Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan.
Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan.
Allergol Int. 2019 Apr;68(2):225-232. doi: 10.1016/j.alit.2018.09.005. Epub 2018 Oct 19.
In Eosinophilic chronic rhinosinusitis (ECRS), it is difficult to estimate the refractoriness and recurrence risk for each patient. Fraction of exhaled nitric oxide (FeNO) is known as a biomarker of eosinophilic inflammation in lower airway. It has been reported that nasal NO has some crucial functions in the upper and lower airways. However, in upper airway, paranasal sinuses, the usefulness of NO measurement remains controversial. The purpose of this study is to identify the usefulness of nasal NO measurement in ECRS and the involvement of nasal NO in the pathogenesis of ECRS.
We compared the nasal NO levels of ECRS, non-ECRS, and normal control groups. Correlation between nasal NO levels and clinical findings were observed. Then, we compared nasal NO levels before and after endoscopic sinus surgery (ESS). We also examine whether nasal NO levels might discriminate ECRS by the receiver operating characteristic (ROC) curve analysis.
Nasal NO levels were significantly decreased in ECRS compared to the other two groups. Moreover, nasal NO levels in ECRS significantly and negatively correlated with eosinophil levels and CT score. However, they did not correlate with the nasal polyp score. Nasal NO levels were not upregulated soon after opening the sinus ostium by ESS. The ROC curves for nasal NO levels were used to discriminate all CRS patients and ECRS patients from normal controls.
Nasal NO may be useful as a marker of ECRS severity and low nasal NO levels in ECRS may contribute to its pathogenesis.
在嗜酸性慢性鼻-鼻窦炎（ECRS）中，难以估计每个患者的难治性和复发风险。呼出气一氧化氮（FeNO）分数是下气道嗜酸性炎症的生物标志物。据报道，鼻 NO 在上下气道中具有一些关键功能。然而，在上气道，鼻窦中，NO 测量的有用性仍存在争议。本研究的目的是确定鼻 NO 测量在 ECRS 中的有用性以及 NO 在 ECRS 发病机制中的作用。
我们比较了 ECRS、非 ECRS 和正常对照组的鼻 NO 水平。观察鼻 NO 水平与临床发现之间的相关性。然后，我们比较了内镜鼻窦手术（ESS）前后的鼻 NO 水平。我们还通过接收者操作特征（ROC）曲线分析检查鼻 NO 水平是否可以区分 ECRS。
与其他两组相比，ECRS 的鼻 NO 水平显著降低。此外，ECRS 中的鼻 NO 水平与嗜酸性粒细胞水平和 CT 评分呈显著负相关。然而，它们与鼻息肉评分无关。ESS 后，窦口开放后鼻 NO 水平并未立即上调。鼻 NO 水平的 ROC 曲线用于区分所有 CRS 患者和 ECRS 患者与正常对照组。
鼻 NO 可能是 ECRS 严重程度的有用标志物，而 ECRS 中的低鼻 NO 水平可能有助于其发病机制。
