Adult ; Humans ; Male ; Maxillary Sinusitis ; complications ; Nasal Polyps ; complications

Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma is a common clinical refractory airway disease. Comprehensive treatment of nasal endoscopic surgery including nasal endoscopic surgery and medication, which can significantly improve nose-pulmonary symptoms and make sinusitis and asthma easier to be controlled by medication, has certain superiority. But the existence of disease heterogeneity of CRSwNP with asthma causes different reactions to the current treatment, which manifests as parts of polyps and asthma easy to recur and difficult to control. According to the research recently, the study of the heterogeneity of airway diseases, for example endotype, is a hot area of research. Endotype is a subtype of a condition, which is defined by a distinct functional or pathobiological mechanism. This is distinct from a phenotype, which is any observable characteristic or trait of a disease. Different Inflammatory subtypes often represent different pathophysiology and even different pathogenesis. The concept of inflammatory subtypes of airway diseases provides a new perspective for studies of airway diseases of endotype and the mechanism of combined airway diseases. This review summarizes recent advances in the clinical characterization and treatment of the CRSwNP with asthma. On this basis, we analyze and summarize the heterogeneity of CRSwNP and asthma separately from the perspective of inflammatory subtypes. Then according to the concept of the combined airway diseases and the common pathogenesis, we put forward the definition of inflammatory subtypes of the CRSwNP with asthma and preliminarily discuss the method of the definition.
Asthma ; complications ; Chronic Disease ; Endoscopy ; Humans ; Nasal Polyps ; complications ; Rhinitis ; complications ; diagnosis ; Sinusitis ; complications ; diagnosis

Biological Products ; Chronic Disease ; Humans ; Nasal Polyps/complications* ; Rhinitis/complications* ; Sinusitis/complications*

OBJECTIVE: To investigate the efficacy of the treatment of endoscopic sinus surgery on patients dignosed as chronic sinusitis with nasal polyps(CRSwNP) complicated and asthma. METHOD: Data of 45 patients with CRSwNP complicated asthma were analyzed retrospectively. RESULT: All cases were followed up for a period of 1 to 3 years after operation. In the 45 cases treated with ESS, 32 cases were cured, 9 cases were improved and 4 cases were inefficient by the treatment. The cure rate was 91.1% (41/45). The asthma symptoms were improved in 16 patients compared to 4 before the surgery. CONCLUSION With ESS based on combined therapy,it can significantly improve the condition of CRSwNP, asthma symptoms and pulmonary function. Meanwhile, sufficient perioperative period preparation should be made to ensure the safety of the operation.
Asthma ; complications ; Chronic Disease ; Endoscopy ; Humans ; Nasal Polyps ; complications ; Nasal Surgical Procedures ; Paranasal Sinuses ; surgery ; Retrospective Studies ; Sinusitis ; complications ; surgery

Aged ; Ethmoid Sinus ; pathology ; Female ; Humans ; Nasal Polyps ; complications ; Oculomotor Nerve Diseases ; complications ; Sphenoid Sinus ; pathology

Chronic Disease ; Humans ; Nasal Polyps/complications* ; Rhinitis/complications* ; Rhinitis, Allergic ; Sinusitis/complications* ; Staphylococcal Infections/complications* ; Staphylococcus aureus

Heart Septal Defects, Atrial ; complications ; Humans ; Infant, Newborn ; Male ; Nasal Polyps ; complications ; congenital ; Nasopharyngeal Diseases ; complications ; congenital

OBJECTIVE: To investigate the features and correlation of nasal inverted papilloma complicated with polyps. METHOD: Twelve patients diagnosed as nasal inverted papilloma complicated with polyps were studied. The pathological specimens were taken from the surface, core and base of papilloma and sinus in every patient. Through comparing pathological findings, the features and correlation of nasal inverted papilloma complicated with polyps were evaluated. RESULT: In most cases, nasal inverted papilloma was located in the core and base of the mass, while the polyps were located in the surface of the mass. CONCLUSION Nasal inverted papilloma complicated with polyps may result from long-term inflammation that occurred in the surface of the epithelia of superficial papilloma. Therefore, the occurrence of neoplastic disease in core should be alerted in unilateral nasal polyp case.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; complications ; pathology ; Nose Neoplasms ; complications ; pathology ; Papilloma, Inverted ; complications ; pathology

OBJECTIVE: To investigate the clinical relationship between allergic rhinitis and allergic factors with chronic rhinosinusitis with or without nasal polyps. METHOD: Two hundred patients were divided into A and B two groups. Group A of 110 patients was diagnosed allergic rhinitis. Group B of 90 patients was diagnosed chronic sinusitis with or without nasal polyps. Serums sIgE was detected with EUROIMMUN, and observe the recurrence rate of chronic sinusitis with or without nasal polyps patients who accept operation treatment and observe the incidence of allergic rhinitis superinduced chronic sinusitis with or without nasal polyps. RESULT: The total positive rate of group A sIgE was 89.09%. The total positive rate of group B sIgE was 74.44%. The postoperative recurrence rate of sIgE positive group was 58.21% and the postoperative recurrence rate of sIgE negative group was 8.70% in the group B. In the group A, the positive rate of serums sIgE in allergic rhinitis with chronic sinusitis with or without nasal polyps (37.27%) was 97.56%, while the positive rate of serums sIgE in allergic rhinitis without chronic sinusitis (62.73%) was 79.71%, there is a significant difference in allergic rhinitis with or without chronic sinusitis (χ2 = 6.96, P < 0.01). CONCLUSION There is a certain correlation between allergic rhinitis and allergic factors with chronic sinusitis with or without nasal polyps. Therefore, through avoiding allergen exposure, the treatment of allergic rhinitis can effectively control recurrence rate of chronic sinusitis and nasal polyp.
Adult ; Chronic Disease ; Humans ; Immunoglobulin E ; blood ; Nasal Polyps ; complications ; immunology ; Recurrence ; Rhinitis, Allergic ; complications ; immunology ; Sinusitis ; complications ; immunology

Objective: To detect the percentages of CD8⁺Treg cells in the nasal mucosa and peripheral blood of chronic rhinosinusitis (CRS) and to explore their correlation with eosinophilic infiltration. Methods: Thirty-three chronic rhinosinusitis with polyp (CRSwNP), 26 chronic rhinosinusitis without polyp (CRSsNP) and 27 control patients who were collected with the nose mucosal tissue and peripheral blood in the Third Affiliated Hospital of Sun Yat-sen University from March 2017 to October 2018 were selected, including 59 males and 27 females, aging from 18 to 72 years. Hematoxylin and eosin (HE) staining was used to observe the number of eosinophils in the nasal tissues and to classify the CRS into eosinophilic CRS (ECRS) and non-eosinophilic CRS (Non-ECRS). Flow cytometry was used to detect the percentages of CD4⁺ and CD8⁺T cells in lymphocytes of nasal mucosa and peripheral blood. The percentages of CD8⁺Foxp3⁺Treg cells, CD8⁺Foxp3^-IL-10⁺Treg cells, CD8⁺IFN-γ⁺T cells (Tc1), CD8⁺IL-4⁺T cells (Tc2) and CD8⁺IL-17A⁺T cells (Tc17) in lymphocytes of nasal mucosa and peripheral blood were also tested. Besides, the percentages of Foxp3⁺TGF-β⁺Treg cells and Foxp3⁺IL-10⁺Treg cells in CD8⁺T cells were determined. All data were represented by M (IQR). GraphPad 7.0 and SPSS 16.0 were used for illustration and statistical analysis. Results: The percentage of CD8⁺T cells (37.75%(17.35%)) was higher than that of CD4⁺T cells (4.72%(4.29%)) in nasal mucosa (Z=-5.70, P<0.001), while lower (23.60%(9.33%)) than that of CD4⁺T cells (44.05% (10.93%)) in peripheral blood (t=9.72, P<0.001). CRSwNP patients possessed the highest Tc2 (1.82% (1.22%)) and Tc17 (1.93% (2.32%)) percentages than CRSsNP (Tc2: 0.84% (0.79%); Tc17: 0.54% (1.04%)) and control (Tc2: 1.09% (0.92%); Tc17: 0.47% (0.51%), both P<0.05) patients. While, CRSwNP patients possessed the lowest CD8⁺Foxp3⁺Treg cells percentage (0.10% (0.32%)) than CRSsNP (0.43% (1.45%)) and control (0.48% (0.83%), Z value was -2.24, -2.22, respectively, P value was 0.025, 0.027, respectively). The percentages of Foxp3⁺TGF-β⁺Treg cells and Foxp3⁺IL-10⁺Treg cells of CD8⁺T cells in nasal mucosa in CRSwNP were also lower than controls (Z value was 1.46, 0.49, respectively, both P=0.001). Moreover, the percentage of CD8⁺Foxp3^-IL-10⁺Treg cells of CD8⁺T cells was decreased in nasal mucosa of CRSwNP patients (0.14% (0.28%)) when compared with that of CRSsNP (0.89% (0.81%), Z=0.61, P=0.03). ECRS patients had the lower percentages of CD8⁺Foxp3⁺Treg cells (0.07% (0.44%)) and CD8⁺Foxp3^-IL-10⁺Treg cells (0.13% (0.21%)) than Non-ECRS patients (CD8⁺Foxp3⁺Treg cells: 0.53% (0.75%); CD8⁺Foxp3^-IL-10⁺Treg cells: 0.29% (0.76%), t value was 2.14, 2.78, respectively, both P<0.05). The percentage of CD8⁺Foxp3⁺Treg cells and the ratio of CD8⁺Foxp3^-IL-10⁺T per CD8⁺T cells were negatively correlated with the percentage of eosinophils in CRS patients(R² value was 0.56, 0.78, respectively, both P<0.001). There was no significant difference in the distribution of CD8⁺Fxop3⁺Treg cells and CD8⁺Fxop3^-IL-10⁺Treg cells in peripheral blood among different groups. Conclusion: The percentages of CD8⁺Treg cells decrease in CRSwNP patients, especially in ECRS patients, which are opposite to that of Tc2 and Tc17, and negatively correlate with the eosinophils percentage. This indicates that the decrease in the ratio of CD8⁺Treg cell may be associated with the immune-imbalance and eosinophilic infiltration in nasal mucosa of CRS patients.
CD8-Positive T-Lymphocytes ; Chronic Disease ; Female ; Humans ; Male ; Nasal Polyps/complications* ; Rhinitis/complications* ; Sinusitis/complications* ; T-Lymphocytes, Regulatory