Fenghong Chen

Induction of IL-6 and IL-8 by House Dust Mite Allergen Der p1 in Cultured Human Nasal Epithelial Cells Is Associated with PAR/PI3K/NFĸB Signaling

Objective: The mechanism of action involved in how Dermatophagoides pteronyssinus (Der p) 1 initiates the nasal allergic cascade is poorly understood. Methods: We detected proinflammatory cytokine production (GM-CSF, TNF-α, IL-1β, IL-6, and IL-8) and associated signal molecules in primarily cultured nasal epithelial cells (NECs) from patients with allergic rhinitis (AR) after Der p1 stimulation, using ELISA, RT-PCR, and Western blot. We also evaluated the importance of protease-activated receptors (PAR)/phosphatidylinositol 3 kinase (PI3K)/NFĸB signaling pathways in IL-6 and IL-8 production using glucocorticoids and specific inhibitors, LY294002 and PDTC. Results: We observed significantly elevated IL-6 and IL-8 production (both gene and protein) in NECs after Der p1 stimulation, and demonstrated that the expressions of PAR2, pAkt, and pp65 were upregulated afterDer p1 stimulation, which were associated with IL-6 and IL-8 production in NECs. Conclusion: These findings demonstrate that the PAR/PI3K/NFĸB signaling pathway is involved in the induction of IL-6 and IL-8 in Der-p1-stimulated NECs from AR patients, and may have potential implications for the prevention and treatment of AR and asthma.

Long-term results of endoscopic sinus surgery-oriented treatment for chronic rhinosinusitis with asthma.

The aims of this study were to evaluate the efficacy of functional endoscopic sinus surgery (FESS)–oriented multimodality treatment in chronic rhinosinusitis (CRS) patients with asthma and its impact on asthma.

The elevated expression of osteopontin and vascular endothelial growth factor in sinonasal inverted papilloma and its relationship with clinical severity.

Background Osteopontin (OPN) is involved in cell survival, immunity, and tumor progression. The overexpression of OPN has been proposed as a biomarker of progression and metastasis for several tumor types, but it is still unclear whether it is up-regulated in sinonasal inverted papilloma (SIP). Methods We enrolled 33 subjects with SIP and 15 normal controls to determine the importance of OPN and vascular endothelial growth factor (VEGF) in SIP. Using immunohistochemistry, quantitative polymerase chain reaction, and enzyme-linked immunosorbent assay, we examined the distribution, mRNA expression, and protein levels, respectively, of OPN and VEGF. We then correlated these values with clinical severity. Results The immunostaining levels for OPN and VEGF were significantly increased in SIP tissues compared with control tissues (p < 0.05), as were their mRNA expression and protein levels (p < 0.05). The correlation between OPN and VEGF expression and the clinical stage of SIP was significant (p < 0.05). Conclusion Our findings indicate that OPN and VEGF were both overexpressed in the analyzed SIP tissues and were associated with clinical severity, suggesting that the OPN–VEGF axis might contribute to tumor progression by enhancing angiogenesis. Therefore, OPN may serve as a potential therapeutic target for preventing SIP progression and recurrence.

Expression and regulation of osteopontin in chronic rhinosinusitis with nasal polyps

Osteopontin (OPN) has been proposed to be associated with airway inflammation including asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). This study sought to evaluate the expression and regulation of the OPN in CRSwNP patients.

Evaluation of Long-Term Clarithromycin Treatment in Adult Chinese Patients with Chronic Rhinosinusitis without Nasal Polyps

Objective: To evaluate the efficacy of long-term clarithromycin (CAM) treatment in adult Chinese patients suffering from chronic rhinosinusitis without nasal polyps (CRSnNP). Methods: Thirty-three CRSnNP patients were enrolled and subjected to CAM treatment for 12 weeks (250 mg daily). The total nasal symptom scores (TNSS), nasal resistance and inflammatory mediators including interleukin (IL)-8 and myeloperoxidase (MPO) were evaluated at weeks 0 and 12. Quality of life (QoL) was assessed in all patients by using the Sinonasal Outcome Test 20 and Short Form 36 questionnaires. Results: CAM treatment significantly improved TNSS, nasal resistance and QoL, and it inhibited IL-8 and MPO production in CRSnNP patients (p < 0.05). CAM treatment was more effective for IL-8high CRSnNP patients than for IL-8low CRSnNP patients (p < 0.05). Conclusion: Long-term, low-dose CAM treatment is effective and safe for the treatment of CRSnNP in Chinese patients.

Frontal Sinus Cerebrospinal Fluid Leaks: Repair in 15 Patients Using an Endoscopic Surgical Approach

Objectives: To clarify the utility of a safe and effective endoscopic procedure for closing frontal sinus cerebrospinal fluid (CSF) leaks. Methods: A retrospective review of all 15 patients seen at our hospital from 2002 to 2008 whose CSF leak originated within the frontal sinus or frontal recess. A transnasal endoscopic or combined transfrontal endoscopic approach was used to repair the CSF leak. Results and Surgical Outcomes: Four defects originated in the frontal recess and 11 involved the posterior wall of the frontal sinus. Nine patients were repaired by a direct endoscopic approach and 4 patients were repaired after widening the frontal recess endoscopically. Two patients were repaired using the combined transfrontal and transnasal approach. The leak was stopped in 14 cases (93%) after the first operation. One patient (7%) required a second repair 1 month after initial surgery and has remained well after 27 months. Complications included a frontal lobe abscess and a frontal sinus obstructive mucocele. These 2 patients were successfully treated without further complications. Patient follow-up ranged from 4 to 44 months (mean 30 months). Conclusions: Most frontal CSF leaks can be successfully closed by an endoscopic surgical approach.

Expression and regulation of transcription factor FoxA2 in chronic rhinosinusitis with and without nasal polyps.

Purpose Chronic rhinosinusitis (CRS) is characterized by the excessive production of mucus. However, the molecular mechanism underlying mucin overproduction in CRS with or without nasal polyps (CRSwNP and CRSsNP, respectively) is poorly understood. This study was conducted to assess the importance of the transcription factor FoxA2 in mucin production and to investigate the targeting of FoxA2 as a potential therapeutic strategy for mucus hypersecretion in CRS patients. Methods We enrolled 15 CRSwNP patients, 15 CRSsNP patients, and 10 normal controls in this study. The expression levels of FoxA2, MUC5AC, and MUC5B in inflamed and healthy nasal tissues were examined via immunohistochemistry and quantitative reverse transcription-polymerase chain reaction, and the levels of several proinflammatory cytokines in nasal secretions were measured via FlowCytomix analysis. In addition, the expression of MUC5AC and FoxA2 was determined in polyp-derived epithelial cells and NCI-H292 cells after in vitro stimulation. Results FoxA2 was significantly down-regulated, and MUC5AC and MUC5B were significantly up-regulated in both the CRSwNP and CRSsNP patients compared to the controls (P<0.05), and the protein level of FoxA2 was negatively associated with the IL-6 level in the CRS patients (P<0.05). IL-6 significantly increased MUC5AC expression but inhibited FoxA2 expression in vitro (P<0.05). Transfection with a FoxA2 expression plasmid significantly decreased MUC5AC promoter activity (P<0.05) and inhibited IL-6-induced MUC5AC production (P<0.05). In addition, clarithromycin significantly alleviated IL-6-induced FoxA2 suppression and decreased MUC5AC expression in vitro (P<0.05). Conclusions Our findings suggest that FoxA2 may be considered a therapeutic target for the modulation of mucus hypersecretion in CRS patients.

A modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy

Background: Although the endoscopic anterior-to-posterior technique offers many advantages, the long-term effects of the iatrogenic trauma (removal of the uncinate process and anterior ethmoidal sinus) resulting from the complete ethmoidectomy procedure used to gain full access to the optic nerve canal is unknown, and sequelae such as nasal synechia and sinusitis should not be ignored. Aims: The aim of our study is to develop a less invasive procedure for endoscopic optic nerve decompression. Materials and Methods: We proposed a modified trans-sphenoidal surgical procedure for endoscopic optic nerve decompression in five patients with traumatic optic neuropathy (TON), all with high sphenoidal pneumatisation and without Onodi cellulae. Results: After performing a direct sphenoidotomy through the natural ostium of the sphenoid sinus rather than a complete ethmo-sphnoidectomy, we found that the modified approach provided adequate access to the optic nerve canal and the apex using a 45° angled endoscope. Successful decompression of the canal optic nerve was performed trans-sphenoidally in all five TON patients using an angled endoscope. No surgical complications occurred, and none of the patients suffered from anterior ethmoidal sinus or skull base damage. Conclusions: The modified trans-sphenoidal approach is a feasible, safe, effective, and minimally invasive approach for TON patients with high sphenoidal pneumatisation and without supersphenoid-ethmoid cellulae.

Local IL-25 contributes to Th2-biased inflammatory profiles in nasal polyps

IL‐25 has been proposed to play a key role in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to evaluate the association of IL‐25 with the Th2‐biased inflammatory profiles in CRSwNP.

Endoscopic sandwich technique for moderate nasal septal perforations

The aim of this article was to describe our surgical technique for the treatment of nasal septal perforations with diameters of 1 to 2 cm.