Abstract
Chronic rhinosinusitis is known to be influenced by cigarette exposure; however, this relationship is based on the presence of nasal polyps, and objective measurements of cigarette exposure in chronic rhinosinusitis are not well established. This study aimed to estimate the association between chronic rhinosinusitis and smoking status based on self-reported questionnaires and urinary cotinine levels according to the presence of nasal polyps. We analyzed a total of 23,621 participants who participated from the fifth Korea National Health and Nutrition Examination Survey (2010–2012). Serum total and specific IgE level were measured. Higher prevalence of chronic rhinosinusitis with nasal polyps was associated with current smoking status (OR = 1.43, 95% CI = 1.00–2.03). This association was prevalent in participants aged ≤ 50 years (OR = 1.76, 95% CI = 1.01–3.05), and higher urinary cotinine level showed correlation with higher prevalence of chronic rhinosinusitis with nasal polyps in this age group (OR = 1.04, 95% CI = 1.00–1.08). In addition, positive correlation between serum total IgE and urinary cotinine levels was greater in patients with chronic rhinosinusitis (β = 0.493, 95% CI = 0.071–0.916) than in controls (β = 0.062, 95% CI = 0.021–0.103). Aggressive smoking interventions should be performed in patients with chronic rhinosinusitis with nasal polyp, especially in cases of young adults or high serum IgE levels.
Highlights
Chronic rhinosinusitis (CRS) is an inflammatory condition of the paranasal sinus mucosa characterized by presentation of the following symptoms for at least 12 weeks: nasal obstruction, anterior/posterior discharge, olfactory dysfunction, and facial pain/pressure
In addition to self-reported exposure to cigarettes, we investigated the association between urinary cotinine levels, an objective measurement of smoking exposure, and CRS, as well as their correlation with atopic conditions associated with CRS
The analysis from the present study showed an association between urinary cotinine level and serum total Immunoglobulin E (IgE) levels, even after adjustment for confounding factors, and this association was much stronger in CRS patients
Summary
Chronic rhinosinusitis (CRS) is an inflammatory condition of the paranasal sinus mucosa characterized by presentation of the following symptoms for at least 12 weeks: nasal obstruction, anterior/posterior discharge, olfactory dysfunction, and facial pain/pressure. Epidemiologic studies on CRS report its prevalence as 5.2%–27.1%; only 25%–30% of these patients have nasal polyps [2,3,4]. Cigarette smoke exposure is one of the most important factors that affects occurrence and the course of CRS, as well as a variety of upper and lower airway tract diseases. Previous pathophysiology studies identified that CRS due to cigarette exposure develops through decreased mucociliary clearance with chloride channel transport loss, goblet cell hyperplasia, tissue remodelling, and changes in biofilms of the nasal cavities [6,7,8,9]. A systemic review article, reviewing 112 related studies, reported a definite correlation between prevalence of CRS and both active/passive cigarette smoke
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