Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy

Pearlman, Aaron N.; Chandra, Rakesh K.; Chang, Dennis; Conley, David B.; Tripathi-Peters, Anju; Grammer, Leslie C.; Schleimer, Robert T.; Kern, Robert C.
March 2009
American Journal of Rhinology & Allergy;Mar2009, Vol. 23 Issue 2, p145
Academic Journal
Background: The effect of comorbid conditions such as asthma and atopy on the severity of chronic rhinosinusitis (CRS) and the presence of nasal polyps (NPs) remains an area of investigation. We sought to elucidate the relationship among these entities. Methods: The study population included 106 consecutive patients who were referred to a multidisciplinary, university-based allergy and sinus clinic that underwent computed tomography (CT) scan, skin-prick testing, and had CRS. Data were analyzed to determine Lund-MacKay score (LMS), presence of NPs, asthma status, and sensitivity to seven classes of aeroallergens. Results: Skin tests were positive in 52 cases and negative in 54 cases. Although, there was no statistical relationship between LMS and atopic status in the entire group, among the asthmatic subgroup, mean LMS was greater in nonatopic asthmatic patients than in atopic asthmatic patients. Asthmatic patients had a higher LMS than nonasthmatic patients (p < 0.0001). Asthmatic patients were more likely than nonasthmatic patients to have NPs (57.6% versus 25%; p = 0.0015), regardless of atopic status. Mean LMS was higher in NP patients compared with nonpolyp patients (p < 0.0001), independent of atopic status. Mean LMS was not affected by sensitivity to any particular allergen, with the exception of cockroach-allergic patients who were more likely to have an LMS of >10 (p = 0.0236) and had more severe maxillary sinus involvement (p = 0.0391). Conclusion: These data indicate a strong relationship between CRS severity, as measured by LMS, and chronic airway inflammatory diseases, asthma, and NPs. The association between LMS and atopic status appears weak. The present study suggests that CRS is an inflammatory disease that occurs independently of systemic IgE-mediated pathways.


Related Articles

  • Smoking, longer disease duration and absence of rhinosinusitis are related to fixed airway obstruction in Koreans with severe asthma: findings from the COREA study. Taehoon Lee; Yoon Su Lee; Yun-Jeong Bae; Tae-Bum Kim; Seon Ok Kim; Sang-Heon Cho; Hee-Bom Moon; You Sook Cho // Respiratory Research;Jan2011, Vol. 12 Issue 1, p1 

    Background: The clinical manifestations of severe asthma are heterogeneous. Some individuals with severe asthma develop irreversible fixed airway obstruction, which is associated with poor outcomes. We therefore investigated the factors associated with fixed airway obstruction in Korean patients...

  • The Effect of Inhaled Budesonide and Formoterol on Bronchial Remodeling and HRCT Features in Young Asthmatics. Capraz, Firuz; Kunter, Erdogan; Cermik, Hakan; Ilvan, Ahmet; Pocan, Suheyl // Lung;Mar2007, Vol. 185 Issue 2, p89 

    Asthma is a chronic disease that may cause remodeling of the airways. We aimed to observe the effects of the combined use of inhaled budesonide and formoterol on both the reversibility of remodeling and structural changes in the airways. Thirty-six male patients (age range, 20�31) with...

  • Sputum mediator profiling and relationship to airway wall geometry imaging in severe asthma. Desai, Dhananjay; Gupta, Sumit; Siddiqui, Salman; Singapuri, Amisha; Monteiro, William; Entwisle, James; Visvanathan, Sudha; Parmar, Harsukh; Kajekar, Radhika; Brightling, Christopher E. // Respiratory Research;Feb2013, Vol. 14 Issue 2, p1 

    Background: Severe asthma is a heterogeneous disease and the relationship between airway inflammation and airway remodelling is poorly understood. We sought to define sputum mediator profiles in severe asthmatics categorised by CT-determined airway geometry and sputum differential cell counts....

  • Association between severity of asthma and degree of chronic rhinosinusitis. Lin, David C.; Chandra, Rakesh K.; Tan, Bruce K.; Zirkle, Whitney; Conley, David B.; Grammer, Leslie C.; Kern, Robert C.; Schleimer, Robert P.; Peters, Anju T. // American Journal of Rhinology & Allergy;Jul/Aug2011, Vol. 25 Issue 4, p205 

    Background: There is a clinical association between asthma and chronic rhinosinusitis (CRS). This study was designed to determine whether severity of coexistent asthma affects the clinical presentation of CRS. Methods: Cross-sectional analysis was performed of prospectively collected data in 187...

  • Effects of formoterol-budesonide on airway remodeling in patients with moderate asthma. Wang, Ke; Liu, Chun-tao; Wu, Yong-hong; Feng, Yu-lin; Bai, Hong-li; Ma, En-sen; Wen, Fu-qiang // Acta Pharmacologica Sinica;Jan2011, Vol. 32 Issue 1, p126 

    Aim:To evaluate the effect of inhaled formoterol-budesonide on airway remodeling in adult patients with moderate asthma.Methods:Thirty asthmatic patients and thirty control subjects were enrolled. Asthmatic subjects used inhaled Symbicort 4.5/160 μg twice daily for one year. The effect of...

  • What are ventilation defects in asthma? Svenningsen, Sarah; Kirby, Miranda; Starr, Danielle; Coxson, Harvey O.; Paterson, Nigel A. M.; McCormack, David G.; Parraga, Grace // Thorax;Jan2014, Vol. 69 Issue 1, p63 

    Background Hyperpolarised ³He MRI provides a way to visualise regional pulmonary functional abnormalities that in asthma are thought to be related to airway morphological abnormalities. However, the exact aetiology of ventilation defects in asthma is not well understood. Objective To better...

  • Neurogenic Inflammation and Asthma. Butler, Claire A.; Heaney, Liam G. // Inflammation & Allergy - Drug Targets;Apr2007, Vol. 6 Issue 2, p127 

    Over the past number of decades there has been considerable interest in the role of neurogenic inflammation in asthma with the identification of many biologically active neuropeptides in the lung. Whilst there is convincing evidence of neurogenic inflammation in various animal models of asthma,...

  • Small airway dysfunction by impulse oscillometry in asthmatic patients with normal forced expiratory volume in the 1st second values. Pisi, R.; Tzani, P.; Aiello, M.; Martinelli, E.; Marangio, E.; Nicolini, G.; Olivieri, D.; Chetta, A. // Allergy & Asthma Proceedings;Jan/Feb2013, Vol. 34 Issue 1, p112 

    Small airways are relevant to the pathophysiology of asthma. We investigated whether in asthmatic patients with normal forced expiratory volume in the 1st second (FEV1) values, impulse oscillometry system (IOS), as a measure of small airway function, contributed additional information to...

  • Breakthrough in understanding of severe asthma has potential for new treatment. J. S. // Foods Matter (UK);Sep2009, p16 

    The article discusses the study which focuses on the potential of calcium in and out of muscle cells in regulating cellular activities. It cites one of the pumps, which control the amount of calcium in muscle cells, called SERCA2. The study found that SERCA2 levels were reduced in people with...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics