Rowan Nicholas R, Wang Eric W, Kanaan Alyssa, Sahu Nivedita, Williams John V, Phillips Caleb D, Lee Stella E
Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Am J Rhinol Allergy. 2017 Mar 1;31(2):105-108. doi: 10.2500/ajra.2017.31.4422.
Pulmonary colonization with antibiotic-resistant organisms in patients with cystic fibrosis (CF) is often preceded by upper-airway infections. Although there is a well-described relationship between pulmonary respiratory viral infections and overall disease progression of CF, the pathogenicity of respiratory viral infections in the paranasal sinuses of patients with CF remains unknown. With recent advances in respiratory virus detection techniques, this study sought to detect the presence of respiratory viruses in the paranasal sinuses of patients with CF in comparison with healthy controls and to correlate the viral presence with clinical measures of sinonasal disease.
This prospective individual cohort study compared 24 patients with CF with 14 healthy controls. Basic demographics, clinical measures of disease and respiratory viral screens (commercial multiplex) obtained directly from the paranasal sinuses were compared between the two groups.
Respiratory viruses were detected in 33% of patients with CF (8/24) compared with 0% of the healthy controls (0/14) (p = 0.017). Respiratory viruses were only detected during the winter months, and the most commonly identified were influenza A and human rhinovirus strains. There was no statistical difference in the 22-Item Sino-Nasal Outcome Test (SNOT-22) scores (p = 0.93) or modified Lund-Kennedy scores (p = 0.74) between patients with CF with a positive viral test and those without a positive result.
Respiratory viral detection is more commonly detected in the paranasal sinuses of patients with CF compared with healthy controls. Although respiratory viral presence did not correlate with a worse clinical severity of sinonasal disease, these findings may provide insight into the pathophysiology of CF and open new avenues for potential targeted therapy.
囊性纤维化（CF）患者肺部出现抗生素耐药菌定植之前，通常先有上呼吸道感染。虽然肺部呼吸道病毒感染与CF的整体疾病进展之间的关系已有详细描述，但CF患者鼻旁窦中呼吸道病毒感染的致病性仍不清楚。随着呼吸道病毒检测技术的最新进展，本研究旨在检测CF患者鼻旁窦中呼吸道病毒的存在情况，并与健康对照进行比较，同时将病毒的存在情况与鼻旁窦疾病的临床指标相关联。
这项前瞻性个体队列研究将24例CF患者与14名健康对照进行了比较。比较了两组之间的基本人口统计学、疾病临床指标以及直接从鼻旁窦获得的呼吸道病毒筛查结果（商业多重检测）。
33%的CF患者（8/24）检测到呼吸道病毒，而健康对照中这一比例为0%（0/14）（p = 0.017）。呼吸道病毒仅在冬季被检测到，最常见的是甲型流感病毒和人鼻病毒株。病毒检测呈阳性的CF患者与检测结果为阴性的患者在22项鼻鼻窦结局测试（SNOT-22）评分（p = 0.93）或改良的Lund-Kennedy评分（p = 0.74）上没有统计学差异。
与健康对照相比，CF患者鼻旁窦中呼吸道病毒检测更为常见。虽然呼吸道病毒的存在与鼻旁窦疾病更严重的临床严重程度无关，但这些发现可能有助于深入了解CF的病理生理学，并为潜在的靶向治疗开辟新途径。
