Allergic Rhinosinusitis and Airway Diseases

A special issue of Sinusitis (ISSN 2673-351X).

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 53543

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Guest Editor
1. Division of Pulmonary, Allergy and Critical Care Medicine, Penn State Health, Milton S. Hershey Medical Center and Pennsylvania State University College of Medicine, Hershey, PA, USA
2. Respiratory and Lung Functional Exploration Department, Cochin Hospital, Paris Descartes University, Paris, France
3. Bio-Medical Research Center, Lam Dong Medical College, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
Interests: allergic rhinitis; anosmia; asthma; snoring; obstructive sleep apnea; exhaled nitric oxide; COVID-19; long COVID-19
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Special Issue Information

Dear Colleagues,

The concept of united airway disease interaction comprises allergic rhinosinusitis including allergic rhinitis, eosinophilic chronic rhinosinusitis, and other upper or lower airway disorders such as obstructive sleep apnea, bronchial hyperresponsiveness and allergic asthma. It embodies a coherent pathophysiology and a comprehensive approach to the treatment of upper and lower airway disorders. The treatment of chronic allergic rhinosinusitis may reduce obstructive sleep apnea symptoms, chronic cough, or the dose of inhaled corticosteroids necessary to treat asthma, and vice versa.

Many objectives in the interaction concept between allergic rhinosinusitis and airway disease management should be achieved in the near future for reliable control of each disease. More awareness of allergic rhinosinusitis and its comorbidity with other airway diseases must be emphasized in the patients' management programs. Progress in diagnosis, with the help of the advanced biomarkers and relevant imagery techniques associated with accurate treatment of allergic rhinosinusitis and airway diseases, should be developed by scientists to drive indication and follow-up of target treatment with biologic therapies. Finally, more research on the interaction between allergic rhinosinusitis and airway diseases considered comorbidities or modifiable cofactors should be reconsidered by physicians in the next decade.

This Special Issue, “Allergic Rhinosinusitis and Airway Diseases” is open to the publication of relevant data and ideas from clinical practice and research. The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Sy Duong-Quy
Guest Editor

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Keywords

  • allergic rhinitis
  • allergic rhinosinusitis
  • nasal polyps
  • chronic cough
  • obstructive sleep apnea
  • asthma
  • airway hyperreactivity/hyperresponsiveness
  • hypereosinophilic airways
  • th-2 biomarkers
  • exhaled nitric oxide

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Published Papers (10 papers)

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Editorial

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5 pages, 754 KiB  
Editorial
Allergic Rhinosinusitis and Airway Diseases
by Sy Duong-Quy
Sinusitis 2022, 6(1), 21-25; https://doi.org/10.3390/sinusitis6010003 - 14 May 2022
Viewed by 3123
Abstract
The concept of united airway disease interaction, which comprises chronic rhinosinusitis and other lower airway disorders such as asthma, has been recognized for over a decade [...] Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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Research

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14 pages, 1855 KiB  
Article
Atopic Status in Children with Asthma and Respiratory Allergies—Comparative Analysis of Total IgE, ImmunoCAP Phadiatop/fx5 and Euroimmun Pediatric Immunoblot
by Snezhina Lazova, Marta Baleva, Stamatios Priftis, Emilia Naseva and Tsvetelina Velikova
Sinusitis 2022, 6(1), 1-14; https://doi.org/10.3390/sinusitis6010001 - 29 Dec 2021
Cited by 2 | Viewed by 5096
Abstract
Introduction: An atopic status assessment (skin prick test or specific immunoglobulin (sIgE)) in asthmatic children is considered a milestone in identifying potential risk factors and triggers provoking loss of asthma control and asthma exacerbation. Objective: The study aims to perform a comparative analysis [...] Read more.
Introduction: An atopic status assessment (skin prick test or specific immunoglobulin (sIgE)) in asthmatic children is considered a milestone in identifying potential risk factors and triggers provoking loss of asthma control and asthma exacerbation. Objective: The study aims to perform a comparative analysis of different laboratory methods for a serological assessment of an atopic status in asthma and respiratory allergies in children. Material and methods: A total of 86 children were included, all of whom were diagnosed with bronchial asthma, aged from 5 to 17 years and screened for total IgE level using enzyme-linked immunosorbent assay (ELISA). In 48 randomly selected children, we performed a semi-quantitative serological in vitro assessment of the specific IgE antibodies against food and aeroallergen, using two different laboratory methods—Euroimmun Immunoblot and ImmunoCAP (Phadiatop/fx5). Results: In 70% of the children with a history of allergies, and 65.3% without clinically manifested allergies, multiscreen test ImmunoCAP Phadiatop/fx5 showed positivity and confirmed atopy. Our results showed a significant moderate to strong correlation between multiscreen ImmunoCAP Phadiatop/fx5, and Euroimmun specific IgE titers against aero-allergens—cats, mites, tree mix and food allergens—soy, wheat (р = 0.006), rice, р = 0.090), apple р = 0.007) and peanut. A sensitivity of 63% and specificity of 73.5% was observed for EUROIMMUN Pediatric (food allergens, IgE titer > 1) compared with the gold standard ImmunoCap/fx5. The mean value of total IgE is significantly higher in children with asthma and concomitant with allergic rhinitis compared to those without allergic rhinitis (mean 202.52 U/mL, IQR 102.50 (24.20–363.95) vs. 316.68, IQR 261.00 (109.20–552.50), p = 0.005). Conclusion: Establishing the spectrum of the most common respiratory and food allergens is an essential factor for maintaining asthma control, both through a strategy to avoid allergen exposure and by developing a recommendation plan. The immunoblotting technique is easily applicable in daily clinical and laboratory practice. It is also a cost-effective and reliable alternative to the “gold standard” ImmunoCAP Phadiatop/fx5 in diagnosing atopy in children. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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9 pages, 852 KiB  
Article
Study of Nasal Fractional Exhaled Nitric Oxide (FENO) in Children with Allergic Rhinitis
by Sy Duong-Quy, Thuy Nguyen-Thi-Dieu, Khai Tran-Quang, Tram Tang-Thi-Thao, Toi Nguyen-Van, Thu Vo-Pham-Minh, Quan Vu-Tran-Thien, Khue Bui-Diem, Vinh Nguyen-Nhu, Lam Hoang-Thi and Timothy Craig
Sinusitis 2021, 5(2), 123-131; https://doi.org/10.3390/sinusitis5020013 - 8 Oct 2021
Cited by 2 | Viewed by 4609
Abstract
(1) Background: Exhaled nitric oxide (NO) has been considered as a biomarker of airway inflammation. The measurement of fractional exhaled NO (FENO) is a valuable test for assessing local inflammation in subjects with allergic rhinitis (AR). (2) Objective: To evaluate (a) the correlation [...] Read more.
(1) Background: Exhaled nitric oxide (NO) has been considered as a biomarker of airway inflammation. The measurement of fractional exhaled NO (FENO) is a valuable test for assessing local inflammation in subjects with allergic rhinitis (AR). (2) Objective: To evaluate (a) the correlation between nasal FENO with anthropometric characteristics, symptoms of AR and nasal peak flows in children without and with AR; and (b) the cut-off of nasal FENO for diagnosis of AR in symptomatic children. (3) Methods: The study was a descriptive and cross-sectional study in subjects with and without AR < 18 years old. All clinical and functional characteristics of the study subjects were recorded for analysis. They were divided into healthy subjects for the control group and subjects with AR who met all inclusion criteria. (4) Results: 100 subjects (14 ± 3 years) were included, including 32 control subjects and 68 patients with AR. Nasal FENO in AR patients was significantly higher than in control subjects: 985 ± 232 ppb vs. 229 ± 65 ppb (p < 0.001). In control subjects, nasal FENO was not correlated with anthropometric characteristics and nasal inspiratory or expiratory peak flows (IPF or EPF) (p > 0.05). There was a correlation between nasal FENO and AR symptoms in AR patients and nasal IPF and EPF (p = 0.001 and 0.0001, respectively). The cut-off of nasal FENO for positive AR diagnosis with the highest specificity and sensitivity was ≥794 ppb (96.7% and 92.6%, respectively). (5) Conclusion: The use of nasal FENO as a biomarker of AR provides a useful tool and additional armamentarium in the management of allergic rhinitis. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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15 pages, 1563 KiB  
Article
Effects of the Traditional Mediterranean Diet in Childhood Recurrent Acute Rhinosinusitis
by Fernando M. Calatayud-Sáez, Blanca Calatayud and Ana Calatayud
Sinusitis 2021, 5(2), 101-115; https://doi.org/10.3390/sinusitis5020011 - 2 Sep 2021
Cited by 5 | Viewed by 4402
Abstract
Introduction: There are more and more studies that demonstrate the anti-inflammatory effects of the traditional Mediterranean diet (TMD). The aim of the study was to assess the effects of an intervention with the TMD in patients with recurrent acute and chronic rhinosinusitis. Material [...] Read more.
Introduction: There are more and more studies that demonstrate the anti-inflammatory effects of the traditional Mediterranean diet (TMD). The aim of the study was to assess the effects of an intervention with the TMD in patients with recurrent acute and chronic rhinosinusitis. Material and Methods: We performed a pretest–posttest comparison study in 114 patients (56 girls and 58 boys) aged one to five years who had three or more acute rhinosinusitis episodes in the period of 1 year. They were included for a year in the nutritional program “Learning to eat from the Mediterranean”. The anthropometric, clinical, and therapeutic characteristics were studied. Results: All the studied indicators showed a positive and statistically significant evolution. Of the patients, 53.5% did not have any episode of acute rhinosinusitis, and 26.3% had only one, compared to the 3.37 they had on average in the previous year. The use of antibiotics decreased by 87.6%. The degree of satisfaction of the families was very high. The Mediterranean Diet Quality Index (KIDMED) that assesses the quality of the TMD rose from 7.7 to 11 points. Conclusions: The adoption of the TMD could have promising effects in the prevention and treatment of recurrent acute and chronic rhinosinusitis, limiting the pharmacological and surgical intervention in many of these patients. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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15 pages, 2599 KiB  
Article
Anti-Asthmatic Effects of Saffron Extract and Salbutamol in an Ovalbumin-Induced Airway Model of Allergic Asthma
by Pranav Nair and Kedar Prabhavalkar
Sinusitis 2021, 5(1), 17-31; https://doi.org/10.3390/sinusitis5010003 - 24 Jan 2021
Cited by 7 | Viewed by 6906
Abstract
Introduction: Asthma is a chronic inflammatory disorder of the airways often characterized by airway remodeling and influx of inflammatory cells into the airways. Saffron (C. sativus) has been reported to possess anti-inflammatory, anti-allergic and immunomodulatory properties. Salbutamol is known to relax airway smooth [...] Read more.
Introduction: Asthma is a chronic inflammatory disorder of the airways often characterized by airway remodeling and influx of inflammatory cells into the airways. Saffron (C. sativus) has been reported to possess anti-inflammatory, anti-allergic and immunomodulatory properties. Salbutamol is known to relax airway smooth muscles. Objective: To investigate the combined anti-asthmatic effect of C. sativus extract (CSE) and salbutamol in an ovalbumin (OVA)-induced asthma in rats. Materials and methods: Airway hyperresponsiveness (AHR) was induced in male Sprague-Dawley rats by OVA challenge and treated with CSE (30 mg/kg and 60 mg/kg i.p.) and salbutamol (0.5 mg/kg p.o) for 28 days. After the induction period, various hematological, biochemical, molecular (ELISA) and histological analyses were performed. Results: OVA-induced alterations observed in hematological parameters (total and differential cell counts observed in Bronchoalveolar Lavage Fluid (BALF) were significantly attenuated (p < 0.01) by CSE (30 mg/kg and 60 mg/kg) and salbutamol (0.5 mg/kg). The treatment combination also significantly decreased (p < 0.01) the levels of total protein and albumin in serum, BALF and lung tissues. Treatment with CSE and salbutamol significantly attenuated (p < 0.01) increase in OVA induced Th2 cytokine levels (TNF-α, IL-1β, IL-4, IL-13). Histopathological analysis of lung tissue showed that combined effect of CSE and salbutamol treatment ameliorated OVA-induced inflammatory influx and ultrastructural aberrations. Conclusion: The results obtained from this study show that the combined effect of CSE and salbutamol exhibited anti-asthmatic properties via its anti-inflammatory effect and by alleviating Th2 mediated immune response. Thus, this treatment combination could be considered as a new therapeutic strategy for management of asthma. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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12 pages, 676 KiB  
Article
Prevalence and Risk Factors of Sinus and Nasal Allergies among Tannery Workers of Kanpur City
by Gyan Chandra Kashyap, Deepanjali Vishwakarma and Shri Kant Singh
Sinusitis 2021, 5(1), 5-16; https://doi.org/10.3390/sinusitis5010002 - 11 Jan 2021
Cited by 5 | Viewed by 9943
Abstract
India is greatly afflicted by sinusitis, which is a condition that involves inflaming sinuses (the air cavities in the nasal passage) in your nose, according to the National Institute of Allergy and Infectious Diseases (NIAID). The study’s objective was to evaluate the prevalence [...] Read more.
India is greatly afflicted by sinusitis, which is a condition that involves inflaming sinuses (the air cavities in the nasal passage) in your nose, according to the National Institute of Allergy and Infectious Diseases (NIAID). The study’s objective was to evaluate the prevalence and risk factors of sinus and nasal allergies among tannery workers of Kanpur city. The study has used primary datasets obtained from a cross-sectional household study of tannery workers from the Jajmau area of Kanpur in northern India, which was conducted during January–June 2015 as part of a doctoral program. The study covered 286 tannery workers from the study area. Bivariate and logistic regression analysis was used to study the association between outcome variables (self-reported prevalence of sinus and nasal allergies) and predictor variables (socioeconomic and work-related characteristics). Results portray that a higher proportion of the tannery workers belong to economically and socially backward classes. Overall, 13.4 and 12.3% of sinus and nasal allergy prevalence have been reported by tannery workers, whereas tannery workers from the oldest age group were those who mainly suffered. A study found that the severity of nasal and sinus allergies increases with the increasing age and work duration in the tannery. Workers with low exposure to airborne dust were significantly more likely to develop sinus problems (OR = 4.16; p < 0.05) than those without exposure. Those tannery workers suffering from nasal allergy were more prone to develop sinus problems than those who were not suffering from nasal allergy. The risk factors responsible for these health hazards can be eliminated by improving the overall working conditions and ensuring necessary protective regulations for the tannery workers. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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Review

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6 pages, 215 KiB  
Review
Promoting Equity When Using the SNOT-22 Score: A Scoping Review and Literature Review
by Abigail Weaver and Andrew Wood
Sinusitis 2022, 6(1), 15-20; https://doi.org/10.3390/sinusitis6010002 - 16 Jan 2022
Cited by 1 | Viewed by 3187
Abstract
It is established that non-white people experience worse health outcomes than white people within the same population. Equity addresses differences between patient subgroups, allowing needs-based distribution of resources. The use of quality-of-life (QoL) tools to assist clinical decision making such as the SNOT-22 [...] Read more.
It is established that non-white people experience worse health outcomes than white people within the same population. Equity addresses differences between patient subgroups, allowing needs-based distribution of resources. The use of quality-of-life (QoL) tools to assist clinical decision making such as the SNOT-22 for chronic rhinosinusitis promotes equality, not equity, as quality-of-life (QoL) tools provide the same criteria of symptom scoring across diverse populations. We considered the effects of ethnicity and race on SNOT-22 scores and whether these scores should be adjusted to improve equity. PubMed and MEDLINE provided papers for a scoping review. A combination of the following search terms was used: patient-reported outcome measures (PROM) (OR) quality of life; (AND) race (OR) ethnicity (OR) disparities; (AND) otolaryngology (OR) SNOT-22 (OR) sinusitis. The first study identified no evidence of ethnic variability in SNOT-22 scores. However, the study did not represent the local population, including 86% white people. Other studies identified baseline SNOT-22 disparities with respect to population demographics, gender, and age. Ethnic differences appear to exist in acute sinusitis symptomatology. In other fields both within and outside of otorhinolaryngology, ethnic differences exist with regard to QoL tools. This scoping review identified a paucity of data in rhinology. However, evidence implies some form of correction to QoL scores could help promote equity for non-white patients. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
7 pages, 446 KiB  
Review
Olfactory Disorders in Post-Acute COVID-19 Syndrome
by Laura Araújo, Vanessa Arata and Ricardo G. Figueiredo
Sinusitis 2021, 5(2), 116-122; https://doi.org/10.3390/sinusitis5020012 - 24 Sep 2021
Cited by 6 | Viewed by 5027
Abstract
Altered smell is one of the most prevalent symptoms in acute COVID-19 infection. Although most patients recover normal neurosensory function in a few weeks, approximately one-tenth of patients report long-term smell dysfunction, including anosmia, hyposmia, parosmia and phantosmia, with a particularly notable impact [...] Read more.
Altered smell is one of the most prevalent symptoms in acute COVID-19 infection. Although most patients recover normal neurosensory function in a few weeks, approximately one-tenth of patients report long-term smell dysfunction, including anosmia, hyposmia, parosmia and phantosmia, with a particularly notable impact on quality of life. In this complex scenario, inflammation and cellular damage may play a key role in the pathogenesis of olfactory dysfunctions and may affect olfactory signaling from the peripheral to the central nervous system. Appropriate management of smell disturbances in COVID-19 patients must focus on the underlying mechanisms and the assessment of neurosensorial pathways. This article aims to review the aspects of olfactory impairment, including its pathophysiology, epidemiology, and clinical management in post-acute COVID-19 syndrome (PACS). Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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8 pages, 748 KiB  
Review
Immunological and microRNA Features of Allergic Rhinitis in the Context of United Airway Disease
by Kremena Naydenova, Vasil Dimitrov and Tsvetelina Velikova
Sinusitis 2021, 5(1), 45-52; https://doi.org/10.3390/sinusitis5010005 - 19 Feb 2021
Cited by 3 | Viewed by 5074
Abstract
Inflammation of the upper respiratory tract in patients with allergic rhinitis (AR) may contribute to lower respiratory airways’ inflammation. T-helper 17 (Th17) cells and related cytokines are also involved in the immunological mechanism of AR along with the classical Th2 cells. It is [...] Read more.
Inflammation of the upper respiratory tract in patients with allergic rhinitis (AR) may contribute to lower respiratory airways’ inflammation. T-helper 17 (Th17) cells and related cytokines are also involved in the immunological mechanism of AR along with the classical Th2 cells. It is hypothesized that upon Th2 pressure, the inflammatory response in the lungs may lead to Th17-induced neutrophilic inflammation. However, the findings for interleukin-17 (IL-17) are bidirectional. Furthermore, the role of Th17 cells and their counterpart—T regulatory cells—remains unclear in AR patients. It was also shown that a regulator of inflammation might be the individual circulating specific non-coding microRNAs (miRNAs), which were distinctively expressed in AR and bronchial asthma (BA) patients. However, although several circulating miRNAs have been related to upper and lower respiratory tract diseases, their function and clinical value are far from being clarified. Still, they can serve as noninvasive biomarkers for diagnosing, characterizing, and providing therapeutic targets for anti-inflammatory treatment along with the confirmed contributors to the pathogenesis—Th17 cells and related cytokines. The narrow pathogenetic relationship between the nose and the bronchi, e.g., upper and lower respiratory tracts, confirms the concept of unified airway diseases. Thus, there is no doubt that AR and BA should be diagnosed, managed, and treated in an integrated manner. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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Other

4 pages, 1073 KiB  
Case Report
Low-Grade B Cell Lymphoproliferative Disorder Masquerading as Chronic Rhinosinusitis
by Rory Chan, Chris RuiWen Kuo and Brian Lipworth
Sinusitis 2021, 5(1), 1-4; https://doi.org/10.3390/sinusitis5010001 - 11 Jan 2021
Cited by 1 | Viewed by 4384
Abstract
Chronic rhinosinusitis (CRS) is one of the most common persistent disorders of the developed world, requiring input from various specialists including primary care physicians, otolaryngologists, respiratory physicians, and allergologists. B-cell lymphoproliferative disorders (BLPDs) are a heterogenous group of malignant conditions defined by an [...] Read more.
Chronic rhinosinusitis (CRS) is one of the most common persistent disorders of the developed world, requiring input from various specialists including primary care physicians, otolaryngologists, respiratory physicians, and allergologists. B-cell lymphoproliferative disorders (BLPDs) are a heterogenous group of malignant conditions defined by an accumulation of mature B lymphocytes in the bone marrow, blood, and lymphoid tissues. We present a case report of an elderly man with rhinosinusitis-like symptoms and atypical features prompting further investigations that culminated in a diagnosis of BLPD. Full article
(This article belongs to the Special Issue Allergic Rhinosinusitis and Airway Diseases)
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