Otorhinolaryngological Diseases Research Articles

A review of health-related quality of life issues in children suffering from certain key otolaryngological illnesses.

The health-related quality of life (HRQoL) concept is nowadays increasingly and more broadly used for helping evaluate the effectiveness of medical treatment, superseding the earlier "quality of life" approach. The HRQoL concept likewise applies to otolaryngology and this narrative review study is focused on HRQoL outcomes in four key childhood otolaryngological diseases as reported in the literature. To retrospectively evaluate the literature on measuring HRQoL in children suffering from selected otolaryngological illnesses, during treatment. Published studies/case reports were searched for in Medline, PubMed, Web of Science, Scopus and ORCID on the quality of life based on paediatric patient questionnaires, whether completed by subjects themselves or by their parents (by proxy). The following key words were used: health quality of life, otolaryngology/ENT, pediatrics/paediatrics. Studies before 1999 were omitted because hitherto, the "quality of life" had been imprecisely defined thus rendering any subsequent comparisions problematic. HRQoL scores and well-being were found to significantly deteriorate in child patients suffering from four important otolaryngological disorders: chronic sinusitis, nasal septum deviation, adenoid hypertrophy and hearing disease. The main problems found were infection, inflammation, disruption to family life and child-parental interaction, fitness-related issues, reduced ENT patencies and apnea. The HRQoL appears to significantly deteriorate in children suffering from otolaryngological diseases. Further such studies are needed for other ENT diseases.

Immunohistochemical Localization of D-β-Aspartic Acid and Periostin in Vocal Fold Polyps.

Long-term voice abuse or sudden vocal fold microvascular disruption may lead to injury and subsequent repair/remodeling in the vocal fold mucosa. Periostin is known to be involved in airway remodeling and also in various otolaryngological diseases. D-β-aspartic acid is the major isomer of D-aspartic acid found in elderly tissue. In this study we investigated the expression and the role of D-β-aspartic acid and periostin in the formation of vocal fold polyps. The expression patterns of D-β-aspartic acid and periostin in 36 surgical specimens of vocal fold polyps from 36 patients were investigated immunohistochemically. In the epithelium of vocal polyps, D-β-aspartic acid was expressed in all cases. Expression of D-β-aspartic acid was detected in 25 samples obtained from patients with vocal fold polyps stroma. Expression of periostin was detected in 28 samples obtained from patients with vocal fold polyps. Two patterns of D-β-aspartic acid expression were observed in vocal fold polyps stroma: positive type and negative type. The following four patterns of periostin expression were observed in vocal fold polyps: negative type, superficial type, infiltrative type, and diffuse type. An association was observed between D-β-aspartic acid expression patterns and periostin expression patterns. From these findings we speculate that periostin and D-β-aspartic acid participate in certain pathological changes in vocal fold polyps, such as extracellular matrix accumulation, local fibrosis, and the formation and development of vocal fold polyps.

Состояние слуховой функции у детей-воспитанников детских домов, эвакуированных из зоны военных действий

In this study, the structure and frequency of hearing impairment in children who lived at various times in the territories of military operations were studied. The high prevalence of otorhinolaryngological diseases, combined with low detectability, entails formidable complications, leads to a decrease in the quality of life of the child and the family as a whole, and negatively affects the general level of public health. In total, during the study, 398 children aged 5 to 16 years old were examined, who were in the temporary accommodation center of the Romashka children’s resting camp. The children are students of orphanages in the Donetsk People’s Republic (DPR) and the Luhansk People’s Republic (LPR) evacuated from the war zone in the first days of the Special Operation. There were 216 girls (54.3%) and 182 boys (45.7%) among them. The average age of children was 8.5 years. Hearing loss was detected in 33 children (8.3%). Two children (0.5%) had a severe form of sensorineural hearing loss of 3–4 degrees. Two children (0.5%) had a mild form of sensorineural hearing loss of 1–2 degrees. Four children (1%) had unilateral chronic sensorineural hearing loss. The diagnosis of otitis media with effusion was established in 20 children (5%), tubo-otitis, in three patients (0.8%). Suspicion of an anomaly in the development of the middle ear, in 2 children (0.5%). Examination of children in orphanages evacuated from the DPR and LPR did not reveal a high prevalence of hearing impairment. Sensoneural hearing loss: 2%, conductive hearing loss: 6.3%. The results of the work demonstrate a wide potential for improving hearing health in the examined children. Active diagnostics of hearing pathology is shown to all children in orphanages. After treatment of conductive hearing pathology, mandatory audiological monitoring is indicated, despite the subjective improvement in hearing.

Метаболомические исследования при хроническом риносинусите: обзор клинических перспектив

Chronic rhinosinusitis (CRS) is one of the most common otorhinolaryngological diseases, which significantly reduces the quality of life of patients. The etiopathogenesis of CRS has not been fully studied to date, it is problematic to predict the effectiveness of the therapy and the possible period of remission. To solve such issues in modern medicine, metabolomic studies are carried out that study various low-molecular metabolites, cell components in biological material taken from a person: in a cell, tissue, fluid, exhaled air, saliva, bronchial lavage, etc. Metabolomic studies allow identifying possible disease markers and also quantifying them. As a result, a set of individual molecular parameters is compiled that form the patient’s metabolic profile. Metabolomic studies define a new level of clinical prediction in a wide range of complex human diseases, including cardiovascular, oncological diseases, asthma, diabetes, etc. Today, it is typical to use a multiomics approach that combines various molecular omics technologies (genomics, proteomics, transcriptomics, lipidomics, etc.). Based on the identified quantitatively measured biomolecules, it becomes possible to compare genetic variability with complex phenotypic features. Publications on metabolomic studies in CRS are not extensive; however, they report the identified differences in various forms of rhinosinusitis. Metabolomic studies in CRS allow determining the diagnostically significant molecular markers of various forms of chronic sinusitis as well as creating a personal omics profile of the patient and providing an opportunity to control the effectiveness of the therapy. Together with complete data on the patient’s lifestyle and health status, the patient’s personal ohmic profile may be the basis of personalized medicine.

THEORETICAL AND PRACTICAL SPECIAL COMPETENCIES OF GENERAL PRACTICE DOCTORS-FAMILY PHYSICIANS IN PROVIDING MEDICAL ASSISTANCE FOR DISEASES OF THE EAR, THROAT, AND NOSE

Introduction. Currently, the health care system of Ukraine needs to be restored and optimized due to the situation caused by the military aggression of the Russian Federation against Ukraine and its consequences. At the same time, the availability of medical care is provided by primary medical care on the basis of general medical practice - family medicine. To provide the population with ear, throat, and nose diseases with quality medical care, family doctors must have special theoretical and practical competencies. This determined the relevance of the study. The objective of the study: to determine special theoretical and practical competencies for general practitioners-family doctors in providing medical care for diseases of the ENT organs and the optimal ways to acquire them. Materials and methods. Methods: bibliosemantic, expert assessments, statistical, structural, and logical analysis. Independent experts: 25 specialists according to the defined profile of providing medical care. Materials: project of special competencies of general practitioners-family doctors in providing medical assistance for diseases of the ear, throat, and nose. Results and their discussion. In the course of the study, special theoretical and practical competencies were determined for general practitioners-family doctors in providing medical care for diseases of the ENT organs and the optimal ways of acquiring them to provide the population with high-quality primary health care for otolaryngological diseases. Theoretical special competencies provide family doctors with knowledge of the anatomy and physiology of the external, middle, and internal ear, throat, and nose; clinical symptoms, diagnosis and treatment of the main diseases of the ENT organs and their prevention in the age aspect, as well as the principles of providing emergency care for urgent ENT pathology. The special practical competencies of family doctors in medical care for diseases of the ear, throat, and nose allow doctors to conduct a diagnostic examination and provide emergency medical care and treatment. Conclusion. Theoretical and practical competencies for general practitioners-family doctors in providing medical assistance for diseases of the ENT organs and the optimal ways of their acquisition have been determined by experts.

Otolaryngology Training in Uganda: The Mbarara University of Science and Technology Experience.

Sub-Saharan Africa has a high otolaryngologic disease burden exacerbated by an inadequate number of otolaryngologists. The Otolaryngology department at Mbarara University of Science & Technology in Uganda is addressing this problem by having created Uganda's second national residency training program in 2010. We chronicled an early period in the program's development by reporting surgical case quantity and complexity, as defined by "key indicator procedure" classification per the United States Accreditation Council for Graduate Medical Education, and interpreting it with respect to a timeline of significant events. Procedure complexity, but not total number per year, increased over the study period-KIPs increased from 3% in 2012 (6 of 175 total procedures) to 29% in 2016 (35 of 135 total procedures). During this period of complexity increase, operating room capacity expanded, faculty received advanced training and increased in number, and operative equipment improved.

Nasopharyngeal Carcinoma and Its Effect on Dry Eye Disease: A Nationwide Cohort Study.

The aim of the current study was to investigate the relationship between nasopharyngeal carcinoma (NPC) and dry eye disease (DED) using the National Health Insurance Research Database (NHIRD) of Taiwan. A retrospective cohort study was conducted, and patients with an NPC diagnosis were included. Next, one NPC patient was matched to four non-NPC participants via demographic data and systemic comorbidities. In total, 4184 and 16,736 participants were enrolled in the NPC and non-NPC groups, respectively. The primary outcome was the development of DED one year after the diagnosis of NPC. Cox proportional hazard regression was applied to estimate the adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) of DED. In this study, 717 and 2225 DED cases were found in the NPC and non-NPC groups, respectively, and the NPC group showed a significantly higher incidence of DED development compared to the non-NPC group (aHR: 1.45, 95% CI: 1.33−1.58, p < 0.0001) in the multivariable analysis. The other covariates that were positively correlated with DED development included age over 40 years, an education level higher than senior high school, hypertension, DM, allergic pulmonary diseases, allergic otolaryngologic diseases, and allergic dermatological diseases (all p < 0.05). In conclusion, the presence of NPC is an independent risk factor for subsequent DED.

Research Progress on Non-coding RNAs in Cholesteatoma of the Middle Ear.

Cholesteatoma of the middle ear is a common disease in otolaryngology that is receiving increasing attention. It is estimated that over five million people around the world have suffered from middle ear cholesteatoma. The annual incidence of middle ear cholesteatoma has been reported to be 9.2 per 100,000 in adults and 3 per 100,000 in children. Without timely discovery and intervention, cholesteatomas can become perilously large and damage intratemporal structures, causing various intracranial and extracranial complications. No practical nonsurgical treatments are currently available. Although multiple hypotheses exist, research directions have consistently focused on cell proliferation, apoptosis, and bone destruction. Non-coding RNAs (ncRNAs), especially microRNAs (miRNAs), long ncRNAs (lncRNAs), and circular RNAs (circRNAs), have recently received increasing attention because of their key roles in gene expression, cell cycle regulation, and the development of many diseases. Although ncRNAs are not involved in protein translation, they are abundant in the genome, with only approximately 2% of genes encoding proteins and the remaining approximately 98% encoding ncRNAs. The purpose of this review is to summarize the current state of knowledge regarding the specific role of ncRNAs in middle ear cholesteatoma.

Assessment of the Prevalence of the Use of Nasal Decongestants Among the General Population in Saudi Arabia.

Background A topical nasal decongestant (NDC) is widely prescribed in ENT practice and used as self-medication because it is available over the counter, which makes it an easily accessible medication. Due to its common and long-term use, it is associated with serious nasal complications. It is commonly self-administrated in many otolaryngology diseases like the common cold, sinusitis, and acute or chronic rhinitis. The long-term usage of nasal decongestants is associated with significantly increased side effects. Aim To assess the prevalence of the usage of nasal decongestants among the general population in Saudi Arabia ad the pattern of its use. Methodology A questionnaire-based, cross-sectional survey was applied to level all available populations in Saudi Arabia. Participants with agesaged 10 to 60 years old in Saudi Arabia were invited to participate in the survey. Data were collected from participants using a predesigned online questionnaire. The questionnaire included the participant's demographic data, NDC use, and pattern of use. The questionnaire was uploaded online by researchers and their friends using social media platforms. Results A total of 1456 participants completed the study questionnaire. Participants ages ranged from 10 to 60 years with a mean age of 26.9 ± 12.4 years old. Exact 585 (40.2%) participants were males and 1270 (87.2%) were from urban regions. A total of 657 (45.1%) respondents reported using nasal decongestants while 799 (54.9%) did not use NDC. As for the duration of use, 70.8% used NDC for less than five days and 13.5% used it for 5-15 days. The most reported causes of using NDC were nasal obstruction (62.7%)and common cold (25.7%). Conclusions In conclusion, the study revealed that the frequency of using nasal decongestants was common (45.1%) in the study. More efforts should be paid to improve public awareness regarding indications, duration of use, and method of using nasal decongestants to avoid rebound reactions that may affect patients' daily life activities.

Incidence of Otolaryngological Diseases in General Population: A Study in Eastern Medical College Hospital

Background: Otolaryngological diseases are serious public health problems affecting all age groups. This includes problem of hearing, speech, phonation, breathing, swallowing, smell &amp; taste and protection of lower respiratory passage.&#x0D; Objective: The aim of this study was to determine the common clinical presentation and socio demographic characteristics of the patients attending in ENT outdoor.&#x0D; Method: This cross-sectional study was conducted among 500 patients attending in ENT outdoor in Eastern medical college Hospital, Cumilla, Bangladesh using a self-administered semi-structured questionnaire from July 2020 to September 2020.&#x0D; Result: In this study 44.8% were male and 55.2% female. All age group were included and majority of patients were age group of 21-30 years (28.6%). In our study 38.2% (191) of the study populations were suffering from ear diseases, and then followed by 32% (160) nose diseases and 29.8% (149) throat diseases. Common ear, nose, throat diseases were suppurative otitis media 30.37% (58), allergic rhinitis 23.13% (37), tonsillitis 31.54% (47), respectively.&#x0D; Conclusion: Our study provides basic information of the incidence of ENT disorders in the study area suggests that suppurative otitis media, tinnitus, foreign body ear, allergic rhinitis, nasal polyp, sinusitis, tonsillitis and pharyngitis are the most common Otolaryngological (ENT) problems in general population visiting the ENT Department of this hospital and contribute significantly to morbidity.&#x0D; EMCJ. January 2022; 7(1): 6-10

Measuring the Impact of a Delay in Care on Pediatric Otolaryngologic Surgery Completion.

Objective: To determine if postponement of elective pediatric otorhinolaryngology surgeries results in a change in overall healthcare utilization and if there is any commensurate impact on disease progression. Methods: We identified patients ≤18years of age whose surgeries were postponed at the onset of the COVID-19 pandemic-related shutdown. We then tracked patients' rate of and patterns of rescheduling surgery. Surveys were also sent to caregivers to better characterize his/her decision regarding moving forward with his/her child's surgery during COVID-19. Results: A total of 1915 pediatric patients had elective surgeries canceled, of which 992 (51.8%) were rescheduled within 4 months. No difference in rates of rescheduling was identified based on race or ethnicity. Patients who were scheduled for tonsillectomies and/or adenoidectomies were 1.22 times more likely to reschedule compared to those patients with other planned procedures (CI: 1.02-1.46). A total of 95 caregivers at two hospitals completed surveys: 44 (47.4%) rescheduled their child's surgery. Most caregivers who rescheduled were concerned their child's disease could impact their future (n = 14, 32%). Conclusions: Just over half of patients who had pediatric otolaryngologic surgery canceled during a period of social distancing went on to have surgery within a 4-month timeframe. This reflects the dependence of pediatric otolaryngologic surgery on environmental exposures and may represent a potential target for prevention and management of some pediatric otolaryngology diseases.

Changes in Otorhinolaryngologic Disease Incidences before and during the COVID-19 Pandemic in Korea.

This study aimed to investigate the change in the incidence and variance of otorhinolaryngologic diseases during the coronavirus disease 19 (COVID-19) pandemic. The entire Korean population (~50 million) was evaluated for the monthly incidence of 11 common otorhinolaryngologic diseases of upper respiratory infection (URI), influenza, acute tonsillitis, peritonsillar abscess, retropharyngeal and parapharyngeal abscess, acute laryngitis and bronchitis, stomatitis and related lesions, acute sinusitis, rhinitis, otitis media, and dizziness from January 2018 through March 2021 using the International Classification of Disease (ICD)-10 codes with the data of the Korea National Health Insurance Service. The differences in the mean incidence of 11 common otorhinolaryngologic diseases before and during COVID-19 were compared using the Mann—Whitney U test. The differences in the variance of incidence before and during COVID-19 were compared using Levene’s test. The incidence of all 11 otorhinolaryngologic diseases was lower during COVID-19 than before COVID-19 (all p < 0.05). The variations in disease incidence by season were lower during COVID-19 than before COVID-19 for infectious diseases, including URI, influenza, acute tonsillitis, peritonsillar abscess, retropharyngeal and parapharyngeal abscess, acute laryngitis and bronchitis, acute sinusitis, and otitis media (all p < 0.05), while it was not in noninfectious diseases, including stomatitis, rhinitis, and dizziness. As expected, the incidences of all otorhinolalryngolgic diseases were decreased. Additionally, we found that seasonal variations in infectious diseases disappeared during the COVID-19 pandemic, while noninfectious diseases did not.

Strategies for preventing postoperative recurrence of adenoid hypertrophy

Adenoid hypertrophy is a common disease in pediatric otorhinolaryngology. Surgical resection is the main treatment at present, but many children still face the risk of postoperative recurrence or even secondary surgery. In order to reduce the postoperative recurrence rate and provide reference information for clinical medical staff and parents of the children, this review was carried out to analyze the domestic and foreign pertinent literature in recent years and put forward overall prevention strategies base on the related factors of recurrence.

COVID-19 from the perspective of otorhinolaryngology: An analysis of bibliometrics.

BackgroundSince it began in December 2019, the coronavirus disease 2019 (COVID-19) outbreak has not been completely contained. COVID-19 has attracted the interest of nations throughout the globe. The global coronavirus outbreak has had an especially devastating effect on otolaryngology. The virus is commonly associated with otorhinolaryngological symptoms. COVID-19 research is becoming more common in otorhinolaryngology. Although various studies on covid-19-related Otorhinolaryngology manifestations have been published, there has been no bibliometric analysis of these articles concentrating on COVID-19-related Otorhinolaryngology research.MethodsOriginal publications on Otolaryngological symptoms on COVID-19 were extracted from the Social Sciences Citation Index (SSCI) and the Science Citation Index-Expanded (SCI-E) databases in Clarivate Analytics' Web of Science Core Collection (WoSCC) between January 2020 and May 2022. CiteSpace and VOSviewer were utilized to detect and assess the research focus and trends in this field by extracting the country/region, institution, author, journal, references, and keywords related to this topic.ResultsA total of 631 journals from 97 countries were included in the total of 1,528 articles. Most of the articles on this topic were published in the United States, which had the most citations and the highest H-index. Huazhong University of Science and Technology is the institution with the largest number of articles in the research of COVID-19-related Otorhinolaryngology diseases. Claire Hopkins was the most prolific author belonging to Guy's and St. Thomas' NHS Foundation Trust. Huang CL from Jin Yin-tan Hospital received the most citations among all authors. The most cited article was Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, which was created by Huang CL. Most of the studies relating to COVID-19 and Otorhinolaryngology diseases were published in the European Archives of Oto-Rhino-Laryngology.ConclusionCOVID-related research in the field of otorhinolaryngology has been studied in terms of descriptive quantitative metrics, which show that academics from around the world are working together to combat this pandemic.

Ghrelin Downregulates Lipopolysaccharide/ Leptin-Induced MUC5AC Expression in Human Nasal Epithelial Cells.

Obesity, which induces chronic low-grade systemic inflammation in the human body, is a known risk factor for various diseases. Recent studies have shown associations between various otorhinolaryngological diseases and obesity. In particular, inflammatory sinonasal diseases have been found to be strongly associated with obesity-related proinflammatory mediators. Many studies have been conducted to identify therapeutic agents for controlling obesity-related inflammatory airway diseases. Ghrelin, an endogenous peptide from the stomach, has anti-inflammatory and antioxidative effects in a wide range of tissues. However, the effect of ghrelin on the regulation of mucus secretion has not yet been studied in the human nasal mucosa. Therefore, we investigated the effects of ghrelin on lipopolysaccharide (LPS)/leptin-mediated MUC5AC expression and mechanisms involved in human nasal epithelial cells (HNEpCs). In HNEpCs, the effect and signaling pathways of ghrelin on LPS/leptin-induced MUC5AC expression were examined using reverse transcription polymerase chain reaction, real-time polymerase chain reaction, enzyme immunoassays, Western blotting, and immunofluorescence staining. Growth hormone secretagogue receptor 1a (GHSR1a) was expressed in the HNEpCs. Ghrelin downregulated LPS/leptin-induced MUC5AC expression, which was abolished by D-Lys-3-growth hormone-releasing peptide 6 (D-Lys-3-GHRP-6). Ghrelin significantly inhibited LPS/leptin-activated extracellular signal-regulated kinase 1/2 (ERK1/2) and p38 mitogen-activated protein kinases (MAPKs). These ghrelin-mediated changes in MAPK activation were abolished by D-Lys-3-GHRP-6. These. showed that ghrelin inhibits LPS/leptin-induced MUC5AC overexpression by modulating the ERK1/2 and p38 MAPK pathways in HNEpCs. These findings suggest that ghrelin is a potential therapeutic agent for treating obesity-related inflammatory sinonasal diseases.

Impact of the COVID-19 and Socioeconomic Status on Access to Care for Otorhinolaryngology Patients.

Since December 2019, COVID-19 has greatly influenced public healthcare systems around the globe in various aspects, including limitation of healthcare accessibility due to lack of both human and financial resources, suspension of clinics, and fear of infection causing healthcare avoidance. The aim of this study was to investigate the impact of COVID-19 on access to healthcare for otorhinolaryngology patients from different socioeconomic status (SES) groups. Otorhinolaryngology patients’ disease severity status, diagnosed at the first hospital visit, was investigated during the pre -and post-COVID-19 pandemic era in a single medical center located in Seoul, Korea. An ordinal regression model was used to assess the impact of both SES and the COVID-19 pandemic on otorhinolaryngology diseases. Within the chronic rhinosinusitis group, lower SES was associated with a higher disease severity at the first visit compared to higher SES (OR = 3.25). During the COVID-19 pandemic, while the total number of outpatients was reduced, the severity of these ENT diseases seemed to increase compared to the pre-pandemic severity in every SES group. Our study demonstrates the negative impact a worldwide pandemic can have on healthcare inequity and disease severity, and highlights the importance of re-allocating fundamental resources for those in need during periods of public health crisis.

High-Throughput Sequencing Investigation of Bacterial Diversity in Chronic Suppurative Otitis Media and Middle Ear Cholesteatoma.

Background Chronic otitis media is a common middle ear disease in otolaryngology. Bacterial infection is considered as the cause of the disease, but relying on conventional bacterial cultures can be problematic for identifying specific pathogens. Current research suggests that bacteria in microbial communities can only be identified by rDNA sequencing of bacteria. Methods This cross-sectional study utilized broad-range PCR amplification of 16S rRNA genes with clone analysis to compare bacterial diversity in lesions from 6 patients with chronic suppurative otitis media (CSOM) and 10 patients with cholesteatoma of middle ear lesions. Bacteria were analyzed at the levels of phylum, order, family, genus, and species. Results The age and sex difference between the patients with chronic suppurative otitis media and the patients with middle ear cholesteatoma were comparable (P > 0.05). Bacterial species abundance and species diversity were greater in cholesteatoma of the middle ear lesions than in CSOM lesions. The total number of detected operational taxonomic units (OTU) was 838, comprising 788 OTU detected in cholesteatoma pathological tissues, 230 in CSOM pathological tissues, and 180 OTU common to both groups. Proteus is a major part of CSOM (99.46%, P = 0.000321). The phyla detected in the Cholesteatoma samples were Proteus (Proteobacteria) (35.77%), thikum (Firmicutes) (44.21%, P = 0.001071), and Actinomycetes (Actinobacteria) (16.66%, P = 0.032464). At all bacterial taxonomic levels, the epithelial tissue of middle ear cholesteatoma was complex in terms of bacterial diversity, covering many Gram-positive and Gram-negative bacteria, likely related to bacterial microbiome formation. In contrast, the bacteriology of the CSOM lesions was relatively simple at all taxonomic levels, with all sequences characterized as belonging to Gram-negative bacteria. Conclusion Our results suggest that persistent middle ear cholesteatoma infection may be a microbial flora disorder related to conditional pathogenic bacteria rather than a single bacterial infectious disease. The pathogen is relatively single in the diseased tissue of chronic suppurative otitis media, which is the main reason for its effective antiinfection treatment.

Genetic Loci in Phospholipase C-Like 1 (PLCL1) are Protective Factors for Allergic Rhinitis in Han Population of Northern Shaanxi, China.

BackgroundAllergic rhinitis (AR) is a common allergic disease in otolaryngology. Its pathogenesis is still unclear. PLC1 plays a key role in calcium homeostasis and immune response, which is potentially related to AR. We aimed to explore the association between PLCL1 genetic loci and susceptibility to AR.MethodsWe recruited 1975 volunteers to perform an association analysis through SNPStats online software. False-positive report probability (FPRP) analysis was used to detect whether the positive findings were worth noting. Linkage disequilibrium and haplotype analysis were completed through Haploview and SNPStats. The influence of SNP-SNP interaction on AR susceptibility was evaluated through multifactor dimensionality reduction (MDR).ResultsThe results showed that four genetic loci in PLCL1 (rs2139049, rs212164068, rs2228135, and rs6738825) are associated with AR susceptibility under multiple genetic models. Allele “A” of PLCL1-rs2139049 (OR = 0.85, p = 0.031) or of -rs212164068 (OR = 0.85, p = 0.030), and allele “G” of PLCL1-rs6738825 (OR = 0.84, p = 0.022) are significantly associated with reduced AR risk. PLCL1-rs2228135 is associated with an increased risk of AR in males or participants older than 43 years of age. FPRP analysis showed that most of positive results are noteworthy findings. Three loci model composed of rs2139049, rs2164068, and rs2228135 is the best model for predicting AR risk (p = 0.0022). In addition, the haplotype “Grs2139049Ars6738825Ars2164068Ars2228135” (OR = 0.50, p = 0.033) can reduce the AR risk.ConclusionAllele “A” of PLCL1-rs2139049, allele “A” of -rs212164068, and allele “G” of PLCL1-rs6738825 are protective factors of AR in Han population from northern Shaanxi, China.

Roles of regulatory B cells in the pathogenesis of allergic rhinitis.

Allergic rhinitis (AR) is a common otolaryngologic disease with frequent episodes of sneezing, clear nasal discharge flow and nasal congestion. The mechanisms of AR are complex and considered generally caused by the immune tolerance deficiency. Regulatory B cells (Bregs) are immunosuppressive cells that can modulate immune responses by the secretion of IL-10, IL-35, and tumor growth factor-β (TGF-β) and via the interaction of membrane surface molecules. However, Bregs are numerically deficient and/or dysfunctional in airway allergic diseases such as AR and allergic asthma, and the related mechanisms remain unclear. In this review, we summarize the role of Bregs in AR pathogenesis and highlight the importance of Bregs in maintaining immune tolerance. It is believed that further research on Bregs will contribute to developing new treatments and finding specific biomarkers that could help to predict disease progression.

Influences of Airway Obstruction Caused by Adenoid Hypertrophy on Growth and Development of Craniomaxillofacial Structure and Respiratory Function in Children.

Adenoid hypertrophy (AH) is a common disease in otorhinolaryngology. Children with chronic snoring and hypoxia are susceptible to long-term nasal obstruction, while long-term open-mouth breathing may cause craniofacial bone development disorders and dull facial expressions, the so-called adenoid face. The purpose of this work is to analyze the influence of AH-induced airway obstruction (AO) on the growth and development of craniomaxillofacial structure and respiratory function (RF) in children. The clinical data of 56 AH children (observation group) and 42 healthy children with physical examination (control group) who visited the Hebei Eye Hospital during the same period were retrospectively analyzed. All children received acoustic rhinometry and X-ray cephalometric measurements. The upper airway structure, sleep disorder score, and A/N value of nasopharyngeal lateral X-ray images were compared between cases and controls. For AH children, sleep tests were also performed to assess their RF. X-ray cephalometric measurements of facial morphology showed obvious vertical growth, mandibular retrognathia, and enlarged mandibular angle in AH children. AH mainly affects the size of the nasopharyngeal and oropharyngeal airway. AH children presented with higher nasal airway resistance (5.11 ± 1.95 cmH2O/L min) and lower nasopharyngeal volume (NPV) (16.86 ± 3.93 cm3) than controls. Of the AH children, 45 had abnormal RF, including 4 with obstructive sleep apnea syndrome. The A/N value of nasopharyngeal lateral X-ray images was significantly higher in AH children than in controls. Besides, worse sleep quality was found in AH children. The above differences were all of statistical significance. The above indicates that AH can affect the size of the nasopharyngeal and oropharyngeal airway, change children's respiratory mode and RF, increase nasal resistance, and decrease NPV, resulting in upper respiratory tract stenosis, as well as craniomaxillofacial and oral malformations, which affects children's normal growth and development.