Hongfei Lou

Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population.

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical entity with its propensity for recurrence. Tissue eosinophilia is a hallmark of CRSwNP, and its role in polyp recurrence is a subject of much investigation. Objective The aim of this study was to evaluate the association between clinical parameters, especially tissue eosinophilia and polyp recurrence, and to identify the optimal cutoff value of tissue eosinophilia as a predictor for polyp recurrence in Chinese subjects. Methods Overall, 387 patients with CRSwNP were enrolled in this retrospective analysis and postoperative follow-up for polyp recurrence was over a period that lasted >24 months (mean [standard deviation], 34.03 ± 4.95 months). The baseline demographic and clinical features and the preoperative computed tomography were compared, and mucosal specimens obtained at endoscopic sinus surgery were assessed for inflammatory cells by using histocytologic staining. Predictive factors associated with polyp recurrence were analyzed by logistic regression analysis, and optimal cutoff points of the predictors were determined by receiver operating characteristic curves and the Youden index. Results A total of 55.3% patients (214β87) experienced recurrence. Tissue eosinophilia markedly outweighed other parameters and correlated with polyp recurrence. Receiver operating characteristic curves indicated that a cutoff value of 27% tissue eosinophils predicted recurrence with 96.7% sensitivity and 92.5% specificity (area under the curve = 0.969; p < 0.001); and an absolute count of 55 eosinophils per high power field predicted recurrence with 87.4% sensitivity and 97.1% specificity (area under the curve = 0.969; p < 0.001). Conclusion A tissue eosinophil proportion of >27% of total cells or a tissue eosinophil absolute count of >55 eosinophils per high power field may act as a reliable prognostic indicator for nasal polyp recurrence within 2 years after surgery.

An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011

The prevalence of allergic rhinitis (AR) has increased worldwide in recent decades. This study was conducted to investigate the prevalence of self‐reported AR and profiles of AR‐related comorbidities in the adult population of China over time.

T cell subsets in cord blood are influenced by maternal allergy and associated with atopic dermatitis.

This study aimed to investigate the influence of maternal allergy on cord blood regulatory and effector T cells and to evaluate their role as a predictor of atopic dermatitis (AD) during the first 2 yr of life.

Cellular phenotyping of chronic rhinosinusitis with nasal polyps.

BACKGROUND Defining the phenotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) with prognosis may lead to delivery of personalized treatment. This study aimed to identify cellular phenotypes of CRSwNP using cluster analysis and define an algorithm for different clusters associated with polyp recurrence. METHODS Overall, 366 patients with CRSwNP were enrolled in this retrospective analysis. Eighteen variables, including clinical characteristics and tissue/peripheral inflammatory cells assessments, were selected for factor analysis. Unsupervised cluster analysis was performed after variables reduction and standardization and differences in polyp recurrence during follow-up for a minimum of 24 months were analysed among clusters. Discriminant analysis was further used to develop a clinically useful algorithm for predicting clustering. RESULTS Five phenotypic clusters were identified. Clusters 1 and 2 were plasma cell-dominant and lymphocyte-dominant phenotypes, respectively. Cluster 3 revealed a mixed inflammatory pattern. Cluster 4 was characterized by infiltration of predominantly neutrophils. Cluster 5 was characterized by a marked tissue eosinophilia and highest recurrence rate of 98.5%. The clinical algorithm predicted clustering with 93.7% accuracy. CONCLUSIONS Chinese CRSwNP patients may be classified into five phenotypes with different polyp recurrence rates, based on the presence of predominantly plasma cells, lymphocytes, neutrophils, eosinophils or mixed inflammatory cells in polyps.

Predictive significance of computed tomography in eosinophilic chronic rhinosinusitis with nasal polyps.

Eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP), characterized by eosinophil‐predominant inflammation in mucosa, is a subject of much investigation. However, no satisfactory atraumatic clinical parameter has been established to date for prediagnosis of this condition. The aim of this study was therefore to compare the use of computed tomography (CT) scans with other clinical parameters in prediagnosis of eCRSwNP.

Sensitization patterns and minimum screening panels for aeroallergens in self-reported allergic rhinitis in China

Optimization of skin prick test (SPT) panels, especially in view of significant differences in sensitizations patterns within different geographical areas, is an unmet need within China. Our aim was to assess the patterns and clinical relevance of aeroallergen sensitizations in allergic rhinitis (AR) and define the minimal battery of SPT allergens, classified according to the Köppen-Geiger climate map. Overall, 7148 subjects with self-reported AR completed a standard questionnaire and were assessed for sensitization to relevant allergens by SPT. 6340 (88.7%) patients had at least one positive skin prick reaction, and demonstrated unique sensitization patterns by stratification with age, gender, and geographic region. Sensitization to house dust mites (HDM) was highest in south China, whereas the three most prevalent aeroallergens were mugwort, ragweed and dandelion pollen in north-west China. Higher sensitization rates and multiple sensitizations were associated with AR comorbidities. Eight allergens (Der f, mugwort, Blatella, hazel, goosefoot, Penicillium notatum, animal dander and Der p) allowed identification >96% of sensitized subjects in central China. Differences in optimal panels were observed between regions, with five to six allergens being sufficient for north-east, north-west and south China. These SPT panels may provide a cost-effective tool for screening sensitized patients in China.

Prediction of the originating site of sinonasal inverted papilloma by preoperative magnetic resonance imaging and computed tomography

Precise localization and excision of the originating site of a sinonasal inverted papilloma (SNIP) is essential for decreasing tumor recurrence. In this study we evaluated the use of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) to pinpoint the attachment/originating sites of SNIPs in 143 patients.

Nasal ventilation is an important factor in evaluating the diagnostic value of nasal nitric oxide in allergic rhinitis: Nasal NO in diagnosis of AR

The role of nasal nitric oxide (NO) in the diagnosis of allergic rhinitis (AR) is controversial. The aim of this study was to identify factors that may affect levels of nasal NO in AR patients and evaluate the role of nasal NO in the diagnosis of AR.

Frequency, Suppressive Capacity, Recruitment and Induction Mechanisms of Regulatory T Cells in Sinonasal Squamous Cell Carcinoma and Nasal Inverted Papilloma

Background Sinonasal squamous cell carcinoma (SSCC) and nasal inverted papilloma (NIP) represent the predominant type of malignant and benign tumors in sinonasal tract, respectively. CD4+CD25+Foxp3+ natural regulatory T (Treg) cells might play critical role(s) in the suppression of anti-tumor immune response and thus shed light on tumor progression from benign to malignant. Objective This study aimed to evaluate the frequency and suppressive capacity of Treg cells in SSCC compared to NIP and further to explore the underlying mechanisms. Patients and Methods Frequencies of Treg, Th1 and Th2 cells were evaluated by flow cytometry in tissue homogenate and peripheral blood from 31 SSCC patients, 32 NIP patients and 35 normal controls. Treg cells were tested for regulatory function by co-culture with effector T cells. CCR4 and its ligands, CCL22 and CCL17, were analyzed by flow cytometry and Luminex, respectively. The chemoattractant properties of CCR4/CCL22 and CCR4/CCL17 for Treg cells were assessed using the Boyden chamber technique, to elucidate the potential mechanisms of Treg recruitment in tumor microenvironment. Treg cells induction via TGF-β was assessed with transwells after local CD4+Foxp3+ T cells were assessed by immunohistochemistry and TGF-β concentration was measured by Luminex. Results Tumor-infiltrating Treg cells increased significantly from normal to NIP to SSCC (P ≤ 0.001 for normal vs. NIP and P = 0.004 for NIP vs. SSCC). Significantly elevated frequency and enhanced suppression capacity of circulating Treg cells in SSCC were detected compared to NIP and healthy controls, concomitant with Th1 decrease and Th2 increase. Apparently increased CCL22 attracted CCR4-expressing Treg cells to tumor microenvironment in SSCC, compared to NIP. SSCC produced significantly more TGF-β than NIP and thus possessed greater potential for Treg cell induction. Conclusion Frequency and suppressive capacity of Treg cells enhanced with progression of malignancy from NIP to SSCC. Circulating Treg cells were recruited to tumor tissue via CCR4/CCL22 signalling, whereas tumor-synthesised TGF-β contributed to induction of peripheral Treg cells.

The use of specific immunoglobulin E in nasal secretions for the diagnosis of allergic rhinitis

Although local specific immunoglobulin (sIgE) has been employed as a diagnostic criterion for allergic rhinitis (AR), the use of local sIgE has not been fully evaluated in the diagnosis of allergic rhinitis. The aim of this study was to evaluate the use of nasal secretion sIgE in the diagnosis of allergic rhinitis.