The importance of local eosinophilia in the surgical outcome of chronic rhinosinusitis: a 3-year prospective observational study.

Background: Patients with chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP) benefit from endoscopic sinus surgery (ESS), with an estimated success rate of 80%. At present, the influence on clinical outcome after ESS of eosinophils, eosinophilic mucin (EM), and fungal hyphae (FH) in secretions remains unclear. By delineating CRS groups and subgroups based on the finding of eosinophils, EM, and FH, differences in recurrence after ESS were investigated.

Staphylococcal enterotoxin B influences the DNA methylation pattern in nasal polyp tissue: a preliminary study.

Staphylococcal enterotoxins may influence the pro-inflammatory pattern of chronic sinus diseases via epigenetic events. This work intended to investigate the potential of staphylococcal enterotoxin B (SEB) to induce changes in the DNA methylation pattern. Nasal polyp tissue explants were cultured in the presence and absence of SEB; genomic DNA was then isolated and used for whole genome methylation analysis.

Dissemination and implementation of the ARIA guidelines for allergic rhinitis in general practice.

Background: Allergic rhinitis (AR) is a prevalent problem in general practice. The first evidence-based guidelines for AR, the ARIA guidelines, were published and have been updated repeatedly since 2001 in order to improve the care of AR patients. Very limited information, however, is available on the impact of these guidelines on everyday clinical practice.

Omalizumab is effective in allergic and nonallergic patients with nasal polyps and asthma.

Background: Adult patients with nasal polyps often have comorbid asthma, adding to the serious effect on the quality of life of these patients. Nasal polyps and asthma might represent a therapeutic challenge; inflammation in both diseases shares many features, such as airway eosinophilia, local IgE formation, and a T(H)2 cytokine profile. Omalizumab is a human anti-IgE mAb with proved efficacy in patients with severe allergic asthma.

Syk-kinase inhibition prevents mast cell activation in nasal polyps.

Background: Mast cells are crucial effector cells in the allergic cascade. The cross-linking of the high affinity IgE receptor (FcεRI) activates mast cells and basophils. Spleen tyrosine kinase (Syk) is positioned upstream of the IgE receptor signal transducing pathway and may represent an important target for the treatment of nasal inflammatory diseases.

Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma.

Background: Nasal polyps often are associated with asthma. The phenotype of these patients is unknown.

Objective: To identify the mucosal factors associated with asthma comorbidity, we analyzed the inflammatory patterns of nasal polyps.

Efficacy of desloratadine in persistent allergic rhinitis - a GA²LEN study.

Background: The ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines proposed a classification for allergic rhinitis based on the duration of symptoms (intermittent or persistent) rather than on the time of allergen exposure (seasonal or perennial). There had been no placebo-controlled, randomized, clinical trial of desloratadine (DL) in patients with persistent allergic rhinitis to date.

Objectives: To assess the efficacy and safety of DL in patients with persistent allergic rhinitis based on the ARIA classification.

Oral steroids and doxycycline: two different approaches to treat nasal polyps.

Background: There is little scientific evidence to support the current practice of using oral glucocorticosteroids and antibiotics to treat patients with chronic rhinosinusitis and nasal polyps.

Objective: We evaluated the effects of oral glucocorticoids and doxycycline on symptoms and objective clinical and biological parameters in patients with chronic rhinosinusitis and nasal polyps.

Methods: In a double-blind, placebo-controlled, multicenter trial, we randomly assigned 47 participants with bilateral nasal polyps to receive either methylprednisolone in decreasing doses (32-8 mg once daily), doxycycline (200 mg on the first day, followed by 100 mg once daily), or placebo for 20 days.

Acoustic measurement of overall voice quality: a meta-analysis.

Over the past several decades, many acoustic markers have been proposed to be sensitive to and measure overall voice quality. This meta-analysis presents a retrospective appraisal of scientific reports, which evaluated the relation between perceived overall voice quality and several acoustic-phonetic correlates. Twenty-five studies met the inclusion criteria and were evaluated using meta-analytic techniques.

[GA2LEN (Global Allergy and Asthma European Network), the perspective of the German speaking centers].

Allergic diseases represent a major health problem in Europe. They are increasing in prevalence, severity and costs. GA2LEN (Global Allergy and Asthma European Network), an FP6 Network of Excellence, was created in 2005 as a vehicle to ensure excellence in research bringing together research and clinical institutions to combat fragmentation in the European research area and to tackle allergy as a whole.

Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels.

To improve ecological validity, perceptual and instrumental assessment of disordered voice, including overall voice quality, should ideally sample both sustained vowels and continuous speech. This investigation assessed the utility of combining both voice contexts for the purpose of auditory-perceptual ratings as well as acoustic measurement of overall voice quality. Sustained vowel and continuous speech samples from 251 subjects with (n=229) or without (n=22) various voice disorders were concatenated and perceptually rated on overall voice quality by five experienced voice clinicians.

Perturbation measures of voice: a comparative study between Multi-Dimensional Voice Program and Praat.

Background/aims: Frequency and amplitude perturbations are inherent in voice acoustic signals. The assessment of voice perturbation is influenced by several factors, including the type of recording equipment used and the measurement extraction algorithm applied. In the present study, perturbation measures provided by two computer systems (a purpose-built professional voice analysis apparatus and a personal computer-based system for acoustic voice assessment) and two computer programs (Multi-Dimensional Voice Program and Praat) were compared.

Local complement activation in nasal polyposis.

Objectives/hypothesis: The role of the complement system in nasal polyps (CRSwNP) has so far scarcely been studied. Because nasal polyps are characterized by bacterial colonization, and the complement system is an effective defense mechanism, it might be involved in the pathogenesis of CRSwNP. This study was designed to investigate the local and systemic activation of the complement system in CRSwNP versus control mucosa in relation to the local and systemic eosinophilic and neutrophilic inflammation and local plasma exudation.

Gene profiles of THP-1 macrophages after in vitro exposure to respiratory (non-)sensitizing chemicals: identification of discriminating genetic markers and pathway analysis.

It is recognized that respiratory sensitization is a hazard of high concern. Despite international regulatory requirements there is no established protocol for the identification of chemical respiratory sensitizers. New tests should be based on mechanistic understanding and should be preferentially restricted to in vitro assays.

TGF-beta signaling and collagen deposition in chronic rhinosinusitis.

Background: Chronic rhinosinusitis is an inflammatory disease with distinct cytokine and remodeling patterns.

Objective: The objective was to analyze the presence of TGF-beta isoforms, receptors, intracellular signaling, and collagen deposition in chronic rhinosinusitis.

Methods: Sinonasal mucosal samples obtained from chronic rhinosinusitis with nasal polyps (CRSwNP; n = 13), chronic rhinosinusitis without nasal polyps (CRSsNP; n = 13), and controls (n = 10) were analyzed for TGF-beta isoforms 1 and 2 by means of ELISA and IHC, and for TGF-beta R1, 2, and 3 by RT-PCR and IHC.

Enhanced release of IgE-dependent early phase mediators from nasal polyp tissue.

Background: The mast cell is a crucial effector cell in allergic rhinitis and other inflammatory diseases. During the acute allergic reaction preformed mediators such as histamine, but also de novo produced mediators such as leukotrienes (LTC4/D4/E4) and prostaglandins (PGD2) are released. Mast cells represent targets for therapeutic intervention, and thus a human ex-vivo model to stimulate mast cells taken from mucosal sites would be instrumental for drug intervention studies.

THP-1 monocytes but not macrophages as a potential alternative for CD34+ dendritic cells to identify chemical skin sensitizers.

Early detection of the sensitizing potential of chemicals is an emerging issue for chemical, pharmaceutical and cosmetic industries. In our institute, an in vitro classification model for prediction of chemical-induced skin sensitization based on gene expression signatures in human CD34+ progenitor-derived dendritic cells (DC) has been developed. This primary cell model is able to closely mimic the induction phase of sensitization by Langerhans cells in the skin, but it has drawbacks, such as the availability of cord blood.

Chronic rhinosinusitis with and without nasal polyps: what is the difference?

Chronic rhinosinusitis is a heterogeneous group of chronic sinus diseases that may consist of clearly different disease entities. Further investigation of the pathomechanisms of chronic rhinosinusitis and the introduction of appropriate disease markers have recently facilitated disease classification. Evaluation of inflammatory cell profiles, the differentiation of T-effector cells, characterization of remodeling processes such as fibrosis or edema formation, and innate or adaptive immunity products such as Toll-like receptors and immunoglobulins all provide tools to identify distinct disease entities within the group of chronic sinus diseases.

Pilot study using doxycycline-releasing stents to ameliorate postoperative healing quality after sinus surgery.

Poor postoperative healing after sinus surgery is associated with high concentrations of matrix metalloproteinase-9 (MMP-9). The frontal recess is especially vulnerable to restenosis, and frontal sinus stents have been used to overcome this problem. However, the long-term success rate is still controversial and may be poor.

Gene profiles of a human alveolar epithelial cell line after in vitro exposure to respiratory (non-)sensitizing chemicals: identification of discriminating genetic markers and pathway analysis.

There are currently no accepted biological prediction models for assessing the potential of a substance to cause respiratory sensitization. New tests should be based on mechanistic understanding and should be preferentially restricted to in vitro assays. The major goal of this study was to investigate the alterations in gene expression of human alveolar epithelial (A549) cells after exposure to respiratory sensitizing and non-respiratory sensitizing chemicals, and to identify genes that are able to discriminate between both groups of chemicals.

Gene profiles of a human bronchial epithelial cell line after in vitro exposure to respiratory (non-)sensitizing chemicals: identification of discriminating genetic markers and pathway analysis.

Respiratory sensitization is a concern for occupational and environmental health in consumer product development. Despite international regulatory requirements there is no established protocol for the identification of chemical respiratory sensitizers. New tests should be based on mechanistic understanding and should be preferentially restricted to in vitro assays.

Different types of T-effector cells orchestrate mucosal inflammation in chronic sinus disease.

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by the accumulation of inflammatory cells; however, an eosinophil predominance is seen in white (Belgian), but not Asian (south Chinese), patients with polyps.

Objective: We sought to investigate the association of inflammatory cell predominance with regulatory T-cell and T-effector cell patterns.

Methods: Nasal mucosal tissue was obtained from 26 consecutive Belgian patients with CRSwNP and 21 Belgian control subjects and 29 south Chinese patients with CRSwNP and 29 south Chinese control subjects, who all underwent phenotyping, including nasal endoscopy and computed tomographic scanning.

Anti-IgE for the treatment of allergic rhinitis--and eventually nasal polyps?

In allergic rhinitis, cross-linking of IgE molecules upon allergen contact induces degranulation of mast cells and basophils within the mucosal tissue and results in the release of typical mediators, which consecutively induce the well-known symptoms. Omalizumab counteracts these interactions by reducing serum levels of free IgE. Therapy targeted at IgE also interferes with its binding to the low-affinity receptors inhibiting the amplification of the Th(2)-type response.

The current burden of allergic rhinitis amongst primary care practitioners and its impact on patient management.

Aims: To investigate the burden of allergic rhinitis (AR) amongst primary care practitioners (PCPs), the impact of AR on PCPs' professional lives, and the effect on their management of AR patients of PCPs' personal experience of AR.

Methods: An online questionnaire was completed by 1201 PCPs (50% AR sufferers) from eight countries.

Results: 21% of PCPs reported very well controlled symptoms and 66% quite good control.

T-cell regulation in chronic paranasal sinus disease.

Background: Chronic rhinosinusitis is an inflammatory disease with distinct cytokine and remodeling patterns. Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a T(H)2-skewed eosinophilic inflammation, whereas chronic rhinosinusitis without nasal polyps (CRSsNP) represents a predominant T(H)1 milieu.

Objective: We aimed to study the direct tissue expression of transcription factors for T-cell subpopulations, including T regulatory cells, in relation to the cytokine expression patterns in the different disease subgroups.