Clarissa Brenda Alves Cavalcante, Alessandro Cavalcante Chaves, Vanessa Silva de Oliveira, Maria Amanda Silva de Araújo, Thayres Marinho Cunha e Silva, João Vitor Caetano Goes, Roberta Taiane Germano de Oliveira, Ronald Feitosa Pinheiro, Howard Lopes Ribeiro-Junior
{"title":"Role of Toll-Like Receptors in Myeloid Neoplasms: Focuses on the Molecular Mechanisms and Clinical Impact on Myelodysplastic Syndromes, Acute Myeloid Leukemia, and Chronic Myeloid Leukemia","authors":"Clarissa Brenda Alves Cavalcante, Alessandro Cavalcante Chaves, Vanessa Silva de Oliveira, Maria Amanda Silva de Araújo, Thayres Marinho Cunha e Silva, João Vitor Caetano Goes, Roberta Taiane Germano de Oliveira, Ronald Feitosa Pinheiro, Howard Lopes Ribeiro-Junior","doi":"10.1111/apm.70065","DOIUrl":"https://doi.org/10.1111/apm.70065","url":null,"abstract":"<p>Toll-like receptors (TLRs) are essential components of the innate immune system, functioning as pattern recognition receptors (PRRs) to detect pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs). In hematological malignancies, particularly myelodysplastic syndromes (MDS), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML), TLRs influence inflammation, disease progression, and therapeutic response. This review highlights the prognostic relevance of TLR expression, the role of the MyD88 signaling pathway in clonal evolution, and the dual nature of TLR-mediated immune responses, either promoting antitumor activity or contributing to leukemogenesis. Notably, TLR dysregulation in MDS and AML is associated with poor prognosis and genomic instability, whereas in CML, TLRs contribute to a protective microenvironment via NOD-like and TNF-α pathways. Therapeutic strategies targeting TLRs, including agonists and antagonists, show promise in enhancing antitumor responses, especially when combined with agents like purine nucleoside phosphorylase inhibitors. Furthermore, genetic variations in TLR pathways may influence individual susceptibility to infection and cancer progression, reinforcing the relevance of personalized medicine. Overall, this review underscores the need for continued research into TLR modulation as a foundation for innovative therapies in hematologic cancers.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 9","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Huma Aftab, Christian H. Schouw, Rimtas Dargis, Laus K. Vejrum, Rikke L. Johansen, Josefine Tange Møller, Tina V. Madsen, Asta Lili Laugesen, Jens J. Christensen, Michael Kemp, Xiaohui C. Nielsen
{"title":"Next Generation Sequencing Improves Diagnostic 16S rRNA Amplicon-Based Microbiota Analyses of Clinical Samples Compared to Sanger Sequencing","authors":"Huma Aftab, Christian H. Schouw, Rimtas Dargis, Laus K. Vejrum, Rikke L. Johansen, Josefine Tange Møller, Tina V. Madsen, Asta Lili Laugesen, Jens J. Christensen, Michael Kemp, Xiaohui C. Nielsen","doi":"10.1111/apm.70067","DOIUrl":"https://doi.org/10.1111/apm.70067","url":null,"abstract":"<p>Sequencing of the 16S ribosomal RNA (rRNA) gene is an important tool in addition to conventional methods for the identification of bacterial pathogens in human infections. In polymicrobial samples, Sanger sequencing can produce uninterpretable chromatograms. This limitation can be overcome by Next Generation Sequencing (NGS) of the 16S rRNA gene. We investigated the applicability of Oxford Nanopore Technologies (ONT) sequencing of the partial 16S rRNA gene as a diagnostic routine method for pathogen detection in clinical samples. From June 2021 to August 2022, 101 clinical samples positive in PCR for partial 16S rRNA gene analysis were subjected to both Sanger and ONT sequencing. Sanger sequences were edited and compared with deposited sequences in the NCBI database using BLAST, while ONT data were processed using EPI2ME Fastq 16S. The positivity rate (clinically relevant pathogen) was higher for ONT vs. Sanger sequencing: 72% and 59%, respectively. Concordance between Sanger and ONT sequencing was 80%. Furthermore, ONT detected more samples with polymicrobial presence compared to Sanger (13 vs. 5) sequencing. Interestingly, in one joint fluid sample, <i>Borrelia bissettiiae</i> was identified by ONT but not by Sanger. The results show that the detection of both monobacterial and multiple bacterial species is improved using ONT.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 9","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Praveetha Senthilkumar, Siva Nandhini Suresh, Mohammad Ahmad Wadaan, Charumathi Pushparaj, Ramesh Subramani, Arunadevi Natarajan
{"title":"Kefir Grains in Self-Assembled Nanofibrils: Structural Role and Nutritional Applications","authors":"Praveetha Senthilkumar, Siva Nandhini Suresh, Mohammad Ahmad Wadaan, Charumathi Pushparaj, Ramesh Subramani, Arunadevi Natarajan","doi":"10.1111/apm.70064","DOIUrl":"https://doi.org/10.1111/apm.70064","url":null,"abstract":"<div>\u0000 \u0000 <p>Kefir grains offer numerous health benefits, including boosting the immune system, alleviating digestive issues, and enhancing antimicrobial activity. They are rich in beneficial probiotic bacteria that promote gut health and support a balanced intestinal microbiota. “Beta-lactoglobulin (β-lg), a well-known milk protein,” is used to create nanofibril structures that can serve as scaffolds. In this study, nanofibrils loaded with kefir were prepared using the self-assembly method and were incorporated during the initial stages of cheese preparation to modulate the structural properties. To confirm the integration of kefir grains and β-lactoglobulin (β-lg) nanofibrils, nutritional analysis, color analysis, in vitro release with PBS buffer, pH, and Acidity were analyzed. FT-IR spectroscopy and loading efficiency results (82%) confirm the incorporation of kefir grains into the nanofibrils, enhancing the bioavailability and health benefits. From the results, it is evident that higher loading efficiency occurs at lower concentrations (2%) of kefir grains, while at higher concentrations (3%), the kefir grains tend to form aggregates due to the bundling effect. Additionally, β-lg nanofibrils served as an effective scaffold material, supporting a novel strategy for developing functional dairy products with added gut health benefits.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 9","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bile Acids and Bile Acid Metabolites in the Activation and Inhibition of Pyroptotic Cell Death, Influencing Inflammation","authors":"Sukran Yagmur Avcioglu, Caglar Berkel","doi":"10.1111/apm.70066","DOIUrl":"https://doi.org/10.1111/apm.70066","url":null,"abstract":"<div>\u0000 \u0000 <p>Pyroptosis is a lytic and pro-inflammatory regulated cell death pathway mediated by pores formed by the oligomerization of gasdermin proteins on cellular membranes. Different pro-inflammatory molecules such as interleukin-18 are released from these pores, promoting inflammation. Pyroptotic cell death has been implicated in many pathological conditions, including cancer and liver diseases. Bile acids are amphipathic cholesterol-derived molecules, regulating many biological processes due to their unique structures and functions. Increasing data has recently shown that bile acids have additional novel functions besides their classical role as a lipid solubilizer in dietary lipid digestion. In the present review, primary and secondary bile acids that have been shown to be involved either in the activation or in the inhibition of pyroptotic cell death in diverse cell types and contexts, thereby modulating inflammation, were covered. Besides, their mechanisms of action in pro-inflammatory cell death and subsequent inflammation were detailed. These studies together point out that different bile acids might influence pyroptotic events in varied ways (either positively or negatively) depending on different parameters such as the type of bile acid, via distinct downstream players and molecular processes. A more complete understanding of bile acid-induced changes in pyroptotic events in different disease conditions is needed.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 9","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Performance of Short-Term Culture and Direct MALDI-TOF MS for Identification of Candida Species From Blood Cultures","authors":"Tugce Unalan-Altintop, Kristoffer Jansson, Volkan Özenci","doi":"10.1111/apm.70063","DOIUrl":"https://doi.org/10.1111/apm.70063","url":null,"abstract":"<p>Rapid and reliable identification of <i>Candida</i> spp. is crucial due to changing epidemiology and increasing resistance. This study aims to compare the identification rates, average Log Score (LS) values, and three different methods: short-term culture, Sepsityper kit, and an in-house method. Simulated blood culture (BC) samples with clinical <i>Candida</i> isolates and human blood from healthy donors were used. Sepsityper kit was used according to manufacturers' recommendations. An in-house protocol was designed using SDS for lysis of erythrocytes. Short-term culture was performed by inoculation of BC broth on Sabouraud Dextrose Agar (SDA) and chromogenic plates and cultured for 6 h. A total of 52 clinical <i>Candida</i> isolates were included in the study. The identification rate was highest (71.9%) for the short-term culture method, 59.6% for the Sepsityper kit, and 57.3% for the in-house method when all types of bottles were analyzed. Higher identification rates were obtained using the BD BACTEC Mycosis-IC/F bottles: 76.7% for the short-term culture method, 100% for the in-house method, and 76.9% for the Sepsityper kit. Short-term culture has high performance in the identification of <i>Candida</i> species, despite a slightly longer detection time than direct MALDI-TOF MS methods.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nidhi Chandrakar, Sudhir K. Shukla, Dugeshwar Karley, Namrata Upadhyay, Y. V. Nancharaiah
{"title":"Biogenic Silver Nanoparticles Exhibit Antifungal and Antibiofilm Activity Against Candida albicans via Intracellular ROS Production","authors":"Nidhi Chandrakar, Sudhir K. Shukla, Dugeshwar Karley, Namrata Upadhyay, Y. V. Nancharaiah","doi":"10.1111/apm.70061","DOIUrl":"https://doi.org/10.1111/apm.70061","url":null,"abstract":"<p>The emergence of antifungal resistance in <i>Candida albicans</i> necessitates the development of novel therapeutic strategies. This study evaluates the antifungal and antibiofilm activity of biogenic silver nanoparticles (bAgNPs) synthesized using <i>Staphylococcus saprophyticus</i> bacterial supernatant. UV–Visible spectroscopy confirmed the formation of bAgNPs, with a distinct absorbance peak at 418 nm. Minimum inhibitory concentration (MIC) testing determined that 50 μg/mL effectively inhibited fungal growth. bAgNPs significantly reduced biofilm biomass, with an 80 μg/mL concentration resulting in over a 70% reduction, as demonstrated by crystal violet staining and fluorescence microscopy. Mechanistic studies revealed that bAgNPs induced reactive oxygen species (ROS) production, with fluorescence intensity peaking at 80 μg/mL, leading to oxidative stress-mediated cell death. The yeast-to-hyphal transition, a key virulence mechanism, was inhibited, impeding the fungal invasiveness. Furthermore, the disruption of cell membrane integrity was confirmed by SYTO 9/propidium iodide staining, where over 60% of cells displayed compromised membranes at MIC. MTT assay results demonstrated that bAgNPs impaired mitochondrial function by reducing metabolic activity by 75% at MIC. These findings suggest that bAgNPs target multiple critical pathways, including ROS-mediated oxidative damage, membrane disruption, and metabolic impairment, thereby exerting a potent antifungal effect; thus, they present a promising approach for treating biofilm-associated <i>C. albicans</i> infections.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epigenetic Silencing of SFRP5 Promotes Hepatocellular Carcinoma Progression and Metastasis via Wnt/β-Catenin Signaling","authors":"Zhang Zhao, Fadian Ding, Zhibo Zhang","doi":"10.1111/apm.70060","DOIUrl":"https://doi.org/10.1111/apm.70060","url":null,"abstract":"<div>\u0000 \u0000 <p>Hepatocellular carcinoma (HCC) is an aggressive malignancy with poor prognosis, frequent metastasis, and therapy resistance. Epithelial-mesenchymal transition (EMT) and aberrant Wnt/β-catenin signaling are key drivers of HCC progression. Secreted frizzled-related protein 5 (SFRP5), a Wnt/β-catenin signaling antagonist, has been implicated in various cancers, but its role in HCC remains unclear. This study explores the regulatory interactions between SFRP5, EMT, and Wnt/β-catenin signaling in HCC. Bioinformatics analysis, patient-derived tissue samples, and in vitro experiments revealed significant downregulation of SFRP5 due to promoter hypermethylation. Methylation-specific PCR confirmed extensive SFRP5 methylation, while treatment with 5-Aza-2′-deoxycytidinerestored SFRP5 expression, suppressing Wnt/β-catenin signaling and EMT. Functional assays demonstrated that SFRP5 overexpression inhibited HCC cell proliferation, migration, and colony formation while promoting apoptosis. Western blot and immunofluorescence confirmed that SFRP5 restoration suppressed β-catenin and its targets (MYC, Cyclin D1, Survivin), increased E-cadherin, and decreased mesenchymal markers (Vimentin, Fibronectin, Twist). In vivo xenograft models showed that SFRP5 overexpression reduced tumor growth and EMT marker expression. These findings highlight SFRP5 as a tumor suppressor in HCC, where epigenetic silencing promotes tumor progression via Wnt/β-catenin signaling activation. Targeting SFRP5 methylation may provide a novel therapeutic strategy for HCC.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of Subcarinal Angle on Parenchymal Involvement and Disease Severity in COVID-19 Pneumonia: A Retrospective Analysis","authors":"Seda Akyol, Önder Eraslan","doi":"10.1111/apm.70062","DOIUrl":"https://doi.org/10.1111/apm.70062","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aims to examine the relationship between the subcarinal angle (SCA) and the risk and severity of parenchymal involvement in COVID-19 positive patients. This retrospective study involved 2006 patients, categorized into a study group of 1003 COVID-19 positive patients with parenchymal involvement and a control group of 1003 patients with COVID-19-like symptoms but without parenchymal involvement. Receiver Operating Characteristic (ROC) analysis was used to establish cut-off values for SCA and age that predict disease progression and severity. The study and control groups had mean ages of 51.80 and 45.76 years, respectively. Males had a higher frequency of parenchymal involvement (<i>p</i> = 0.003). ROC analysis identified SCA cut-offs of 34.5°–35.5° for the right SCA, 39.5°–40.5° for the left SCA, and 74.5°–75.5° for the total SCA. Age cut-offs were set at 47 years for increased risk and 54 years for greater severity of involvement. SCA values above 36° for the right, 42° for the left, and 77° for the total significantly increased the Tomographic Severity Score (TSS), indicating more severe disease. The TSS was higher in males and positively correlated with age and SCA, suggesting that both factors are important in predicting the severity of COVID-19 pneumonia. SCA is a key predictor of the severity and extent of COVID-19 pneumonia. Measuring SCA alongside age can enhance early risk assessment, disease management, and the implementation of timely and effective interventions, potentially reducing the morbidity and mortality associated with the disease.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gizem Babuccu, Özgür Albayrak, Füsun Can, Özlem Doğan
{"title":"Early Human Neutrophil Response to Different Morphotypes of Candida albicans Compared to Bacterial Pathogens","authors":"Gizem Babuccu, Özgür Albayrak, Füsun Can, Özlem Doğan","doi":"10.1111/apm.70059","DOIUrl":"https://doi.org/10.1111/apm.70059","url":null,"abstract":"<div>\u0000 \u0000 <p>Neutrophils are among the first immune cells recruited during the critical early phase of infection; yet their reaction to <i>Candida albicans</i> morphotypes is not fully defined. Here, we aimed to investigate early neutrophil responses to <i>C. albicans</i> morphotypes compared to bacteria. Freshly isolated human neutrophils were incubated with heat-killed <i>C. albicans</i>, live <i>C. albicans</i>, <i>Escherichia coli</i>, and <i>Staphylococcus aureus</i> as bacterial comparisons for 30 min, 1 h, and 4 h. Afterward, neutrophil activation was assessed via gene expression of neutrophil elastase (ELANE) and myeloperoxidase (MPO), CD66b/CD11b surface marker expression, microbicidal activity, and cytokine release, including IL-22, IL-17A, IL-1ɑ, IL-1β, TNF-ɑ, and IL-6. Neutrophil response pathways were significantly more activated by hyphal <i>C. albicans</i> than HK <i>C. albicans, E</i><i>.coli</i><i>,</i> and <i>S. aureus</i>, including the highest MPO and ELANE expression within the first 4 h, compared to heat-killed <i>C. albicans</i> and bacteria. CD66b expression significantly upregulated at 1 h in response to hyphal <i>C. albicans</i>. Neutrophils exhibited a 68% candidacidal effect at 1 h. IL-22 peaked at 1 h and remained elevated; heat-killed <i>C. albicans</i> induced IL-22 and IL-17A at 4 h. Neutrophils show stronger early responses against <i>C. albicans</i> morphotypes compared to <i>E. coli</i> and <i>S. aureus</i>, particularly within 1 h.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Clarithromycin Combined With Oxymetazoline Hydrochloride Spray on Olfactory Function and Inflammatory Factors in Patients With Acute Exacerbations of Chronic Rhinosinusitis","authors":"Kailin Jin, Qin Zhao, Yinzhong Chen","doi":"10.1111/apm.70055","DOIUrl":"https://doi.org/10.1111/apm.70055","url":null,"abstract":"<div>\u0000 \u0000 <p>This study is intended to expound the effect of clarithromycin combined with oxymetazoline hydrochloride (OZH) spray in acute exacerbations of chronic rhinosinusitis (AECRS). Patients with AECRS were retrospectively collected and divided into a control group and an observation group. The control group received clarithromycin, and the observation group received OZH spray in addition to clarithromycin. Symptom resolution time, nasal mucociliary transmission velocity, nasal endoscopy score, olfactory function, serum inflammatory factor levels, incidence of adverse reactions, and 6-month recurrence were recorded. After treatment, the observation group showed shorter resolution times for headache, runny nose, nasal congestion, and nasal mucosal edema; higher nasal mucociliary transport rate (MTR) and clearance (MCC); lower Lund-Kennedy score; more Grades I cases; fewer Grades III cases; lower levels of serum IL-6, TNF-α, hs-CRP, IL-8, and IL-1β; and lower recurrence rate than the control group (<i>p <</i> 0.05). The incidence of adverse reactions in the two groups was not statistically significant (<i>p</i> > 0.05). Clarithromycin combined with OZH spray is more effective in patients with AECRS, which can shorten symptom resolution time, increase nasal MTR, improve olfactory function, reduce inflammation and recurrence rates, and have a high degree of safety.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}