Kejun Zuo

Opposing roles of IL-17A and IL-25 in the regulation of TSLP production in human nasal epithelial cells.

To cite this article: Xu G, Zhang L, Wang DY, Xu R, Liu Z, Han DM, Wang XD, Zuo KJ, Li HB. Opposing roles of IL‐17A and IL‐25 in the regulation of TSLP production in human nasal epithelial cells. Allergy 2010; 65: 581–589.

Nasal Saline Irrigation Facilitates Control of Allergic Rhinitis by Topical Steroid in Children

Objective: This study was designed to determine whether nasal saline irrigation improved the symptoms and signs of allergic rhinitis (AR) and whether nasal saline irrigation could be used as a complementary management of AR in children while less steroids were used. Method: 26 children with AR were divided into three groups and were given nasal saline irrigation and/or topical steroid. Symptoms and signs of AR and mucociliary clearance (MCC) were evaluated, and concentration of soluble intercellular adhesion molecule (sICAM)-1 in nasal secretion was detected. Results: In AR children treated with nasal irrigation and tapered topical steroid at week 8 and week 12, a significant improvement in symptoms and signs was observed, and a significant decrease in the mean values of MCC and the mean concentrations of sICAM-1 in nasal secretions was also detected. Conclusion: Nasal saline irrigation can be viewed as a good adjunctive treatment option for AR. It permitted the use of less topical steroids for controlling AR in children, which will contribute to fewer side effects and less economic burden.

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.

Elevated serum osteopontin level is associated with blood eosinophilia and asthma comorbidity in patients with allergic rhinitis.

From the Division of Immunology, Children’s Hospital, Boston, Mass; the Department of Pediatrics, Harvard Medical School, Boston, Mass; the Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon; the Unit e de G en etique M edicale, Universit e Saint Joseph, Beirut, Lebanon; the CNRS-Institut de G en etique Humaine et Universit e Montpellier 2, Montpellier, France; the Division of Pediatric Hematology and Oncology, Children’s Center for Cancer and Blood Diseases, Rafik Hariri University Hospital, Beirut, Lebanon; and the Department of Pediatrics, ‘‘Angelo Nocivelli’’ Institute for Molecular Medicine, University of Brescia, Brescia, Italy. E-mail: raif.geha@childrens.harvard.edu. *These authors contributed equally to this work. This study was supported by USPHS grants 1P01AI076210-01A1 (to R.S.G. and L.D.N.) and T32AI007512 (to R.S.G. and J.C.), a grant from the Dubai Harvard Foundation for Medical Research (R.S.G.), and a grant provided by the Jeffrey Modell Foundation (to L.D.N.). Disclosure of potential conflict of interest: J. Chou received research support from the National Institutes of Health (NIH). L. D. Notarangelo received research support from the NIAID-NIH and the Jeffrey Modell Foundation. R. Geha received research support from the NIH and the Jeffrey Modell Foundation. The rest of the authors declare that they have no relevant conflicts of interest.

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.

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.

A hospital-based survey on the prevalence of bronchial asthma in patients with allergic rhinitis in southern China.

Background The prevalence of bronchial asthma (BA) and the underlying risk factors in patients with allergic rhinitis (AR) in China are largely unknown. Thus, this study is designed to assess the BA comorbidity in AR patients in two cities (Guangzhou and Zhuhai) of southern China and to determine the risk factors of BA in these AR patients. Methods We performed a cross-sectional, hospital-based survey in two modernized cities in southern China. The BA prevalence was evaluated in 1931 AR patients. Participants were asked to complete a questionnaire containing specific items for AR and BA. A logistic regression analysis was used to assess the risk factors of BA comorbidity in AR patients. Results The prevalence of concomitant BA in AR patients is 5.33% (103/1931). Most of the participants (98.4%) were sensitized to more than one allergen, and the most common sensitization was to house-dust mites. The strongest risk factor of BA determined by a multiple logistic regression analysis was a duration of AR of >5 years (adjusted odds ratio [OR], 8.67; 95% confidence interval [CI], 3.74–20.06), followed by smoking (adjusted OR, 7.21; 95% CI, 1.86–8.23) and self-medication with antibiotics (adjusted OR, 6.35; 95% CI, 3.43–11.78). Conclusion Our findings suggested the risk factors of concomitant BA in AR patients may be helpful to establish preventive strategies.

Endoscopic optic nerve decompression for patients with traumatic optic neuropathy: is nerve sheath incision necessary?

Objective: To evaluate the necessity of nerve sheath incision for the treatment of patients with traumatic optic neuropathy (TON) during endoscopic optic nerve decompression. Methods: Seventy-four TON patients were enrolled and subjected to endoscopic optic nerve decompression. In 31 TON patients (group A), osseous decompression and nerve sheath incision were performed, and in 43 TON patients (group B), osseous decompression alone was carried out. Visual acuity was evaluated postoperatively. Results: After surgery, visual acuity was improved in 47 of 74 patients, with a total effectiveness ratio of 63.5%. The total ratio of improvement in groups A and B was 61.2 and 65.1%, respectively, and no significant difference was observed (p > 0.05). As to the patients with residual vision preoperatively, the ratio of improvement in groups A and B was 64.2 and 71.4%, respectively (p > 0.05), not favoring nerve sheath incision during endoscopic optic nerve decompression. Conclusion: Our preliminary results suggest that during endoscopic optic nerve decompression for the treatment of TON patients, nerve sheath incision is not obligatory for the improvement of visual acuity.

Expression of leukotriene and its receptors in eosinophilic chronic rhinosinusitis with nasal polyps.

Cysteinyl leukotriene (LT) has been proposed in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). This study sought to examine the expression of the LT receptor (LTR) in CRSwNP patients and evaluate the potential role of LTR antagonist (LTRA) in the management of eosinophilic CRSwNP (ECRS) patients.

WDPCP regulates the ciliogenesis of human sinonasal epithelial cells in chronic rhinosinusitis

Damage to the mucociliary clearance system is a typical change in the pathogenesis in chronic rhinosinusitis. However, the mechanisms underlying cilia loss remain unclear. WDPCP is a key protein essential for ciliogenesis, and is also an effector of the planar cell polarity signaling system. In this study, we sought to determine the role of WDPCP in cilia loss in patients with chronic rhinosinusitis. We demonstrated the expression of WDPCP in human sinonasal epithelium from patients with chronic rhinosinusitis and control subjects. We also used air‐liquid interface to culture primary human sinonasal epithelial cells in‐vitro model and to investigate WDPCP function. We then explored links between rhinosinusitis, WDPCP and inflammation. Accompanied with cilia loss, expression of WDPCP in human sinonasal epithelium from patients with chronic rhinosinusitis was decreased significantly compared with control subjects. In vitro study, we found that WDPCP level increased at first, and then decreased. Inhibiting WDPCP expression could lead to the poor quantity and length of cilia with reduced expression of Septin7. Also, Th1 type inflammatory mediators could decrease the expression of WDPCP. In conclusion, inflammatory cytokines cause reduced WDPCP expression, which contributes to impaired ciliogenesis in human rhinosinusitis.