Predictive factors for identifying macrolide responder in treating chronic rhinosinusitis

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
K. Seresirikachorn ◽  
S.J. Kerr ◽  
S. Aeumjaturapat ◽  
S. Chusakul ◽  
J. Kanjanaumporn ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chronic Rhinosinusitis ◽  
Nasal Secretion ◽  
Receiver Operating Curve ◽  
Total Ige ◽  
Receiver Operating Curve Analysis ◽  
Nasal Secretions ◽  
Aspirin Hypersensitivity ◽  
Independent Association ◽  
Serum Total Ige

BACKGROUND: Low-dose macrolides (LDM) are anti-inflammatory agents with antineutrophilic activity, but patient selection for LDM therapy in treating chronic rhinosinusitis (CRS) is controversial. This study aimed to assess factors which predict LDM responders. METHODOLOGY: A prospective cohort study was performed. Patients with CRS received roxithromycin (150 mg) once daily for 12 weeks. Nasal secretions and serology were collected. Nine predictors for LDM response were assessed: nasal secretion IgE, nasal secretion IL-5, serum IgE, serum eosinophils, serum neutrophils, nasal polyps, asthma, allergy, and aspirin hypersensitivity, using receiver-operating curve analysis and multivariable logistic regression. Macrolide responders were those with sino-nasal outcome test-22 improvement, symptoms visual analogue scale decreased to ≤5, and no rescue medication. RESULTS: One hundred CRS patients (mean age 47.4±14.1 years, 45% male) were enrolled. Univariable logistic regression showed local total IgE less than 5.21; and serum eosinophils less than 2.2% associated with macrolide response. Multivariate models showed local total IgE maintained an independent association with macrolide response, with an ability to discriminate between responders and non-responders of 63%. Serum total IgE, nasal secretion IL-5, serum neutrophil, nasal polyp, asthma, allergy, and aspirin hypersensitivity showed no association with LDM response. CONCLUSIONS: Low total IgE level in the nasal secretion but not in the serum, predict LDM response.

scholarly journals Association between methylation in nasal epithelial TSLP gene and chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Jingyun Li ◽  
Jian Jiao ◽  
Yunbo Gao ◽  
Yuan Zhang ◽  
Luo Zhang
Keyword(s):  
Dna Methylation ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Inferior Turbinate ◽  
Nasal Resistance ◽  
Total Ige ◽  
Control Subjects ◽  
Human Nasal Epithelial Cells ◽  
Serum Total Ige ◽  
And Control

Abstract Background This study was performed to determine whether there was any association between abnormal DNA methylation of a thymic stromal lymphopoietin (TSLP) locus and pathogenesis of chronic rhinosinusitis (CRS). Methods A total of 48 CRS patients with nasal polyps (CRSwNP), 28 CRS patients without nasal polyps (CRSsNP) and 21 control subjects were enrolled into the study; and evaluated for serum total IgE level, olfactory score and nasal resistance. Samples were obtained from nasal polyps of CRSwNP patients, ethmoid mucosae of CRSsNP patients and inferior turbinate (IT) mucosa of control subjects during surgery, and used to isolate purified primary human nasal epithelial cells (HNECs). Genomic DNA was extracted from purified primary HNECs of each subject and DNA methylation ratios for a selected region of the TSLP gene were screened the using MassARRAY EpiTYPER. Results A total of 17 CpG units were analyzed; of which two CpG units (CpG3 and 22:23:24) had increased methylation ratios in the CRSwNP patients compared to the CRSsNP and control subjects after correction for false discovery rate (FDR) (Q < 0.1). The methylation ratios at both CpG3 and CpG22:23:24 units were positively correlated with olfactory score (r = 0.41, P = 0.0001; r = 0.25, P = 0.021) and unilateral nasal resistance at 75 Pa (r = 0.24, P = 0.04; r = 0.24, P = 0.036) and 150 Pa (r = 0.34, P = 0.004; r = 0.25, P = 0.031). Total nasal resistance at 75 Pa/150 Pa or serum total IgE levels were not correlated with the methylation ratios at either CpG unit. Conclusions Increased DNA methylation at the TSLP locus is likely to be associated with CRSwNP pathogenesis; however these findings need to be confirmed in larger multicentre group studies.

Predictive Significance of Charcot-Leyden Crystal Protein in Nasal Secretions in Recurrent Chronic Rhinosinusitis with Nasal Polyps

2020 ◽  
Vol 182 (1) ◽  
pp. 65-75
Author(s):  
Di Wu ◽  
Bing Yan ◽  
Yang Wang ◽  
Luo Zhang ◽  
Chengshuo Wang
Keyword(s):  
Logistic Regression ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Outpatient Service ◽  
Binary Logistic Regression ◽  
Sinus Surgery ◽  
Youden Index ◽  
Predictive Values ◽  
Nasal Secretions ◽  
Polyp Recurrence

<b><i>Introduction:</i></b> The recurrence occurs frequently among patients with chronic rhinosinusitis with nasal polyps (CRSwNP), and predictors that could be conveniently detected during practice in outpatient service are needed. <b><i>Objective:</i></b> We aimed to illustrate that the concentration of Charcot-Leyden crystal (CLC) in nasal secretions can effectively and noninvasively predict polyp recurrence. <b><i>Methods:</i></b> 108 patients with CRSwNP were divided into recurrence (<i>n</i> = 68) and recurrence-free (<i>n</i> = 40) groups. Preoperative CLC concentrations in nasal secretions were collected and detected by ELISA. Polyp tissues were harvested during biopsy or endoscopic sinus surgery and were evaluated for inflammatory cells by histopathological staining. Demographic information and the clinical characteristics of each patient were reviewed for associations with recurrence. Binary logistic regression analysis was performed to determine predictive factors for polyp recurrence. Receiver operating characteristic (ROC) curves and the Youden index were performed to determine their predictive values. Survival analysis was performed to compare recurrence risk of patients with different CLC concentrations. <b><i>Results:</i></b> Sixty-eight (62.96%) patients developed recurrence during a 12- to 33-month postoperative follow-up. CLC concentrations in nasal secretions were positively correlated with eosinophil percent in polyp tissue and peripheral blood and were significantly higher in patients of the recurrence group than in the patients of the recurrence-free group (<i>p &#x3c;</i> 0.001). Binary logistic regression and ROC curve demonstrated that CLC protein in nasal secretions is predictive of polyp recurrence. According to the Youden index, a CLC concentration of 34.24 ng/mL can predict postoperative polyp recurrence with 92.6% sensitivity and 87.5% specificity. Patients with CLC concentrations higher than the cutoff value yielded a higher risk of recurrence (<i>p &#x3c;</i> 0.001, HR = 11.31, 95% CI: 6.41–19.98). <b><i>Conclusions:</i></b> CLC protein in nasal secretions may serve as a promising noninvasive biomarker to predict CRSwNP recurrence.

scholarly journals Association between obesity and chronic rhinosinusitis with nasal polyps: a national population-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047230
Author(s):  
Jae-Sung Nam ◽  
Yun Ho Roh ◽  
Wasan Almazouq Fahad ◽  
Hae-Eun Noh ◽  
Jong-Gyun Ha ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Chronic Rhinosinusitis ◽  
Logistic Regression Analysis ◽  
Central Obesity ◽  
Nasal Polyps ◽  
Control Group ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

ObjectivesWe performed a cross-sectional analysis of data from the nationwide Korea National Health and Nutrition Examination Survey to evaluate the association between obesity and chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyp (CRSsNP).DesignRetrospective cross-sectional analysis of health survey data.SettingVoluntary survey of representative South Korean populations.ParticipantsIn total, 32 384 individuals aged 19 years or older with available data on CRS and obesity were included.Primary and secondary outcome measuresDiagnosis of CRSwNP or CRSsNP was performed by trained otolaryngologists through sinus endoscopy and surveys of medical history. General and central obesity was diagnosed using body mass index (BMI) and waist circumference (WC), respectively.MethodsA multivariate logistic regression analysis was used to clarify the association between CRSwNP or CRSsNP and obesity according to BMI and WC. Non-obese individuals were recruited as controls.ResultsThe prevalence of CRSwNP was higher in the general (OR, 1.438; 95% CI, 1.170 to 1.768; p<0.001) and central (OR, 1.251; 95% CI, 1.031 to 1.520; p=0.033) obesity groups than in the control group. Prevalence of CRSsNP was not correlated with obesity. In a logistic regression analysis, olfactory dysfunction (OR, 1.329; 95% CI, 1.137 to 1.553; p<0.001) and purulent discharge (OR, 1.383; 95% CI, 1.193 to 1.603; p<0.001) showed a higher incidence in the central obesity group than in the control group.ConclusionsWe demonstrated an association between CRSwNP and general and central obesity. Further investigations on the mechanism underlying this correlation are necessary for an improved understanding of the pathogenesis of CRSwNP.

Associations of Quantity Smoked and Socioeconomic Status With Smoke-Free Homes and Cars Among Daily Smokers

2021 ◽  
pp. 109019812110104
Author(s):  
Annie Pelekanakis ◽  
Jennifer L. O’Loughlin ◽  
Katerina Maximova ◽  
Annie Montreuil ◽  
Jodi Kalubi ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Logistic Regression ◽  
Household Income ◽  
Employment Status ◽  
Telephone Survey ◽  
Low Ses ◽  
Annual Household Income ◽  
Cross Sectional ◽  
Shs Exposure ◽  
Independent Association

Introduction An association between socioeconomic status (SES) and smoke-free private spaces among smokers could be due to heavier smoking among low SES smokers. We assessed whether quantity smoked or SES are independently associated with smoke-free homes or cars in daily smokers. Method Data were drawn from a cross-sectional telephone survey (2011–2012) of 750 daily smokers age ≥18 years in Quebec, Canada (45% response). Multivariable logistic regression was used to model the independent association between (a) number of cigarettes smoked per day, and (b) each of educational attainment, annual household income, or active employment status and smoke-free homes or cars. Results Participants were 41.0 years old on average, 57% were female. Median (IQR) number of cigarettes smoked per day was 14 (10, 20). Forty-eight percent of participants reported smoke-free homes; 34% reported smoke-free cars. Quantity smoked was strongly associated with both smoke-free homes and cars. Income and education (but not actively employed) were associated with smoke-free homes. None of the SES indicators were associated with smoke-free cars. Conclusions Interventions targeting smokers to promote smoke-free homes and cars should incorporate components to help smokers reduce quantity smoked or preferably, to quit. Interventions targeting smoke-free homes will also need to address SES inequalities by education and income. Our data suggest that reduction in quantity smoked may help smokers reduce SHS exposure in cars, but that an inequality lens may not be relevant.

Neuron-Specific Enolase in Nasal Secretions as a Novel Biomarker of Olfactory Dysfunction in Chronic Rhinosinusitis

2016 ◽  
Vol 30 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Namjil N. Tsybikov ◽  
Elena V. Egorova ◽  
Boris I. Kuznik ◽  
Elena V. Fefelova ◽  
Eli Magen
Keyword(s):  
Chronic Rhinosinusitis ◽  
Neuron Specific Enolase ◽  
Olfactory Dysfunction ◽  
Nasal Secretions

Carbonic Anhydrase in Human Nasal Epithelium: Localization and Effect of the Inhibition by Dichlorphenamide

1996 ◽  
Vol 10 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Franco Cavaliere ◽  
Simonetta Masieri ◽  
Stefania Nori ◽  
Sergio I. Magalini ◽  
Salvatore R. Allegra
Keyword(s):  
Carbonic Anhydrase ◽  
Nasal Mucosa ◽  
Ph Value ◽  
Inferior Turbinate ◽  
Nasal Secretion ◽  
Human Nasal Mucosa ◽  
Human Nasal Epithelium ◽  
Stratified Squamous Epithelium ◽  
Nasal Secretions ◽  
K Concentration

Carbonic anhydrase has not hitherto been reported in nasal mucosa. In the first part of this study, five specimens of human nasal mucosa from the inferior turbinate were obtained from five healthy subjects and tested for this enzyme with a histochemical reaction. Carbonic anhydrase was identified in the columnar ciliated respiratory epithelium, but was absent in the adjacent stratified squamous epithelium. The effect of the inhibition of this enzyme on the pH values and Na, K, and Cl activity in nasal secretion was subsequently investigated. Fifteen patients, affected by endocranial hypertension and to whom dichlorphenamide—an inhibitor of carbonic anhydrase—was administered, were studied. The pH value, determined with a surface electrode before giving the drug and 30, 60, and 90 minutes later, significantly increased and reached a peak at 60 minutes. Na, K, and Cl concentration was assessed by indirect potentiometry in the nasal secretion and in the plasma both before giving dichlorphenamide and 60 minutes later. Although no change was observed in the plasma, in the nasal secretion Na and Cl concentration increased and K concentration decreased. As a consequence, the gradients of Na and K between plasma and secretion decreased, and that of Cl increased. We assume analogous changes in the rate of transport through the mucosa to occur. These results thus suggest that carbonic anhydrase is involved in control of the pH of nasal secretions as well as in the electrolyte transport through the epithelium.

Ultrasonic Adaptive Sound Speed Estimation for the Diagnosis and Quantification of Hepatic Steatosis: A Pilot Study

2018 ◽  
Vol 40 (06) ◽  
pp. 722-733 ◽  
Author(s):  
Marco Dioguardi Burgio ◽  
Marion Imbault ◽  
Maxime Ronot ◽  
Alex Faccinetto ◽  
Bernard E. Van Beers ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Sound Speed ◽  
Validation Cohort ◽  
Liver Steatosis ◽  
Receiver Operating Curve ◽  
Coefficient Of Determination ◽  
Proton Density ◽  
Speed Estimation ◽  
Training Cohort ◽  
Receiver Operating Curve Analysis

Abstract Purpose To evaluate the ability of a new ultrasound (US) method based on sound speed estimation (SSE) with respect to the detection, quantification, and grading of hepatic steatosis using magnetic resonance (MR) proton density fat fraction (PDFF) as the reference standard and to calculate one US fat index based on the patient’s SSE. Materials and Methods This study received local IRB approval. Written informed consent was obtained from patients. We consecutively included N = 50 patients as the training cohort and a further N = 50 as the validation cohort who underwent both SSE and abdominal MR. Hepatic steatosis was classified according to MR-PDFF cutoffs as: S0 ≤ 6.5 %, S1 6.5 to 16.5 %, S2 16.5 to 22 %, S3 ≥ 22 %. Receiver operating curve analysis was performed to evaluate the diagnostic performance of SSE in the diagnosis of steatosis (S1–S3). Based on the optimal data fit derived from our study, we proposed a correspondence between the MR-PDFF and a US fat index. Coefficient of determination R2 was used to evaluate fit quality and was considered robust when R2 > 0.6. Results The training and validation cohorts presented mean SSE values of 1.570 ± 0.026 and 1.568 ± 0.023 mm/µs for S0 and 1.521 ± 0.031 and 1.514 ± 0.019 mm/µs for S1–S3 (p < 0.01) patients, respectively. An SSE threshold of ≤ 1.537 mm/µs had a sensitivity of 80 % and a specificity of 85.7 % in the diagnosis of steatosis (S1-S3) in the training cohort. Robust correspondence between MR-PDFF and the US fat index was found both for the training (R2 = 0.73) and the validation cohort (R2 = 0.76). Conclusion SSE can be used to detect, quantify and grade liver steatosis and to calculate a US fat index.

scholarly journals Erratum: In-Depth, Proteomic Analysis of Nasal Secretions from Patients With Chronic Rhinosinusitis and Nasal Polyps

2020 ◽  
Vol 12 (4) ◽  
pp. 744
Author(s):  
Yi-Sook Kim ◽  
Dohyun Han ◽  
JinYoup Kim ◽  
Dae Woo Kim ◽  
Yong-Min Kim ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Proteomic Analysis ◽  
Nasal Polyps ◽  
Nasal Secretions
Sign in / Sign up

Export Citation Format

Share Document