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Role of Toll‐like receptor 9 signaling on activation of nasal polyp–derived fibroblasts and its association with nasal polypogenesis 下载免费PDF全文
Soo Kyoung Park MD Soung Yong Jin MD PhD Sun Hee Yeon PM Sung Bok Lee MD PhD Jun Xu MD PhD Young Hoon Yoon MD Ki Sang Rha MD PhD Yong Min Kim MD PhD 《International forum of allergy & rhinology》2018,8(9):1001-1012
Background
Nasal polyposis is characterized by persistent inflammation and remodeling in sinonasal mucosa. Toll‐like receptor 9 (TLR9) is a DNA receptor of the innate immune system that plays a pivotal role in fibrosis and inflammatory responses. The aim of this study is to explore the expression, activity, and potential pathogenic role of TLR9 signaling in tissue remodeling in nasal polyp–derived fibroblasts (NPDFs).Methods
Fibrotic and inflammatory responses elicited by type A CpG oligonucleotides were examined in the NPDFs by a combination of real‐time quantitative polymerase chain reaction, Western blot analysis, enzyme‐linked immunosorbent assay, and immunofluorescence staining. For these experiments, the NPDFs were stimulated with different TLR9 agonists (CpG A and B) and blocked with inhibitors (MyD88 inhibitor and chloroquine).Results
TLR9 expression was significantly higher in nasal polyposis (NP) tissues compared to control or chronic rhinosinusitis (CRS) mucosa. In the NPDFs, TLR9 showed intracellular localization and expression of TLR9 was increased after treatment with CpG A. CpG A increased production of α‐smooth muscle actin (α‐SMA), fibronectin, and matrix metalloproteinases (MMPs) (MMP1, MMP2, and MMP9) in the NPDFs, while MyD88 inhibitor and chloroquine, which are known to block the TLR9 signaling pathway, inhibited their production. CpG A also produced type I interferons (IFN‐α and IFN‐β), which were inhibited by MyD88 inhibitor.Conclusion
Our data indicates that CpG A–induced fibroblast activation and cytokine production were mediated via TLR9 stimulation in NPDFs. Disrupting this process with an inhibitor targeting TLR9 or its downstream signaling pathways could represent a novel approach to CRS with NP (CRSwNP) therapy.5.
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Clinical features of cytotoxic CD8+ T‐lymphocyte deficiency in chronic rhinosinusitis patients: a demographic and functional study 下载免费PDF全文
Leandra Mfuna Endam MSc Rose Marie Brito MSc Françoise Larivière MD FRCPC Sawsan Al‐Mot MSc Françoise LeDeist MD PhD Martin Desrosiers MD FRCSC 《International forum of allergy & rhinology》2014,4(6):495-501
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Total intravenous anesthesia vs inhaled anesthetic for intraoperative visualization during endoscopic sinus surgery: a double blind randomized controlled trial 下载免费PDF全文
Michael Little MD Victor Tran MD FRCPC Angelo Chiarella MD FRCPC Erin D. Wright MDCM MEd FRCSC 《International forum of allergy & rhinology》2018,8(10):1123-1126
Background
Bleeding during endoscopic sinus surgery (ESS) can impair visualization and delay surgical progress. The role that anesthetic technique may have on the quality of surgical field during ESS has been previously studied. However, meta‐analyses have deemed the current literature inconclusive and lacking methodological consistency. This study was designed with these critiques in mind to assess the effect of total intravenous anesthesia (TIVA) vs inhaled anesthetic on the quality of the surgical field during ESS.Methods
This study was a double‐blind, randomized, controlled trial of 30 patients of American Society of Anesthesiologists (ASA) class 1 or 2 undergoing bilateral ESS for the primary diagnosis of chronic rhinosinusitis. In addition to standard techniques to minimize blood loss, study patients were randomized to maintenance anesthesia with intravenous propofol or inhaled desflurane. Anesthetic depth was standardized using bispectral index (BIS). The primary outcome measured was the Wormald grading scale to assess the endoscopic surgical field.Results
The use of TIVA was associated with a statistically significant reduction in mean Wormald score compared to desflurane (4.21 vs 5.53, p = 0.024). Mean Boezaart score was also lower in the TIVA arm (2.18 vs 2.76, p = 0.034). Experimental groups were homogeneous in all compared baseline characteristics. Secondary outcomes including surgical duration, time to extubation, and estimated blood loss were not found to be statistically significant between experimental groups.Conclusion
Even with all other factors implemented to optimize the surgical field, utilization of TIVA vs inhaled anesthetic still resulted in a statistically significant improvement in surgical field during ESS.13.
Lack of additional effects of long‐term,low‐dose clarithromycin combined treatment compared with topical steroids alone for chronic rhinosinusitis in China: a randomized,controlled trial 下载免费PDF全文
Jie Deng MD Fenghong Chen MD YinYan Lai MD PhD Qing Luo MD PhD Rui Xu MD PhD Chunquan Ou MD PhD Qingling Fu MD PhD Jianbo Shi MD PhD 《International forum of allergy & rhinology》2018,8(1):8-14
Background
In China, clarithromycin is considered an effective treatment option for chronic rhinosinusitis (CRS) due to its unique immunopathologic characteristics. Our study's aim was to determine whether a topical steroid and clarithromycin combination is better than a single topical steroid for Chinese patients with CRS.Methods
Patients with CRS with/without nasal polyps were included in this study and randomly assigned to a clarithromycin plus budesonide aqua nasal spray group (CLM + BUD, clarithromycin 0.25 g/d and budesonide 256 μg/d) or a budesonide‐alone group (BUD, budesonide 256 μg/d). The treatment period was 3 months. The primary outcome was visual analog scale (VAS) score for 5 major symptoms and a general nasal symptom. Other assessments included the 22‐item Sino‐Nasal Outcome Test (SNOT‐22), computed tomography scan (Lund‐Mackay score), and rigid nasal endoscopy (Lund‐Kennedy score). Nasal secretion evaluation was the secondary outcome.Results
Seventy‐four patients were included and randomly assigned to the CLM + BUD group (n = 38) or the BUD group (n = 36). VAS scores for nasal obstruction, rhinorrhea, smell reduction, headache, nasal pain, and general nasal symptom were markedly improved in both treatment arms, but the differences between groups were not significant. Furthermore, SNOT‐22, Lund‐Mackay, and Lund‐Kennedy scores improved significantly after treatment in both groups, and were slightly better in the CLM + BUD group. For the responders in the CLM + BUD group, interleukin (IL)‐6 and IL‐8 were markedly reduced.Conclusion
The combination of CLM + BUD for the treatment of first‐time‐diagnosed CRS in this Chinese population cohort did not show a better effect compared with a single BUD regimen, but it may have a better effect in some patients with increased IL‐6 or IL‐8. 相似文献14.
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Nitric oxide‐releasing microparticles as a potent antimicrobial therapeutic against chronic rhinosinusitis bacterial isolates 下载免费PDF全文
Waleed M. Abuzeid MD Vallerinteavide Mavelli Girish PhD Judd H. Fastenberg MD Andrew R. Draganski PhD Andrew Y. Lee MD Joshua D. Nosanchuk MD Joel M. Friedman MD PhD 《International forum of allergy & rhinology》2018,8(10):1190-1198
Background
Bacteria, particularly in the biofilm state, may be implicated in the pathogenesis of chronic rhinosinusitis (CRS) and enhance antibiotic resistance. Nitric oxide (NO) is a gaseous immunomodulator with antimicrobial activity and a short half‐life, complicating achievement of therapeutic concentrations. We hypothesized that a novel microparticle‐based delivery platform, which allows for adjustable release of NO, could exhibit potent antibacterial effects.Methods
Porous organosilica microparticles (SNO‐MP) containing nitrosylated thiol groups were formulated. Dissociation of the nitrosothiol groups generates NO at body temperature. The susceptibility of bacterial isolates from CRS patients to SNO‐MP was evaluated through a colony forming unit (CFU) assay. Serial dilutions of SNO‐MP in triplicate were incubated with isolates in suspension for 6 hours followed by plating on tryptic soy agar and overnight incubation followed by CFU quantification. Statistical analysis was performed with SPSS using one‐way analysis of variance with Bonferroni correction.Results
SNO‐MP displayed antibacterial activity against gram‐positive (methicillin‐resistant and ‐sensitive Staphylococcus aureus) and gram‐negative (Pseudomonas aeruginosa, Enterobacter aerogenes, and Proteus mirabilis) isolates. SNO‐MP induced dose‐dependent reductions in CFU across all strains. Compared with controls and blank nanoparticles, SNO‐MP (10 mg/mL) induced a 99.99%‐100% reduction in CFU across all isolates, equivalent to a 5–9 log kill (p < 0.005). There was no statistically significant difference in CFU concentration between controls and blank microparticles.Conclusion
SNO‐MP demonstrates potent bactericidal effect against antibiotic‐resistant CRS bacterial strains.19.
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上下呼吸道炎症反应密切相关,慢性鼻-鼻窦炎和支气管哮喘(简称哮喘)分别作为上、下呼吸道的常见疾病,发病率高。慢性鼻-鼻窦炎的患者往往较易罹患哮喘,而有效治疗慢性鼻-鼻窦炎可以改善哮喘症状。本文就慢性鼻-鼻窦炎对哮喘的影响作一综述。 相似文献