Odat Haitham, Alali Maulla, Al-Qudah Mohannad
Division of Otolaryngology, Department of Special Surgery, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan.
SAGE Open Med. 2020 Jun 25;8:2050312120933809. doi: 10.1177/2050312120933809. eCollection 2020.
The aim of this study is to report the aeroallergen sensitization profile in medically resistant chronic rhinosinusitis with or without nasal polyps and its relationship to asthma.
Retrospective charts review of 402 chronic rhinosinusitis patients who failed to respond to medical treatment and scheduled for surgery at a tertiary academic center was performed. One hundred and fifty-five patients had chronic rhinosinusitis with nasal polyps and 247 patients had chronic rhinosinusitis without nasal polyps, furthermore; the two phenotypes were subdivided according to the presence or absence of asthma. Allergen-specific immunoglobulin E to 24 inhalant allergens was measured to all patients by the enzyme allergo-sorbent test.
The average age was 35 years ( ± 13) with 236 males and 166 females. Two hundred and fifty-three patients (63%) were tested positive for at least one allergen with no significant difference between patients with or without polyp (in chronic rhinosinusitis with nasal polyps, 103 patients (66%) were positive compared with 150 patients (61%) in chronic rhinosinusitis without nasal polyps). There were no significant differences in the prevalence, type, and number of positive allergens between the two phenotypes. The prevalence of asthma was found to be 19% in patients with chronic rhinosinusitis without nasal polyps versus 46% in those with chronic rhinosinusitis with nasal polyps ( = 0.001), and the prevalence of high eosinophils was 27%, and 47% in both phenotypes, respectively ( = 0.0001).
The prevalence of inhalational allergy in medically resistant chronic rhinosinusitis is high, however, this profile does not differ based on the presence of polyp. Patients with chronic rhinosinusitis with nasal polyps had a higher prevalence of asthma and blood eosinophils as compared with chronic rhinosinusitis without nasal polyps. Our results showed a little role of inhalant allergens in nasal polyps or asthma comorbidity in refractory sinusitis patients.
本研究旨在报告药物治疗抵抗的慢性鼻-鼻窦炎伴或不伴鼻息肉患者的气传变应原致敏情况及其与哮喘的关系。
对在一家三级学术中心接受手术治疗的402例药物治疗无效的慢性鼻-鼻窦炎患者进行回顾性病历审查。其中155例为慢性鼻-鼻窦炎伴鼻息肉患者，247例为慢性鼻-鼻窦炎不伴鼻息肉患者；此外，根据哮喘的有无将这两种表型进一步细分。通过酶联免疫吸附试验对所有患者检测24种吸入性变应原的特异性免疫球蛋白E。
平均年龄为35岁（±13），男性236例，女性166例。253例患者（63%）至少对一种变应原检测呈阳性，伴息肉或不伴息肉的患者之间无显著差异（在慢性鼻-鼻窦炎伴鼻息肉患者中，103例（66%）呈阳性，而慢性鼻-鼻窦炎不伴鼻息肉患者中有150例（61%）呈阳性）。两种表型在变应原阳性的患病率、类型和数量方面无显著差异。发现慢性鼻-鼻窦炎不伴鼻息肉患者的哮喘患病率为19%，而慢性鼻-鼻窦炎伴鼻息肉患者为46%（P = 0.001），两种表型中嗜酸性粒细胞增多的患病率分别为27%和47%（P = 0.0001）。
药物治疗抵抗的慢性鼻-鼻窦炎患者中吸入性过敏的患病率较高，然而，这种情况并不因鼻息肉的存在而有所不同。与慢性鼻-鼻窦炎不伴鼻息肉患者相比，慢性鼻-鼻窦炎伴鼻息肉患者的哮喘患病率和血液嗜酸性粒细胞水平更高。我们的结果显示吸入性变应原在难治性鼻窦炎患者鼻息肉或哮喘合并症中作用较小。
