of lymphoepithelial cyst formed in the nasogenian sulcus is reported. Lymphoepithelial cysts are comprised of a stratified squamous epithelial lining above dense lymphoid tissue. They are uncommon in the oral region and, to our knowledge, have never been reported in the nasogenian sulcus. Surgical excision was performed and no recurrence was noted after 6 months. In this report, we describe the etiopathogenesis of lymphoepithelial cysts, as well as the differential diagnosis of nasogenian sulcus swellings.
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Affiliation(s)
- C Hupin
- Department of Otorhinolaryngology and Head and Neck Surgery, Catholic University of Louvain, University Hospital St. Luc, Brussels, Belgium
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Hupin C, Lévèque N, Eloy P, Bertrand B, Rombaux P. Congenital dacryocystocele: five clinical cases. B-ENT 2008; 4:141-145. [PMID: 18949960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Congenital dacryocystocele (CDC) is recognised as a cause of nasal airway obstruction or respiratory distress in newborns. CDC is caused by the distal obstruction of the lachrymal duct and presents as a cystic formation in the inferior meatus. We discuss five cases of dacryocystocele, together with surgical management and outcome. Endoscopic endonasal marsupialisation and appropriate postoperative care resulted in definitive recovery for all patients. In newborns or infants with nasal obstruction, CDC should be considered in the differential diagnosis, and prompt endoscopic endonasal marsupialisation is mandatory.
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Affiliation(s)
- C Hupin
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Louvain, Cliniques Saint Luc, Brussels, Belgium
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Hupin C, de Suray JM, Versluys J, Lorent M, Dodion L, Lesne M. Bioavailability study of gitoxin in a solid dosage form. Int J Clin Pharmacol Biopharm 1979; 17:197-204. [PMID: 468445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although the cardiotonic activity of gitoxin is known for almost half a century, this digitalis glycoside has never been used in therapy, due to its apparent lack of resorption after administration by oral route. Recent studies have demonstrated that the bioavailability of gitoxin could be upraised to 100% provided it be given as a hydroalcoholic solution. The present paper deals with the development of a solid dosage form (tablets) using a physical association of gitoxin and sodium escinate.
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De Becker J, Hupin C, Massart N. [Analysis of volatile constituents in aerosols using gas chromatography]. J Pharm Belg 1967; 22:188-98. [PMID: 5615273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Hupin C. [Identification of a mono-formyl-xi-gitoxin obtained after formylation of gitoxin]. J Pharm Belg 1966; 21:515-21. [PMID: 5976610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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