A proinflammatory marker in chronic rhinosinusitis: serum calprotectin

Introduction: Studies have shown that calprotectin has a strong pro-inflammatory effect. Elevated calprotectin levels in the serum can be used as a strong clinical marker indicating the presence of inflammation. Objective: To investigate serum calprotectin levels in patients with chronic rhinosinusitis (CRS) and to determine the applicability of calprotectin as a potential molecular pro-inflammatory biomarker for CRS. Methods: The study consisted of three groups: chronic rhinosinusitis with polyps (CRSwNP group), chronic rhinosinusitis without polyps (CRSwoNP), and healthy control. CRS patients with polyps were further divided into two groups depending on the presence/absence of Samter’s triad. The Nose Obstruction Symptom Evaluation (NOSE) scale score and serum calprotectin value were evaluated in all participants. Results: The mean serum calprotectin value was 79.5±11.8 ng/ml for the CRSwNP group, 71.3±16 ng/ml for the CRSwoNP group, and 61.9±11.6 ng/ml for the control group (p<0.001). The Samter’s triad group had a significantly higher calprotectin value than the non-Samter’s triad group (p=0.03). There was a significant correlation between the NOSE scores and calprotectin levels (rho=0.734, p<0.001). Conclusion: Serum calprotectin values were correlated with the severity of symptoms in patients with CRS; thus, it seems to be a valuable pro-inflammatory biomarker for the diagnosis of the disease and determining its severity. Further studies with larger series are needed to evaluate the preoperative and postoperative serum calprotectin values ​​in patients undergoing surgery.

Computed tomography findings in patients with Samter’s Triad: an observational study

Samter’s Triad is a disorder characterized by chronic rhinosinusitis (CRS) with nasal polyps (NPs), asthma, and intolerance to cyclooxygenase-1 inhibitors. However, there have been no studies investigating the prediction of Samter’s Triad using imaging findings. Therefore, the authors aimed to investigate whether there is a difference in computed tomography (CT) findings between patients who have CRS with NPs and those with Samter’s Triad. Patients were classified into a CRS group and a Samter group. Opacification was measured using data from CT scans by scoring each sinus on a numerical rating scale ranging from 0 to 4. The opacification scores of the ethmoid and frontal sinuses were significantly higher in the Samter’s Triad group. Furthermore, Samter’s Triad was more common in patients who scored ≤ 2 for maxillary opacification (7/16) than in those who scored ≥3 (4/45, p=0.005). Patients with Samter’s Triad exhibited a tendency toward higher opacification scores for the ethmoid and frontal sinuses, with a relatively lower opacification score for the maxillary sinus. These findings could be helpful in distinguishing patients with Samter’s Triad from those who have CRS with NPs, and to plan treatment strategies without having to perform additional laboratory or radiological tests.

Isotopy classes of embeddings and homotopy

Haefliger's theorem (3) that the group of isotopy classes of embeddings of Sx in Sn when n − x > 2 is isomorphic to the triad group πx+1(G; G(n − x),SO), where G(n − x) is the H-space of homotopy equivalences of Sn−x−1 of degree 1, , and SO is the stable special orthogonal group, is generalized in this paper by replacing Sx and Sn by arbitrary compact connected smooth manifolds Xx, Mn without boundary. The embedding and knot problems are reduced to homotopy theory. The question of P.L. manifolds is discussed in section 4. The case Mn = Sn will be considered first; the generalization is stated in section 3.