Sinonasal symptoms and systemic Type 2 Inflammation markers in children with concomitant asthma and allergic rhinitis: The impact of polypoid-hyperplastic changes of the sinonasal mucosa.



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Abstract

BACKGROUND: Bronchial asthma (BA) and allergic rhinitis (AR) often concomitant to form a single clinical and pathogenetic syndrome based on the activation of T2 inflammation. Important biomarkers of this type of inflammation are eosinophils and total immunoglobulin E (IgE). Prolonged course of AR in patients with asthma can lead to the development of chronic rhinosinusitis with polypoid-hyperplastic changes (PHC) in the sinonasal mucosa. The effect of PHC on the severity of clinical manifestations and the level of systemic biomarkers of T2 inflammation in patients with a combination of asthma and AR in the pediatric population cannot be considered established.

AIMS: Сomparаtive the clinical manifestations (assessed by TNSS and SNOT-22 scales) and the content of systemic biomarkers of T2 inflammation between groups with the presence and absence of PHC in children and adolescents with combined course of BA and AR.

MATERIALS AND METHODS: The single-stage, single-center observational study included patients with asthma and AR aged 6-17 years. All patients underwent clinical and laboratory examinations, rhino endoscopy and computed tomography of the nose and paranasal sinuses according to indications.

RESULTS: Totally, 268 patients were examined: 203 boys (75,75%) and 65 girls (24,25%). PHC was detected in 31,84% of patients. Clinical symptoms (assessed using the TNSS and SNOT-22 scales) were more pronounced in children with PGSS compared to those without PHC (p<0,001), but there was no significant difference between boys and girls in terms of these symptoms. At the same time, TNSS scores were statistically significantly higher for girls than for boys (p=0,045), and SNOT22 scores were significantly higher in both groups (p <0,05). Higher levels of eosinophils and total IgE were also recorded by children with PHC (p< 0,01 and 0,5 respectively), indicating a significant role for systemic T2 inflammation in this

CONCLUSIONS: The presence of PHC by children and adolescents with asthma and AR correlates with increased clinical symptoms and increased levels of eosinophils in blood and total serum IgE, especially in girls. The results obtained indicate the potential involvement of systemic T2-inflammation in the processes of pathological remodeling and the formation of structural disorders of PHC

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About the authors

Svetlana Krasilnikova

Privolzhsky Research Medical University

Email: mashkovasv@mail.ru
ORCID iD: 0000-0001-6153-6691
SPIN-code: 2581-2539

кандидат медицинских наук, доцент кафедры болезней уха, горла и носа им. профессора В.Ю. Шахова

Россия

Kseniya Viktorovna Gorbunova

Email: ksenya.gorbunova@mail.ru
ORCID iD: 0000-0003-4985-1546
SPIN-code: 3218-6210

Dmitry Yu. Ovsyannikov

Patrice Lumumba Peoples’ Friendship University of Russia

Email: mdovsyannikov@yahoo.com
ORCID iD: 0000-0002-4961-384X
SPIN-code: 5249-5760
Patrice Lumumba Peoples’ Friendship University of Russia

Valentin I. Popadyuk

Patrice Lumumba Peoples’ Friendship University of Russia

Email: popadyuk-vi@rudn.ru
ORCID iD: 0000-0003-3309-4683
SPIN-code: 6284-8040

Elizaveta V. Krasilnikova

Email: eliz_nova1026@mail.ru
ORCID iD: 0009-0003-5418-0561

Tatyana I. Eliseeva

Author for correspondence.
Email: eliseevati@yandex.ru
ORCID iD: 0000-0002-1769-3670
SPIN-code: 5036-8467

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