慢性鼻窦炎和鼻炎：临床术语“慢性鼻-鼻窦炎”得到进一步支持。
Chronic sinusitis and rhinitis: clinical terminology "Chronic Rhinosinusitis" further supported.
机构信息
Upper Airway Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Gent, Belgium.
出版信息
Rhinology. 2010 Mar;48(1):54-8. doi: 10.4193/Rhin09.078.
BACKGROUND
Chronic rhinosinusitis (CRS) is a heterogeneous group of inflammatory diseases of the nasal and paranasal cavities, either accompanied by polyp formation (CRSwNP) or without polyps (CRSsNP). The etiology and pathophysiology is unknown; some specialists define rhinitis and sinusitis as one clinical entity, whereas others regard both as separate dis-eases. We therefore investigated the immunological background of the chronically inflamed nasal and sinusal mucosa.
METHODS
Protein levels of the inflammatory mediators ILl-beta, IL-5, ECP, INF-gamma, and TGF-beta were assessed in ethmoidal mucosal samples from CRSsNP and CRSwNP patients, and compared with the expression profile in nasal inferior turbinate (17) mucosa of the same patient groups. Nasal tissue of patients without disease served as control.
RESULTS
In CRSwNP, increased levels of IL-5 and ECP were not only observed in ethmoidal samples, but also in the nasal IT-mucosa. TGF-beta levels were lower in polyps, reaching significance versus ethmoidal mucosa of CRSsNP. In CRSsNP, INF-gamma levels are up-regulated in both ethmoidal and nasal mucosa compared to control tissue.
CONCLUSION
On the basis of similar inflammatory mediator profiles, we conclude that rhinitis accompanies chronic sinusitis, supporting the consensus term "rhinosinusitis". On the other hand, CRSsNP and CRSwNP should be regarded as distinct clinical entities.
背景
慢性鼻-鼻窦炎（CRS）是鼻腔和鼻旁窦的炎症性疾病，其表现为伴有息肉形成（CRSwNP）或不伴有息肉（CRSsNP）。其病因和发病机制尚不清楚；一些专家将鼻炎和鼻窦炎定义为一种临床实体，而另一些专家则认为它们是两种独立的疾病。因此，我们研究了慢性炎症性鼻-鼻窦黏膜的免疫学背景。
方法
评估了 CRSsNP 和 CRSwNP 患者筛窦黏膜样本中炎症介质白细胞介素 1β（IL-1β）、白细胞介素 5（IL-5）、嗜酸性粒细胞阳离子蛋白（ECP）、干扰素 γ（INF-γ）和转化生长因子-β（TGF-β）的蛋白水平，并与同一患者组的下鼻甲（17）黏膜的表达谱进行比较。未患病患者的鼻组织作为对照。
结果
在 CRSwNP 中，不仅在筛窦样本中，而且在鼻内下鼻甲黏膜中均观察到 IL-5 和 ECP 水平升高。TGF-β 水平在息肉中较低，与 CRSsNP 的筛窦黏膜相比达到显著水平。在 CRSsNP 中，与对照组织相比，IFN-γ水平在内窥镜和鼻黏膜中均上调。
结论
基于相似的炎症介质谱，我们得出结论，鼻炎伴随慢性鼻窦炎，支持“鼻-鼻窦炎”这一共识术语。另一方面，CRSsNP 和 CRSwNP 应被视为两种不同的临床实体。
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