The Cutting Edge of Rhinology Research

Abstract

Dear Colleagues, The worldwide scientific community has risen to the unprecedented challenge of the COVID-19 pandemic. Healthcare workers and research scientists alike have demonstrated tremendous ingenuity, tireless determination, and an inspiring degree of altruism and collaboration. Several enduring themes have emerged throughout this crisis, perhaps none more paramount than the essential need for high-quality research, clear scientific communication, and broad dissemination of critical information. The American Journal of Rhinology & Allergy is committed to publishing high-impact research from our colleagues around the world, and the present issue is no exception. We are honored to share the latest in clinical, translational, and basic science advances from our rhinology and allergy community around the globe. The pathogenic role of eosinophilic inflammation in chronic rhinosinusitis (CRS) remains a critical focus of investigation and is the subject of several outstanding contributions in this issue. Chitguppi et al. demonstrate in their retrospective series that in patients with eosinophilic asthma and CRS with nasal polyps (CRSwNP), benralizumab was associated with significant improvement in pulmonary function test results, and the majority of patients also had a significant improvement in sinonasal quality of life as well. Du et al. construct a creative nomogram to aid in prediction of polyp recurrence in patients with CRSwNP following endoscopic sinus surgery (ESS), with high predictive value in a model consisting of serum eosinophil levels, serum IgE, concurrent asthma, and number of previous sinus surgeries. Farrell et al. perform a cross-sectional study of patients undergoing ESS for CRS and establish that after controlling for polyp status, eosinophilic versus neutrophilic inflammation did not significantly associate with sinonasal symptoms or objective olfactory assessment. Warman et al. demonstrate that, unlike the eosinophilic inflammatory profile seen in Caucasian patients with diffuse CRSwNP, antrochoanal polyps appear to have a distinctly neutrophilic predominant inflammatory infiltrate, along with greater intramural cyst formation and lower levels of mast and plasma cells. The pathophysiology of CRSwNP is the subject of deeper exploration in this issue, as Lin et al. identify increased levels of thioredoxin-interacting protein, a protein central to mechanisms of oxidative stress, in patients with CRSwNP at both the protein and mRNA levels. Hussien et al. establish that total immunoglobulin E, interleukin-17, and Pentraxin-3 may all serve as biomarkers for CRSwNP, as they are found in significantly higher values than in control patients, and are all associated with increased sinonasal symptoms, radiographic disease, and risk of polyp recurrence. Makary et al. explore the role of sinonasal anatomic variants in the pathogenesis of unilateral allergic fungal rhinosinusitis and find that a concha bullosa is significantly more likely to be found in the diseased side than in the healthy side. Our understanding of normal sinonasal physiology has advanced dramatically in recent decades, and it profoundly informs our approach to chronic inflammatory conditions. To that end, Alekseenko et al. elegantly utilize high-speed videomicroscopy to demonstrate abnormal mucosal morphology and worse mucociliary function in children with acute and CRS as compared to healthy children. Watanabe et al. advance the field of epigenomics with their study demonstrating that lysophosphatidylcholine acyltransferase 2-methylation in nasal mucosa scraping cells may serve as a novel biomarker to establish the severity of cedar pollen allergy. Bogdan et al. investigate the impact of the menstrual cycle on nasal mucosa and olfactory function, identifying distinct functional differences between the luteal and ovulatory phases. Allevi et al. utilize systematic review methodology to demonstrate considerable heterogeneity of diagnostic criteria for odontogenic sinusitis, and they recommend establishing a consistent shared definition. Zheng et al. find that patients with silent sinus syndrome are more likely to have a history of maxillary dental disease, Editorial