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[PMID]: 29287887
[Au] Autor:Hamill CS; Sykes KJ; Harrison CJ; Weatherly RA
[Ad] Address:University Hospitals Cleveland Medical Center, United States. Electronic address: chelsea.hamill@uhhospitals.org.
[Ti] Title:Infection rates of MRSA in complicated pediatric rhinosinusitis: An up to date review.
[So] Source:Int J Pediatr Otorhinolaryngol;104:79-83, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Published studies have reported a rise in MRSA isolates in head and neck infections, but the microbiology of complicated pediatric rhinosinusitis is unclear. One study of such patients showed that MRSA isolates were seen only in the last three years of data collection, suggesting a possible recent increased prevalence. Given the public health concerns of increasing rates of antimicrobial resistance, the goal of this study was to investigate the microbiologic patterns and outcomes of complicated pediatric rhinosinusitis. METHODS: Retrospective cohort of pediatric patients admitted to our children's hospital with complicated acute rhinosinusitis from 2004 to 2014. RESULTS: The mean age of 250 hospitalized children with complicated rhinosinusitis was 7.6 ± 4.9 years; 109 of these (43%) underwent surgical procedures. Although MRSA prevalence was highest in 2014, no significant trend in overall MRSA prevalence occurred when considering the entire study period. No significant relationship was identified between MRSA and intra-orbital versus intra-cranial complications. Interestingly, 22.7% of patients with anaerobes detected by culture had persistent abnormal physical examination (PE) findings versus 6.1% of patients without anaerobes (p = 0.025). Furthermore, multivariate analysis also revealed that detection of anaerobes or MRSA was associated with persistent PE findings being 21.8 and 14.8 times more likely, respectively, when compared to other detected pathogens. DISCUSSION: Our data indicate modest variability in the annual rates of MRSA associated pediatric rhinosinusitis, however there was no statistically significant pattern of change in MRSA prevalence during 2004-2014. Although detection of MRSA was not significantly associated with either intraorbital or intracranial complications of sinusitis, a significant association with a poorer outcome was observed by multivariate analysis for patients from whom MRSA or anaerobes were detected. These data raise the question as to whether clindamycin is adequate for MRSA and anaerobic coverage.
[Mh] MeSH terms primary: Methicillin-Resistant Staphylococcus aureus
Rhinitis/microbiology
Sinusitis/microbiology
Staphylococcal Infections/epidemiology
[Mh] MeSH terms secundary: Adolescent
Child
Child, Preschool
Cohort Studies
Female
Humans
Infant
Male
Prevalence
Retrospective Studies
Rhinitis/complications
Sinusitis/complications
Staphylococcal Infections/diagnosis
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:171231
[St] Status:MEDLINE

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[PMID]: 28452707
[Au] Autor:Roxbury CR; Smith DF; Higgins TS; Lee SE; Gallia GL; Ishii M; Lane AP; Reh DD
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
[Ti] Title:Complete surgical resection and short-term survival in acute invasive fungal rhinosinusitis.
[So] Source:Am J Rhinol Allergy;31(2):109-116, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Acute invasive fungal rhinosinusitis (AIFR) is a fulminant fungal infection seen in patients who are immunocompromised. Due to its rarity, there is little evidence regarding the appropriate antifungal treatment regimen, especially the degree of surgical intervention. OBJECTIVE: To assess factors that impact short-term survival in AIFR as defined by survival to hospital discharge and to develop a staging system to predict survival and complete surgical resection. METHODS: Fifty-four patients with histopathologically diagnosed AIFR who met inclusion criteria were identified between 1984 and 2014. Patient characteristics, disease extent, treatment modality, and short-term survival data were collected. Univariate analysis was performed to assess for factors associated with survival and increased likelihood of surgical resection. RESULTS: Of 52 patients with adequate documentation, 36 (69.2%) survived their hospital stay. Complete surgical resection was the only factor associated with improved survival (survival, 95.5%; p < 0.01). A surgical staging system was proposed to guide probability of complete resection and overall prognosis, with stage I disease limited to the nasal cavity, stage II involving the paranasal sinuses, stage III involving the orbit, and stage IV with skull base or intracranial extension. The χ2 analyses showed a decreased likelihood of complete surgical resection with stage III or IV disease compared with stage I (resection, 90.9%) (stage III resection, 37.5% [p = 0.01]; stage IV resection, 16.7% [p = 0.002]). There was a decreased likelihood of survival associated with increasing disease stage compared with stage I (survival, 100%) (stage II survival, 60% [p = 0.009]; stage III survival, 62.5% [p = 0.02]; stage IV survival, 54.6%, [p = 0.006]). CONCLUSION: Although further studies are needed to define specific treatment protocols, analysis of these data indicated that endoscopic sinus surgery with the goal of complete surgical resection may provide the best survival outcomes in select patients when complete surgical resection can be performed. Our staging system represents the first attempt to predict surgical success and prognosis in patients with AIFR.
[Mh] MeSH terms primary: Invasive Pulmonary Aspergillosis/surgery
Nasal Cavity/surgery
Orbit/surgery
Otorhinolaryngologic Surgical Procedures
Paranasal Sinuses/surgery
Rhinitis/surgery
Sinusitis/surgery
[Mh] MeSH terms secundary: Acute Disease
Adolescent
Adult
Aged
Child
Female
Humans
Immunocompromised Host
Invasive Pulmonary Aspergillosis/mortality
Male
Middle Aged
Nasal Cavity/microbiology
Orbit/microbiology
Paranasal Sinuses/microbiology
Prognosis
Rhinitis/mortality
Sinusitis/mortality
Survival Analysis
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4420

  3 / 23399 MEDLINE  
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[PMID]: 28452704
[Au] Autor:Yan CH; Hahn S; McMahon D; Bonislawski D; Kennedy DW; Adappa ND; Palmer JN; Jiang P; Lee RJ; Cohen NA
[Ad] Address:Department of Otorhinolaryngology-Head and Neck Surgery, Division of Rhinology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
[Ti] Title:Nitric oxide production is stimulated by bitter taste receptors ubiquitously expressed in the sinonasal cavity.
[So] Source:Am J Rhinol Allergy;31(2):85-92, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Bitter taste receptors (T2R) have recently been demonstrated to contribute to sinonasal innate immunity. One T2R, T2R38, regulates mucosal defense against gram-negative organisms through nitric oxide (NO) production, which enhances mucociliary clearance and directly kills bacteria. To determine whether additional T2Rs contribute to this innate defense, we evaluated two other sinonasal T2Rs (T2R4 and T2R16) for regulation of NO production and expression within the human sinonasal cavity. METHODS: Primary human sinonasal cultures were stimulated with ligands specific to T2R4 and T2R16, colchicine and D-salicin, respectively. Cellular NO production was measured by intracellular 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate fluorescence. For T2R expression mapping, sinonasal tissue was obtained from patients who underwent sinus surgery of the middle turbinate, maxillary sinus, ethmoid sinus, or sphenoid sinus. The expression of T2R4, T2R16, and T2R38 was evaluated by using immunofluorescence with validated antibodies. RESULTS: Similar to T2R38, T2R4 and T2R16 trigger NO production in a dose-dependent manner by using the canonical taste signaling pathway in response to stimulation with their respective ligands. All three receptors were expressed in the cilia of human epithelial cells of all regions in the sinonasal cavity. CONCLUSION: These three T2Rs signaled through the same NO-mediated antimicrobial pathway and were ubiquitously expressed in the sinonasal epithelium. Additional T2Rs besides T2R38 may play a role in sinonasal immune defense. Mapping of T2R expression demonstrated the potential widespread role of T2Rs in sinonasal defense, whereas the genetics of these T2Rs may contribute to our understanding of specific endotypes of chronic rhinosinusitis and develop into novel therapeutic targets.
[Mh] MeSH terms primary: Bacterial Infections/immunology
Nasal Mucosa/immunology
Paranasal Sinuses/metabolism
Receptors, G-Protein-Coupled/metabolism
Rhinitis/immunology
Sinusitis/immunology
Taste
[Mh] MeSH terms secundary: Bacteriolysis
Cells, Cultured
Chronic Disease
Humans
Immunity, Innate
Mucociliary Clearance
Nasal Mucosa/microbiology
Nitric Oxide/metabolism
Primary Cell Culture
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Receptors, G-Protein-Coupled); 0 (taste receptors, type 2); 31C4KY9ESH (Nitric Oxide)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4424

  4 / 23399 MEDLINE  
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[PMID]: 29521765
[Au] Autor:Aubin-Lemay C; Acar P; Alnaif N; Alamri A; Azzi AJ; Cugno S
[Ad] Address:Division of Plastic and Reconstructive Surgery, Montreal Children's Hospital, McGill University, Montreal.
[Ti] Title:An Extremely Rare Cause of Orbital Emphysema in a Child.
[So] Source:J Craniofac Surg;, 2018 Mar 08.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The authors present a rare case of nontraumatic medial orbital wall fracture in an 11-year-old girl. Fractures of the orbital wall secondary to nose blowing have not been previously described in the pediatric population. The patient reported a history of chronic forceful nose blowing, followed by periorbital swelling after an episode of vigorous nose blowing. Erroneous diagnoses of sinusitis and periorbital cellulitis lead to unnecessary antibiotic treatment. The authors hypothesize that repeated and aggressive nose blowing is analogous to stress fractures, leading to weakening and eventual fracture of the medial orbital wall.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1097/SCS.0000000000004465

  5 / 23399 MEDLINE  
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[PMID]: 29519311
[Au] Autor:Warren WA; Franco-Palacios D; King CS; Shlobin OA; Nathan SD; Katugaha SB; Mani H; Brown AW
[Ad] Address:Walter Reed National Military Medical Center Department of Pulmonary and Critical Care, Walter Reed Military Medical Center, Bethesda, MD. Electronic address: Whittney.Warren@gmail.com.
[Ti] Title:A 24-Year-Old Woman With Precipitous Respiratory Failure After Lung Transplantation.
[So] Source:Chest;153(3):e53-e56, 2018 Mar.
[Is] ISSN:1931-3543
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:CASE PRESENTATION: A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation. Two days after surgery, she developed acute respiratory failure requiring mechanical ventilation. On day 4 of mechanical ventilation, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was initiated for refractory respiratory failure. The following day, she was listed for bilateral lung transplant and was transplanted 4 days later. Following transplantation, she was decannulated from ECMO; however, over the next 12 hours, oxygenation deteriorated requiring reinstitution of VV-ECMO for presumed severe primary graft dysfunction. Despite treatment with broad spectrum antimicrobial coverage with piperacillin/tazobactam, ciprofloxacin, linezolid, micafungin, voriconazole, and ganciclovir, she failed to improve and developed complex bilateral pleural effusions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review

  6 / 23399 MEDLINE  
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[PMID]: 29240302
[Au] Autor:Choi KJ; Cheng TZ; Honeybrook AL; Gray AL; Snyder LD; Palmer SM; Abi Hachem R; Jang DW
[Ad] Address:Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University, Durham, NC.
[Ti] Title:Correlation between sinus and lung cultures in lung transplant patients with cystic fibrosis.
[So] Source:Int Forum Allergy Rhinol;8(3):389-393, 2018 Mar.
[Is] ISSN:2042-6984
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Lung transplantation has revolutionized the treatment of end-stage pulmonary disease due to cystic fibrosis. However, infection of the transplanted lungs can lead to serious complications, including graft failure and death. Although many of these patients have concurrent sinusitis, it is unclear whether bacteria from the sinuses can infect the allograft. METHODS: This is a single-institution retrospective study of all patients who underwent lung transplantation for cystic fibrosis from 2005 to 2015 at Duke University Hospital. Pre- and posttransplant nasal and pulmonary cultures obtained via nasal endoscopy and bronchoalveolar lavage (BAL), respectively, were analyzed. RESULTS: A total of 141 patients underwent 144 lung transplants. Sinus cultures were available for 76 patients (12 pretransplant, 42 posttransplant, 22 both pre- and posttransplant). Pretransplant BAL cultures were available for 139 patients, and posttransplant BAL cultures were available for all patients. Pseudomonas aeruginosa (PsA) and methicillin-resistant Staphylococcus aureus (MRSA) were the most common organisms cultured. There was a significant correlation between pretransplant sinus and posttransplant BAL cultures for PsA (p = 0.003), MRSA (p = 0.013), and Burkholderia cepacia (p = 0.001). CONCLUSION: There was a high correlation between pretransplant sinus cultures and posttransplant BAL cultures for PsA, MRSA, and Burkholderia sp. This suggests that the paranasal sinuses may act as a reservoir for allograft colonization in patients with cystic fibrosis. Further studies are needed to determine whether treatment of sinusitis affects allograft colonization and transplant outcomes.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1002/alr.22067

  7 / 23399 MEDLINE  
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[PMID]: 29517178
[Au] Autor:Jain R; Hoggard M; Zoing M; Jiang Y; Biswas K; Taylor MW; Douglas RG
[Ad] Address:Department of Surgery, The University of Auckland, Auckland, New Zealand.
[Ti] Title:The effect of medical treatments on the bacterial microbiome in patients with chronic rhinosinusitis: a pilot study.
[So] Source:Int Forum Allergy Rhinol;, 2018 Mar 08.
[Is] ISSN:2042-6984
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Antibiotics and corticosteroids are prescribed to patients with chronic rhinosinusitis (CRS) to reduce bacterial burden and mucosal inflammation. Unfortunately, clinical improvement is often short-lived and symptoms frequently recur following cessation of treatment. The impact of these systemic therapies on bacterial communities is not well understood. Improved knowledge of how medical therapies influence the intranasal ecosystem may allow for more effective prescribing and the development of more targeted treatments. METHODS: Twenty patients with CRS were randomized to receive either doxycycline 100 mg twice daily or prednisone 30 mg once daily for 7 days. A further 6 patients with CRS were recruited as untreated controls. Swabs were taken immediately before and after the study period. Symptom scores (22-item Sino-Nasal Outcome Test [SNOT-22]) were recorded. Bacterial communities were characterized using 16S ribosomal RNA (rRNA) gene-targeted amplicon sequencing. Bacterial abundance was estimated using quantitative polymerase chain reaction (PCR) of 16S rRNA gene copies. RESULTS: Bacterial profiles were dominated by members of the genera Corynebacterium and Staphylococcus. Patients treated with either doxycycline or prednisone had variable and unpredictable changes in communities. The average relative abundance of Propionibacterium increased after treatment in the doxycycline treatment group, and Corynebacterium reduced in the prednisone group. Significant differences in clinical scores, bacterial community richness, diversity, and bacterial abundance were not seen after treatment. CONCLUSION: The short-term response of bacterial communities to antibiotic or corticosteroid therapy is unpredictable. This study suggests that the use of systemic therapy in patients with stable CRS should be rationalized to minimize antibiotic-associated morbidity and bacterial dysbiosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1002/alr.22110

  8 / 23399 MEDLINE  
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[PMID]: 29517156
[Au] Autor:Brooks SG; Trope M; Blasetti M; Doghramji L; Parasher A; Glicksman JT; Kennedy DW; Thaler ER; Cohen NA; Palmer JN; Adappa ND
[Ad] Address:Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA.
[Ti] Title:Preoperative Lund-Mackay computed tomography score is associated with preoperative symptom severity and predicts quality-of-life outcome trajectories after sinus surgery.
[So] Source:Int Forum Allergy Rhinol;, 2018 Mar 08.
[Is] ISSN:2042-6984
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Disagreement exists about the relationship between Lund-Mackay CT scores (LMCTS) and quality-of-life outcome (QoL) measures. We investigated whether preoperative LMCTS are associated with preoperative QoL, and whether LMCTS is predictive of postoperative QoL outcomes in chronic rhinosinusitis (CRS) patients. METHODS: Adult patients with medically recalcitrant CRS (n = 665) were enrolled in a prospective, observational cohort study. Preoperative LMCTS and pre- and postoperative self-reported QoL outcomes (22-item Sino-Nasal Outcomes Test [SNOT-22]) were collected and evaluated over 12 months. Five hundred sixty-eight patients met the inclusion criteria. Longitudinal linear mixed-effects modeling was used to investigate the effect of LMCTS on QoL after functional endoscopic sinus surgery (FESS). RESULTS: Preoperative LMCTS were significantly associated with preoperative SNOT-22 scores (p < 0.01) and postoperative SNOT-22 scores (p < 0.001), driven by Extranasal and Rhinologic subdomains of the QoL questionaire. Patients in the lowest preoperative LMCTS quartile had the lowest mean change in SNOT-22 scores at 12 months (16.8 points; 95% confidence interval [CI], 12.2-21.3). Patients in the second and third lowest preoperative LMCTS quartiles had mean changes at 12 months of 21.1 points (95% CI, 16.7-25.4) and 23.1 points (95% CI, 18.3-27.9). Patients in the highest preoperative LMCTS quartile had the greatest improvement in SNOT-22 scores after FESS (29.9 points; 95% CI, 24.9-34.8). The difference in QoL change at 12 months between the highest and lowest preoperative LMCTS quartiles was 13.1 points (95% CI, 6.0-20.2; p < 0.001). CONCLUSION: Our study demonstrates that preoperative LMCTS correlate with preoperative extranasal and rhinologic symptom severity and that the LMCTS is an indicator of postsurgical QoL outcomes for medically recalcitrant chronic rhinosinusitis patients in a large tertiary otolaryngology setting.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1002/alr.22109

  9 / 23399 MEDLINE  
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[PMID]: 29495142
[Au] Autor:Kim MS; Kim SY; Choi HG
[Ad] Address:Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
[Ti] Title:Adenoidectomy May Not Be Effective to Reduce the Number of Hospital Visits for Sinusitis.
[So] Source:J Korean Med Sci;33(10):e78, 2018 Mar 05.
[Is] ISSN:1598-6357
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:BACKGROUND: The objective of this study was to compare post-operative (post-op) visits for sinusitis between adenoidectomy and non-adenoidectomy participants (control). METHODS: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, we used 1:4 matching to select 2,593 adenoidectomy participants and 10,372 control participants. Post-op visits for sinusitis were measured from post-op 1 year through post-op 9 years. Equivalence testing was used. Margin of equivalence of difference was set as -0.5 to 0.5 in this study. RESULTS: There were trivial differences between the two groups from post-op 1 to 2 years. However, there was no difference between the two groups from post-op 3 through 9 years. Visits for sinusitis gradually decreased in both groups. In the rare and frequent pre-operative sinusitis group, there were minor differences in both groups from post-op 1 to 2 years. In contrast, there were no differences between the two groups in rare and frequent pre-operative sinusitis groups from post-op 3 through 9 years. In the 0-4 years old group, there were minor differences between both groups from post-op 1 to 2 years. However, no differences in the number of visits for sinusitis were found between the two groups during follow up periods from post-op 3 through 9 years. Additionally, there were no differences between the two groups during the entire follow up period. CONCLUSION: Adenoidectomy does not reduce post-op visits for sinusitis. Sinusitis decreased over time whether adenoidectomy was performed or not.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.3346/jkms.2018.33.e78

  10 / 23399 MEDLINE  
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[PMID]: 29429191
[Au] Autor:Zhang YY; Lou HF; Wang CS; Zhang L
[Ad] Address:Deparment of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institude of Otorhinolaryngology, Beijing 100005, China.
[Ti] Title:[Mechanisms underlying glucocorticoid resistance in chronic rhinosinusitis with nasal polyps].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;53(2):154-160, 2018 Feb 07.
[Is] ISSN:1673-0860
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease that occurs in the nasal and sinus mucosa, which is a common disease in otorhinolaryngology. At present, CRSwNP can be effectively treated by glucocorticoids (GC). GC binds to GC receptors in the nasal mucosa, affects the expression of inflammatory genes, inhibits the activation and action of eosinophils, T cell-associated inflammatory responses in nasal polyps, as well as tissue remodeling. However, there are some patients fall reponse to GC, so called GC resistance. The study suggests that the possible mechanism of CRSwNP GC resistance is mainly related to GC receptor abnormal, the role of cytokines and transcription factors, such as Th cells and IL-8. In addition, MAPK-related kinases and histone deacetylase in the GC signaling pathway also play important roles in the GC resistance process. This paper reviews the mechanism of GC treatment of CRSwNP, the mechanism of GC resistance and alternative treatment of GC.
[Mh] MeSH terms primary: Glucocorticoids/therapeutic use
Metabolism, Inborn Errors
Nasal Polyps/drug therapy
Receptors, Glucocorticoid/deficiency
Rhinitis/drug therapy
Sinusitis/drug therapy
[Mh] MeSH terms secundary: Chronic Disease
Cytokines/metabolism
Drug Resistance
Glucocorticoids/metabolism
Humans
Nasal Mucosa/metabolism
Nasal Polyps/complications
Rhinitis/complications
Signal Transduction
Sinusitis/complications
Transcription Factors/metabolism
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Cytokines); 0 (Glucocorticoids); 0 (Receptors, Glucocorticoid); 0 (Transcription Factors)
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Js] Journal subset:IM
[Da] Date of entry for processing:180213
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2018.02.017


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