Sinobronchial Syndrome in Japanese People

Abstract

Sinobronchial syndrome (SBS) involves the coexistence of chronic rhinosinusitis and chronic lower airway inflammation. In Japanese patients, the lower airway lesions may be diffuse panbronchiolitis (DPB), chronic bronchitis, or chronic bronchiectasis. DPB is chronic inflammation of the region around the bronchioles, particularly the respiratory bronchioles, and seems to occur mostly in Japanese. The frequency of occurrence of SBS was 32 (10.4%) in 307 patients seen for chronic rhinosinusitis and 41 (55.4%) in 74 patients seen for chronic lower airway inflammatory disease. In many patients with SBS, the nasal symptoms appeared in childhood and the bronchial symptoms (coughing and expectoration) appeared in or after adolescence. Long-term follow-up of patients who underwent sinus surgery after the onset of SBS showed poor postoperative improvement of the lower airway symptoms. Correlation was strong between SBS and HLA-Bw54, an antigen found specifically in Mongoloids (corrected p value (pc), 3.88 × 10–7; relative risk (KR), 7.03). Correlation of HLA-Bw54 with DPB was stronger than with SBS as a whole (pc, 2.23 × 10–6; RR, 11.00). These results suggested that SBS, and particularly DPB, is a disease strongly dependent on a genetic diathesis in Japanese people.