International Forum of Allergy & Rhinology最新文献

{"title":"In office sampling of eosinophil peroxidase to diagnose eosinophilic chronic rhinosinusitis","authors":"Jacquelyn K. Callander, Annabelle R. Charbit, Kritika Khanna, John V. Fahy, Monica Tang, Maude Liegeois, Steven D. Pletcher, Andrew N. Goldberg, Jose G. Gurrola, Andrew H. Murr, Anna Butrymowicz, Patricia A. Loftus","doi":"10.1002/alr.23448","DOIUrl":"https://doi.org/10.1002/alr.23448","url":null,"abstract":"BackgroundPractical biomarkers for endotypic characterization of chronic rhinosinusitis (CRS) remain elusive, hindering clinical utility. Eosinophil peroxidase (EPX) is an enzyme released by activated eosinophils. The objective of this study was to evaluate a clinic EPX assay as a marker of eosinophilic CRS.MethodsSubjects with and without CRS presenting to a tertiary care rhinology clinic were prospectively enrolled, and nasal cytology brushings were collected from the middle meatus during in‐clinic nasal endoscopy. ELISA assay was used to quantify EPX levels, and a customized multiplex immunoassay was used to quantify inflammatory cytokine mediators. Findings were correlated with clinical data.ResultsForty‐two subjects were enrolled, including 31 CRS subjects and 11 controls. Median EPX levels were 125.0 ng/mL (standard deviation [SD] 1745.8) and 6.5 ng/mL (SD 99.0) for CRS group and controls, respectively (<jats:italic>p</jats:italic> = 0.003). EPX levels were associated with history of asthma (<jats:italic>p</jats:italic> = 0.015), allergies (<jats:italic>p</jats:italic> = 0.028), polyps (<jats:italic>p</jats:italic> = 0.0006), smell loss (<jats:italic>p</jats:italic> = 0.006), and systemic eosinophilia or elevated immunoglobulin E (<jats:italic>p</jats:italic> ≤ 0.0001). Twenty‐eight subjects from both the CRS and control groups had prior pathology for comparison, with histologic confirmation of local tissue eosinophilia (&gt;10 eosinophils/hpf) in 11 subjects. This subgroup had a median EPX level of 967.5 ng/mL compared to 10.6 ng/mL in 17 subjects without local tissue eosinophilia (<jats:italic>p</jats:italic> = 0.0008). EPX levels were positively correlated to interleukin‐5 levels (<jats:italic>p</jats:italic> = 0.0005).ConclusionEPX levels can be measured via well‐tolerated in‐clinic collection of nasal mucus. EPX levels are associated with clinical markers of type 2 inflammation and tissue eosinophilia and may provide a valuable diagnostic tool to delineate eosinophilic CRS.","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"48 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient‐reported disease control versus overall symptom severity as global metrics of chronic rhinosinusitis disease status","authors":"Ryan A. Cotter, Jack T. Garcia, Ahmed Alsayed, Sven Schneider, David T. Liu, Julia Eckl‐Dorna, Firas A. Houssein, Robby S. Boparai, Nikhil A. Parail, Matthew M. Chu, Josh C. Meier, Saad Alsaleh, Katie M. Phillips, Ahmad R. Sedaghat","doi":"10.1002/alr.23435","DOIUrl":"https://doi.org/10.1002/alr.23435","url":null,"abstract":"BackgroundOverall symptom severity (OSS) and patient‐reported chronic rhinosinusitis (CRS) control are global measures of CRS identified as consensus, essential criteria for CRS disease control assessment. We sought to determine the functional relationship between these two metrics.MethodsUsing an international multicenter mixed‐methods design, 260 CRS patients were recruited. OSS score was measured using a visual analog scale. Patient‐reported CRS control was measured as “controlled,” “partly controlled,” and “uncontrolled.” Twelve participants underwent semi‐structured interviews to discuss OSS and patient‐reported CRS control.ResultsThe majority of interviewed participants felt OSS and patient‐reported CRS control measured different constructs—while OSS only measured symptoms, patient‐reported CRS control was more global, including not only symptom severity but also concepts such as medication usage, activity impairment, and exacerbations. Nevertheless, OSS score was strongly correlated with (<jats:italic>ρ</jats:italic> = 0.67, <jats:italic>p</jats:italic> &lt; 0.001) and highly predictive of patient‐reported CRS control. OSS score of &gt;4 (95% confidence interval [CI]: 1.8–4.2) had 74.7% sensitivity and 93.2% specificity in identifying patients reporting their CRS as not controlled. OSS score of &gt;6.6 (95% CI: 4.1–7.1) had 77.0% sensitivity and 75.9% specificity in identifying patients reporting their CRS as uncontrolled. The 22‐item Sinonasal Outcome Test score was also predictive of patient‐reported CRS disease control but OSS was significantly more predictive.ConclusionsPatients conceptually view patient‐reported CRS control as a more global measure that subsumes OSS. Quantitatively, however, OSS is highly correlated with patient‐reported CRS control, possibly reflecting their redundancy. For ease of use, we recommend patient‐reported CRS control be reflected by OSS &lt;4 for controlled, 4 ≤ OSS &lt; 7 for partly controlled, and OSS ≥7 for uncontrolled CRS.","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"25 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing adequacy of surgical extent in CRSwNP: The Completion of Surgery Index","authors":"Alan D. Workman, Krithika Kuppusamy, David K. Lerner, John V. Bosso, Jennifer E. Douglas, Michael A. Kohanski, Nithin D. Adappa, James N. Palmer","doi":"10.1002/alr.23450","DOIUrl":"https://doi.org/10.1002/alr.23450","url":null,"abstract":"BackgroundEndoscopic sinus surgery (ESS) maximized for topical steroid irrigations is highly effective for polyp disease. As extent and completeness of ESS varies widely by situation and practitioner, it is important to understand when revision surgery is appropriate, particularly in the era of biologic treatments.MethodsA Completion of Surgery Index (CoSI) was developed to assess operative changes in polyp patients using pre‐ and postoperative computed tomography scans. The CoSI was then applied and tested in a cohort of consecutive chronic rhinosinusitis with nasal polyps (CRSwNP) patients, and examined within the context of quality‐of‐life improvements.ResultsThe CoSI assesses surgical extent on a scale of 0–100, with 100 representing the highest possible degree of surgical completeness. Among 100 consecutive CRSwNP patients undergoing ESS in 2021 with postoperative topical steroid irrigations, including 75 revision surgeries, SNOT‐22 scores improved at 6 months postoperatively, with durable and consistent improvement at 24 months (<jats:italic>p</jats:italic> &lt; 0.001). Preoperative CoSI scores in revision surgery patients were 49.4 ± 26.0, improving to 91.0 ± 8.1 postoperatively. SNOT‐22 scores for primary ESS patients and patients with a preoperative CoSI score of less than 70 improved by 26.4 and 28.1 points, respectively, in contrast to patients with a preoperative CoSI of 70 or greater (14.1 points, <jats:italic>p</jats:italic> = 0.029).ConclusionsIt is important to define extent of surgery in CRSwNP to stratify postsurgical patients based on likelihood to benefit from revision surgery or alternative medications. The CoSI can be utilized to identify patients who are likely to improve significantly with revision surgical intervention.","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"35 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142199234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age‐related differences in olfactory training outcomes: A prospective cohort study","authors":"Amelia S. Lawrence, Jodi Veach, Rahul Alapati, Celina G. Virgen, Robert Wright, Frank Materia, Jennifer A. Villwock","doi":"10.1002/alr.23451","DOIUrl":"https://doi.org/10.1002/alr.23451","url":null,"abstract":"IntroductionWhile olfactory function decreases with age, it is unknown how age affects olfactory training (OT) efficacy. This study compared OT in two cohorts of subjects: aged ≤50 (younger cohort) and aged 51+ (older cohort) with olfactory dysfunction (OD) primarily from COVID‐19 infection.MethodsSubjects with OD primarily secondary to COVID‐19 infection were prospectively recruited and enrolled into an OT registry. Baseline data were collected and they were provided with a training kit and asked to complete OT at home twice daily for 6 months. Participants were asked to follow‐up at 3 and 6 months during training for olfactory testing and quality‐of‐life surveys (Sino‐Nasal Outcomes Test‐22 [SNOT‐22] and Questionnaire of Olfactory Disorders Negative Statements [QoD‐NS]).ResultsFifty‐six participants completed OT (younger cohort: <jats:italic>n</jats:italic> = 26, older cohort: <jats:italic>n</jats:italic> = 30). There were no significant differences between cohorts’ Affordable Rapid Olfactory Measurement Array (AROMA), QoD‐NS, or SNOT‐22 scores at any time point. Both cohorts showed significant AROMA score improvement of more than 16 points from baseline to 3 months (younger cohort: <jats:italic>p</jats:italic> = 0.001; older cohort: <jats:italic>p</jats:italic> = 0.008). The younger cohort had significant improvements in QoD‐NS (<jats:italic>p</jats:italic> = 0.008) and SNOT‐22 (<jats:italic>p</jats:italic> = 0.042) between baseline and 3 months while the older cohort improved from 3 to 6 months (QoD‐NS: <jats:italic>p</jats:italic> = 0.027, SNOT‐22: <jats:italic>p</jats:italic> = 0.049).ConclusionBoth cohorts demonstrated similar significant improvement in olfactory function after 3 months of OT. The timeline of subjective improvement was different between cohorts, with younger patients experiencing earlier improvement.","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"71 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142199233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective longitudinal study assessing the impact of rhinovirus and bacterial infections in acute exacerbations of chronic rhinosinusitis.","authors":"Nirushan Narendran, Sophia Volpe, Ibrahim Ramadan, Jacob Ryan Herbert, Bonnie LaFleur, Shireen Samargandy, Christopher H Le, Eugene H Chang","doi":"10.1002/alr.23431","DOIUrl":"https://doi.org/10.1002/alr.23431","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbations of chronic rhinosinusitis (AECRS) are thought to arise from common viral infections progressing to secondary bacterial infections. However, the pathophysiology of AECRS remains poorly understood due to a lack of prospective longitudinal studies.</p><p><strong>Methods: </strong>We conducted a one-year prospective longitudinal study involving chronic rhinosinusitis (CRS) adults. At baseline, we assessed subjective symptom scores using a validated upper respiratory infection questionnaire (WURSS), sinonasal outcome testing scores (SNOT-22), and endoscopic scores (modified Lund-Kennedy score). Every 2 weeks, we contacted subjects to collect WURSS and SNOT-22 scores. If WURSS scores were ≥1 and SNOT-22 scores were ≥ 8.9 compared with baseline, subjects underwent an AECRS assessment. We identified rhinovirus (RV) incidence through viral nasal brushings at each visit and bacterial infection through bacterial swabs if mucus scores were ≥1.</p><p><strong>Results: </strong>Thiry-five of 80 CRS subjects reported at least one AECRS episode during the year, predominantly occurring in the fall and winter seasons. RV infections were detected in 8 of 35 cases, bacterial infections in 17 of 35, and co-occurring infections in 7 of 35. All subjects with AECRS visits exhibited significantly higher endoscopic scores compared with baseline. Subjects with co-occurring RV and bacterial infections demonstrated higher disease severity compared with those with either RV or bacterial infection, or no infection.</p><p><strong>Conclusions: </strong>In a one-year prospective longitudinal study involving CRS adults, we identified significant risk factors for AECRS including seasonality and the presence of RV and bacterial infections. These data suggest a standard definition of AECRS and the need to target RV and bacterial infections if we are to help reduce disease severity.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of bovine-derived collagen matrix in the surgical treatment of empty nose syndrome.","authors":"Brian H Cameron, Jason Talmadge, Martin J Citardi","doi":"10.1002/alr.23449","DOIUrl":"https://doi.org/10.1002/alr.23449","url":null,"abstract":"<p><strong>Key points: </strong>Bovine-derived collagen matrix (BDCM) is a safe augmentation material in patients with empty nose syndrome. BDCM augmentation results in clinically and statistically significant improvement in nasal symptoms. Improvements in nasal symptoms with BDCM augmentation may be durable and can be seen up to 2 years postoperative.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A response to Min et al.","authors":"David R. Grimm MD,&nbsp;Z. Jason Qian MD,&nbsp;Michael Yong MD,MPH,MBA,&nbsp;Peter H. Hwang MD","doi":"10.1002/alr.23446","DOIUrl":"10.1002/alr.23446","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"14 10","pages":"1675"},"PeriodicalIF":7.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence to the editor regarding the article entitled, “The effect of PM2.5 on acute sinusitis: A population-based study”","authors":"Hyun Jin Min MD, PhD","doi":"10.1002/alr.23445","DOIUrl":"10.1002/alr.23445","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"14 10","pages":"1671-1672"},"PeriodicalIF":7.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of conflicts of interest in literature on monoclonal antibodies for chronic rhinosinusitis with nasal polyposis using the Open Payments Database.","authors":"Christina Liu, Conrad W Safranek, Rhys Richmond, Trinithas Boyi, Zachary Pickell, Ryan Rimmer, R Peter Manes","doi":"10.1002/alr.23447","DOIUrl":"https://doi.org/10.1002/alr.23447","url":null,"abstract":"<p><strong>Background: </strong>Accurate conflict of interest (COI) information is essential for promoting transparency and trust in research. We aim to assess COI disclosure patterns in monoclonal antibodies (MABs) research for chronic rhinosinusitis with nasal polyposis (CRSwNP) using the Open Payments Database (OPD).</p><p><strong>Methods: </strong>Studies on FDA-approved MABs for CRSwNP (dupilumab, omalizumab, mepolizumab) published between 2019 and 2021 with at least one US author were identified through PubMed. Industry-reported payments from the manufacturers (Sanofi, Regeneron, Genentech, Novartis, and GlaxoSmithKline) between 2018 and 2021 in OPD's General Payments category were collected. Authors were cross-checked against OPD metadata using a previously published ChatGPT-based algorithm. Additionally, this novel algorithm analyzed COI statements for relevant author‒company specific disclosures, identifying disclosed and undisclosed payments made 3‒15 months prior to publication.</p><p><strong>Results: </strong>A total of 214 unique authors from 76 studies were included. Of 30 articles that received at least one relevant payment, 21 (70%) were found to have an undisclosed COI, with a mean total undisclosed payment of $4890 and a median of $10,331. Fifty-six authors had relevant OPD payments and 40 (71.4%) authors did not declare a potential COI. Interestingly, 158 authors had no relevant payments and 62 (39.2%) declared a potential COI. Author order was not significantly associated with potential under- or over-disclosure.</p><p><strong>Conclusion: </strong>This study characterizes COI disclosure patterns in rhinosinusitis-relevant MABs research using a novel automated approach. Given the discrepancy between disclosures and industry-reported payments, our findings suggest a need for improved disclosure education and practices.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPAP-induced sphenoid sinus pressures after endoscopic sinus surgery.","authors":"Glen E D'Souza, Alexander Duffy, Shreya Mandloi, Emily Garvey, Bita Naimi, Paavali Hannikainen, Peter Benedict, Gurston N Nyquist, Christopher Farrell, Marc Rosen, Elina Toskala, James Evans, Mindy R Rabinowitz","doi":"10.1002/alr.23440","DOIUrl":"https://doi.org/10.1002/alr.23440","url":null,"abstract":"<p><strong>Key points: </strong>Positive pressure transmitted from continuous positive airway pressure (CPAP) to the sinuses and skull base in the early post-operative period has not been studied in live subjects and controversy exists in when to restart this post-operatively. This study found that approximately 32.76% and 13.52% of the delivered CPAP pressures reached the post-surgical sphenoid sinus and the mid-nasal cavity, respectively, suggesting that surgical factors such as tissue edema, nasal packing, blood, and nasal secretions may provide a protective effect.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}