Peter Tomassen

Chronic rhinosinusitis in Europe--an underestimated disease. A GA²LEN study.

To cite this article: Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, Bousquet PJ, Brozek G, Bruno A, Dahlén SE, Forsberg B, Gunnbjörnsdóttir M, Kasper L, Krämer U, Kowalski ML, Lange B, Lundbäck B, Salagean E, Todo‐Bom A, Tomassen P, Toskala E, van Drunen CM, Bousquet J, Zuberbier T, Jarvis D, Burney P. Chronic rhinosinusitis in Europe – an underestimated disease. A GA2LEN study. Allergy 2011; 66: 1216–1223.

Asthma in adults and its association with chronic rhinosinusitis: the GA2LEN survey in Europe

To cite this article: Jarvis D, Newson R, Lotvall J, Hastan D, Tomassen P, Keil T, Gjomarkaj M, Forsberg B, Gunnbjornsdottir M, Minov J, Brozek G, Dahlen SE, Toskala E, Kowalski ML, Olze H, Howarth P, Krämer U, Baelum J, Loureiro C, Kasper L, Bousquet PJ, Bousquet J, Bachert C, Fokkens W, Burney P. Asthma in adults and its association with chronic rhinosinusitis: The GA2LEN survey in Europe. Allergy 2012; 67: 91–98.

Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis – a GA2LEN study

To cite this article: Tomassen P, Newson RB, Hoffmans R, Lötvall J, Cardell LO, Gunnbjörnsdóttir M, Thilsing T, Matricardi P, Krämer U, Makowska JS, Brozek G, Gjomarkaj M, Howarth P, Loureiro C, Toskala E, Fokkens W, Bachert C, Burney P, Jarvis D. Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis – a GA2LEN study. Allergy 2011; 66: 556–561.

Prevalence of allergic sensitization versus allergic rhinitis symptoms in an unselected population

Background: Allergic rhinitis (AR) is the most common allergic disorder and its prevalence has significantly increased worldwide, nowadays affecting up to 40% of the population in young adults. The objective of the present survey was to evaluate the prevalence of allergic sensitization and the prevalence of clinically diagnosed AR in a sample of the Belgian population, and to estimate the effect of age and gender. Methods: We performed a cross-sectional population-based study at an annual public fair in Ghent. Participants underwent a skin prick test (SPT) to 3 aeroallergens: a mix of trees (hazel, alder, and birch), grass pollen, and house dust mite (HDM). The clinical relevance of sensitization was assessed by relating relevant symptoms of AR to the corresponding SPT. Results: A total of 2,320 participants (1,475 females, median age 44.7 years, range 3–86) were included in this study. The standardized prevalence rates of sensitization were 13.2% for tree mix, 25.9% for grass pollen, and 25.9% for HDM. Sensitization to at least one of the allergens was present in 40.3% of the subjects. Symptomatic sensitization related to trees was reported in 9.7% of cases, grass-related AR was 17.6%, and HDM-related AR was 17.1%. The overall prevalence of AR was 30.9%. Conclusion: In this study we demonstrated a 40.3% prevalence of a positive SPT to one or more common aeroallergens. A clinical diagnosis of AR was present in 30.9% of cases, peaking in the third and fourth decades of life. It is to be expected that in the next decades, when this generation grows older, the general AR prevalence will further increase.

Pathophysiology of Chronic Rhinosinusitis

Chronic rhinosinusitis (CRS), a disease presenting with chronic symptoms such as nasal obstruction, rhinorrhea, hyposmia and facial pain, is highly prevalent and has a considerable impact on quality of life and health care expenditures. The disease is characterized by chronic inflammation of the sinonasal mucosa and can present with nasal polyps. Current consensus classifies CRS into CRS with nasal polyps and CRS without nasal polyps. This review illustrates the diversity of pathophysiological observations in CRS and highlights selected etiological hypotheses. A wide spectrum of alterations is described regarding histopathology, pattern of T cells and inflammatory effector cells, remodeling, immunoglobulin production, chemokine and eicosanoid production, and the role of microorganisms. The pathophysiological diversity observed in CRS seems to stand in contrast to its nonspecific clinical presentation, but is of the utmost importance in the development and application of highly individualized treatments. Identification of specific disease subgroups and their etiologies is an important and challenging task for future research.

Staphylococcus aureus enterotoxin-specific IgE is associated with asthma in the general population : a GA(2)LEN study

Specific IgE to Staphylococcus aureus enterotoxins (SE‐IgE) has been associated with asthma. In the general population, we aimed to determine the prevalence of and risk factors for serum SE‐IgE and to examine the association with asthma.

Staphylococcal enterotoxin sensitization in a community‐based population: a potential role in adult‐onset asthma

Recent studies suggest that Staphylococcus aureus enterotoxin sensitization is a risk factor for asthma. However, there is a paucity of epidemiologic evidence on adult‐onset asthma in community‐based populations.

Local inflammation in chronic upper airway disease.

Chronic Rhinosinusitis (CRS), a chronic upper airway inflammation, is an inflammation of the nose and the paranasal cavities and is highly prevalent. Chronic rhinosinusitis is currently classified as CRS with nasal polyps or CRS without nasal polyps. This review highlights the pathophysiological differences in CRS on remodeling and on T-cell patterns. Nasal polyps have a high co-morbidity with the lower airway inflammatory disease, asthma. Evidence is accumulating for the role of superantigens, Staphylococcus aureus enterotoxins, in CRS with nasal polyps and asthma, both T helper 2 -biased diseases. Until today there are no biomarkers involved in the diagnosis of CRS or the treatment follow-up. Further differentiation of the phenotype of the disease is needed, which will reflect in the development of new biomarkers and in new innovative treatment options. Defining and predicting response to therapy in individual CRS patients is a challenge for future research.

Respiratory hypersensitivity reactions to NSAIDs in Europe: the global allergy and asthma network (GA(2) LEN) survey.

Nonsteroidal anti‐inflammatory drugs (NSAIDs) are among the most prevalent drugs inducing hypersensitivity reactions. The aim of this analysis was to estimate the prevalence of NSAID‐induced respiratory symptoms in population across Europe and to assess its association with upper and lower respiratory tract disorders.

Staphylococcus-aureus-derived Superantigens in Nasal Polyp Disease

Staphylococcus aureus (SA) secretes enterotoxins, small proteins that act as superantigens because of their potent effect on the immune system. The main mode of action of superantigens is the coupling of the major histocompatibility complex molecule with the T-cell receptor. The effect is a powerful stimulation of the adaptive immune system in a polyclonal (non-antigen-specific) way, resulting in a T-helper-2-biased inflammation. This superantigen mechanism is involved in the pathogenesis of nasal polyps (NP) in about 50% of the cases. The superantigenic effect is hallmarked by immunoglobulin changes in biopsies: high total IgE, polyclonal IgE to multiple allergens, and IgE specific to SA enterotoxins. Serum immunoglobulins coincide only partially with biopsy findings. Patients with this IgE pattern have an increased risk of asthma and aspirin-exacerbated respiratory disease (AERD). Future treatments with topical or systemic antibiotics and monoclonal antibodies to IgE and interleukin-5 (IL-5) are being studied.