- Book学术

发布求助

文献互助智能选刊最新文献

IF 2.5 4区医学 Q3 ALLERGY

International Archives of Allergy and Immunology Pub Date : 2025-02-26 DOI:10.1159/000544872

Yizhen Jia, Junhao Tu, Binxiang Tang, Fan Jiang, Qing Luo, Jing Ye

{"title":"Impact of Nasal Glucocorticoid Therapy on Exhaled Nitric Oxide and Symptom Relief in Chronic Rhinosinusitis with Nasal Polyps: A Randomized Prospective Study.","authors":"Yizhen Jia, Junhao Tu, Binxiang Tang, Fan Jiang, Qing Luo, Jing Ye","doi":"10.1159/000544872","DOIUrl":null,"url":null,"abstract":"Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a widespread inflammatory disease, classified into eosinophilic (EosCRSwNP) and non-eosinophilic (non-EosCRSwNP) types. Nitric oxide (NO) plays a role in pathophysiological processes, with changing levels in airway diseases like asthma and CRS. Intranasal corticosteroids (INCS) are first-line treatments for CRSwNP, providing anti-inflammatory and immunomodulatory effects pre- and post-endoscopic sinus surgery (ESS). This study examines the influence of nasal steroids on nasal exhaled NO (FnNO) post-ESS in EosCRSwNP and non-EosCRSwNP patients and assesses the prognostic value of FnNO measurement for different CRSwNP types.Methods: This randomized, open-label, prospective study included 20 healthy controls, 30 EosCRSwNP patients, and 35 non-EosCRSwNP patients. All CRSwNP subjects underwent ESS following FnNO determination. Post-surgery, both endotypes were randomly assigned to nasal steroid or normal saline groups, receiving budesonide spray or saline irrigation for 90 days. FnNO, nasal endoscopy, and VAS scores were assessed on days 15, 45, and 90.Results: This study found pre-ESS FnNO levels to be lower in CRSwNP patients (181.2 ± 142.0 ppb) compared to controls (330.5 ± 98.7 ppb, p < 0.001) and further reduced in non-EosCRSwNP (144.7 ± 91.2 ppb) compared to EosCRSwNP patients (223.3 ± 147.8 ppb, p < 0.05). Post-ESS, EosCRSwNP patients responded better to nasal steroids, with FnNO levels returning to normal within 90 days of intervention (p > 0.05). No significant correlation was found between post-ESS FnNO levels, changes in Lund-Kennedy endoscopy scores, CT Lund-Mackay paranasal sinus scores, and postoperative prognosis in CRSwNP patients.Conclusion: The determination of FnNO is helpful for the differential diagnosis of EosCRSwNP, which is more sensitive to nasal spray glucocorticoid, and the use of nasal spray glucocorticoid post-ESS is helpful for early and rapid recovery of FnNO. FnNO measurement could not be used as an indicator to assess the recovery status of the postoperative surgical area.","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-13"},"PeriodicalIF":2.5000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Archives of Allergy and Immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000544872","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}

引用次数: 0

摘要

导言：慢性鼻炎伴鼻息肉（CRSwNP）是一种广泛的炎症性疾病，分为嗜酸性（EosCRSwNP）和非嗜酸性（non-EosCRSwNP）两种类型。一氧化氮（NO）在病理生理过程中发挥作用，在哮喘和 CRS 等气道疾病中其含量会发生变化。鼻内皮质类固醇（INCS）是治疗 CRSwNP 的一线药物，在内窥镜鼻窦手术（ESS）前后具有抗炎和免疫调节作用。本研究探讨了鼻腔类固醇对 EosCRSwNP 和非 EosCRSwNP 患者手术后鼻腔呼出一氧化氮（FnNO）的影响，并评估了 FnNO 测量对不同 CRSwNP 类型的预后价值。方法这项随机、开放标签、前瞻性研究包括 20 名健康对照组、30 名 EosCRSwNP 患者和 35 名非 EosCRSwNP 患者。所有 CRSwNP 受试者都在确定 FnNO 后接受了 ESS。手术后，两种内型均被随机分配到鼻腔类固醇组或生理盐水组，接受布地奈德喷剂或生理盐水冲洗，为期 90 天。分别在第 15、45 和 90 天对 FnNO、鼻内窥镜检查和 VAS 评分进行评估。结果该研究发现，与对照组（330.5 ± 98.7 ppb）相比，CRSwNP 患者在手术前的 FnNO 水平较低（181.2 ± 142.0 ppb），而与 EosCRSwNP 患者（223.3 ± 147.8 ppb）相比，非 EosCRSwNP 患者的 FnNO 水平进一步降低（144.7 ± 91.2 ppb），P < 0.05）。干预后，EosCRSwNP 患者对鼻类固醇的反应更好，FnNO 水平在干预后 90 天内恢复正常（p > 0.05）。EosCRSwNP 患者干预后的 FnNO 水平、Lund-Kennedy 内镜检查评分、CT Lund-Mackay 副鼻窦评分的变化与 CRSwNP 患者的术后预后之间没有发现明显的相关性。结论 FnNO 的测定有助于 EosCRSwNP 的鉴别诊断，而 EosCRSwNP 对喷鼻糖皮质激素更为敏感，ESS 后使用喷鼻糖皮质激素有助于 FnNO 的早期快速恢复。FnNO 测量不能作为评估术后手术区域恢复状况的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Impact of Nasal Glucocorticoid Therapy on Exhaled Nitric Oxide and Symptom Relief in Chronic Rhinosinusitis with Nasal Polyps: A Randomized Prospective Study.

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a widespread inflammatory disease, classified into eosinophilic (EosCRSwNP) and non-eosinophilic (non-EosCRSwNP) types. Nitric oxide (NO) plays a role in pathophysiological processes, with changing levels in airway diseases like asthma and CRS. Intranasal corticosteroids (INCS) are first-line treatments for CRSwNP, providing anti-inflammatory and immunomodulatory effects pre- and post-endoscopic sinus surgery (ESS). This study examines the influence of nasal steroids on nasal exhaled NO (FnNO) post-ESS in EosCRSwNP and non-EosCRSwNP patients and assesses the prognostic value of FnNO measurement for different CRSwNP types.

Methods: This randomized, open-label, prospective study included 20 healthy controls, 30 EosCRSwNP patients, and 35 non-EosCRSwNP patients. All CRSwNP subjects underwent ESS following FnNO determination. Post-surgery, both endotypes were randomly assigned to nasal steroid or normal saline groups, receiving budesonide spray or saline irrigation for 90 days. FnNO, nasal endoscopy, and VAS scores were assessed on days 15, 45, and 90.

Results: This study found pre-ESS FnNO levels to be lower in CRSwNP patients (181.2 ± 142.0 ppb) compared to controls (330.5 ± 98.7 ppb, p < 0.001) and further reduced in non-EosCRSwNP (144.7 ± 91.2 ppb) compared to EosCRSwNP patients (223.3 ± 147.8 ppb, p < 0.05). Post-ESS, EosCRSwNP patients responded better to nasal steroids, with FnNO levels returning to normal within 90 days of intervention (p > 0.05). No significant correlation was found between post-ESS FnNO levels, changes in Lund-Kennedy endoscopy scores, CT Lund-Mackay paranasal sinus scores, and postoperative prognosis in CRSwNP patients.

Conclusion: The determination of FnNO is helpful for the differential diagnosis of EosCRSwNP, which is more sensitive to nasal spray glucocorticoid, and the use of nasal spray glucocorticoid post-ESS is helpful for early and rapid recovery of FnNO. FnNO measurement could not be used as an indicator to assess the recovery status of the postoperative surgical area.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

International Archives of Allergy and Immunology 医学-过敏

CiteScore

5.60

自引率

3.60%

发文量

105

审稿时长

2 months

期刊介绍： ''International Archives of Allergy and Immunology'' provides a forum for basic and clinical research in modern molecular and cellular allergology and immunology. Appearing monthly, the journal publishes original work in the fields of allergy, immunopathology, immunogenetics, immunopharmacology, immunoendocrinology, tumor immunology, mucosal immunity, transplantation and immunology of infectious and connective tissue diseases.