Polypous rhinosinusitis in combination with bronchial asthma: clinical features and cellular characteristics of local and systemic inflammation

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  • Authors: Kurbacheva O.M.1, Dyneva M.E.1, Shilovskii I.P.1, Savlevich E.L.2, Kovchina V.I.1, Nikolskii A.A.1, Savushkina E.I.2, Khaitov M.R.3
  • Affiliations:
    1. NRC Institute of Immunology FMBA of Russia
    2. Federal State Budgetary Institution of Higher Professional Education “Central State Medical Academy” of the Office of the President of the Russian Federation
    3. National Research Center - Institute of Immunology Federal Medical-Biological Agency of Russia
  • Issue: Vol 17, No 1 (2020)
  • Pages: 32-49
  • Section: Articles
  • URL: http://rusalljournal.ru/raj/article/view/1346
  • DOI: https://doi.org/10.36691/RAJ.2020.17.1.003
  • Cite item
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Abstract


Background. The combination of chronic rhinosinusitis with nasal polyps (CRSwNP) and bronchial asthma (BA) is currently considered as a separate phenotype characterized by similar features of inflammatory changes leading to an increase in the clinical course of both CRSwNP and BA. The aim of the study was to investigate the clinical features and characteristics of the local and systemic inflammatory process in patients having a combination of CRSwNP and BA. Materials and methods. The study included 96 volunteers, who were divided into 4 groups: group 1 consisted of healthy volunteers (Normal); group 2 consisted of volunteers with CRSwNP in combination with allergic BA (CRSwNP + aBA); group 3 - volunteers with PRS in combination with non-allergic BA (CRSwNP + nBA); and group 4 - CRSwNP without BA. Clinical, laboratory, instrumental and allergology examination methods were applied for all participants of the study. BA control status was determined using the asthma control questionnaire (ACQ-7), and CRSwNP control status was determined using the nasal and paranasal sinus clinical outcome control questionnaire (SNOT-22). At the same time, the quality of life of the patients was also evaluated using AQLQ (Asthma Quality of Life Questionnaire). Results. The results confirmed the interaction of BA and CRSwNP, where the combination of these diseases led to a more severe and uncontrolled clinical course of BA and CRSwNP based on the assessment using SNOT-22, ACQ-7 and AQLQ questionnaires. These results correlated with an increase in the absolute number of eosinophils in peripheral blood and pronounced eosinophilic cell infiltration of nasal polyp stroma. Data processing demonstrated that the combination of CRSwNP and nBA showed signs of more pronounced eosinophilic inflammation, which is an unfavorable prognostic factor. Conclusions. The comparison of the cellular characteristics of the local and systemic inflammatory process in patients with CRSwNP in combination with BA allowed us to conclude that polyp development follows a local inflammatory process. Further study of the pathogenesis of CRSwNP and BA will help to understand the mechanisms that connect these diseases and consider possible target molecules for biological therapy.

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Oksana Mikhailovna Kurbacheva

NRC Institute of Immunology FMBA of Russia

Email: kurbacheva@gmail.com

Miramgul Esengeldyevna Dyneva

NRC Institute of Immunology FMBA of Russia

Email: amanturliva.miramgul@mail.ru

Igor Petrovich Shilovskii

NRC Institute of Immunology FMBA of Russia

Email: igorshilovski@gmail.com

Elena Leonidovna Savlevich

Federal State Budgetary Institution of Higher Professional Education “Central State Medical Academy” of the Office of the President of the Russian Federation

Email: savllena@gmail.com

Valeriia Ivanovna Kovchina

NRC Institute of Immunology FMBA of Russia

Email: kvi91@mail.ru

Aleksandr Arkadevich Nikolskii

NRC Institute of Immunology FMBA of Russia

Email: aa.nikolskii@nrcii.ru

Elizaveta Iurevna Savushkina

Federal State Budgetary Institution of Higher Professional Education “Central State Medical Academy” of the Office of the President of the Russian Federation

Email: lizasavushkina@mail.ru

Musa Rakhimovich Khaitov

National Research Center - Institute of Immunology Federal Medical-Biological Agency of Russia

Email: mr.khaitov@nrcii.ru

  1. Kim DW, Cho SH. Emerging endotypes of chronic rhinosinusitis and its application to precision medicine. Allergy Asthma Immunol Res. 2017;9(4):299-306. DOI: 10.4168/ aair.2017.9.4.299.
  2. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I et al. European position paper on rhinosinusitis and nasal polyps. Rhinol Suppl. 2012;50(23):1-298. DOI: 10.2500/ ajra.2013.27.3925.
  3. Serrano E, Neukirch F, Pribil C, Jankowski R, Klossek JM et al. Nasal polyposis in France: impact on sleep and quality of life. J Laryngol Otol. 2005;119(7):543-549. doi: 10.1258/0022215054352108.
  4. Савлевич ЕЛ, Гаганов ЛЕ, Егоров ВИ, Курбачева ОМ, Герасимов АН, Шачнев КН. Сравнительное пилотное исследование эндотипов хронического полипозного риносинусита у пациентов, проживающих в разных географических регионах Российской Федерации. Иммунология. 2018;39(4):208-213. doi: 10.18821/0206-49522018-39-4-208-213.
  5. Шиловский ИП, Дынева МЕ, Курбачева ОМ, Кудлай ДА, Хаитов МЕ Роль интерлейкина-37 в патогенезе аллергических заболеваний. ACTA NATURAE. 2019;4(43):54-64. doi: 10.32607/20758251-2019-11-4-54-64.
  6. Курбачева ОМ, Павлова КС. Фенотипы и эндотипы бронхиальной астмы: от патогенеза и клинической картины к выбору терапии. Российский Аллергологический Журнал. 2013;10(1):15-24.
  7. Chaaban MR, Walsh EM, Erika M, Woodworth BA et al. Epidemiology and differential diagnosis of nasal polyps. Am J Rhinol Allergy. 2013;27(6):473-478.
  8. Савлевич ЕЛ, Дынева МЕ, Гаганов ЛЕ, Егоров ВИ, Герасимов АН, Курбачева ОМ. Лечебно-диагностический алгоритм при разных фенотипах полипозного риносинусита. Российский Аллергологический Журнал. 2019;16(2):50-61.
  9. Soler ZM, Mace JC, Litvack JR, Smith TL. Chronic rhinosinusitis, race, and ethnicity. Am J Rhinol Allergy. 2012;26:110-116. doi: 10.2500/ajra.2012.26.3741.
  10. Дынева МЕ, Курбачёва ОМ, Савлевич ЕЛ. Бронхиальная астма в сочетании с хроническим полипозным риносинуситом: эпидемиология, распространенность и особенности их взаимоотношения. Российский Аллергологический Журнал. 2018;15(1):16-25.
  11. Stevens WW, Peters AT, Hirsch aG, Nordberg CM, Schwartz BS et al. Clinical Characteristics of Patients with Chronic Rhinosinusitis with Nasal Polyps, Asthma, and Aspirin-Exacerbated Rbiespiratory Disease. J Allergy Clin Immunol Pract. 2017;5(4):1061-1070. doi: 10.1016/j.jaip.2016.12.027.
  12. Mortuaire G, Gengler I, Balden M, Capron M, Lefevre G. Impact of allergy on phenotypic and endotypic profiles of nasal polyposis. European Annals of Otorhinolaryngology Head and Neck Diseases. 2017;135:159-162. DOI: 10.1016/j. anorl.2017.11.005.
  13. Курс патогистологической техники. Под ред. Меркулова ГА. Л.: Медгиз; 1961.
  14. Yeganeh C, Xia H, Movassagh C, Koziol-White Chang Y et al. Emerging mediators of airway smooth muscle dysfunction in asthma. Pulm Pharmacol Ther. 2013;26(1):105-111. doi: 10.1016/j.pupt.2012.06.011.
  15. Raedler D, Ballenberger N, Klucker E, Bock A et al. Identification of novel immune phenotypes for allergic and nonallergic childhood asthma. J Allergy Clin Immunol. 2015;135(1):81-91. doi: 10.1016/j.jaci.2014.07.046.
  16. Lin DC, Chandra RK, Tan BK, Zirkle W Conley DB et al. Association between severity of asthma and degree of chronic rhinosinusitis. Am J Rhinol Allergy. 2011;25:205-208. doi: 10.2500/ajra.2011.25.3613.
  17. Чичкова НВ. Бронхиальная астма и полипозный риносинусит: особенности клинического течения и тактика ведения больных. Астма и аллергия. 2015;1:19-22.
  18. Yacoub MR, Trimarchi M, Cremona G, Dal Farra S et al. Are atopy and eosinophilic bronchial inflammation associated with relapsing forms of chronic rhinosinusitis with nasal polyps? Clin Mol Allergy. 2015; 13(1):1-6. doi: 10.1186/s12948-015-0026-8.
  19. Pearlman AN, Chandra RK, Chang D, Conley DB et al. Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy 2009;23(2):145-148. doi: 10.2500/ajra.2009.23.3284.

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