Enhanced Susceptibility of Nasal Polyp Tissues to Avian and Human Influenza Viruses

BACKGROUND: Influenza viruses bind and infect respiratory epithelial cells through sialic acid on cell surface. Differential preference to sialic acid types contributes to host- and tissue-tropism of avian and seasonal influenza viruses. Although the highly pathogenic avian influenza virus H5N1 can infect and cause severe diseases in humans, it is not efficient in infecting human upper respiratory tract. This is because of the scarcity of its receptor, α2,3-linked sialic acid, in human upper airway. Expression of sialic acid can be influenced by various factors including inflammatory process. Allergic rhinitis and nasal polyp are common inflammatory conditions of nasal mucosa and may affect expression of the sialic acid and susceptibility to influenza infection. METHODOLOGY/PRINCIPAL FINDING: To test this hypothesis, we detected α2,3- and α2,6-linked sialic acid in human nasal polyp and normal nasal mucosal tissues by lectin staining and infected explants of those tissues with avian influenza viruses H5N1 and seasonal influenza viruses. We show here that mucosal surface of nasal polyp expressed higher level of α2,3- and α2,6-linked sialic acid than normal nasal mucosa. Accordingly, both H5N1 avian influenza viruses and seasonal influenza viruses replicated more efficiently in nasal polyp tissues explants. CONCLUSIONS/SIGNIFICANCE: Our data suggest a role of nasal inflammatory conditions in susceptibility to influenza infection, especially by avian influenza viruses, which is generally inefficient in infecting human upper airway. The increased receptor expression may contribute to increased susceptibility in some individuals. This may contribute to the gradual adaptation of the virus to human population

Endotyping of Chronic Rhinosinusitis With and Without Polyp Using Transcription Factor Analysis

Inflammation of the nose and paranasal sinus or rhinosinusitis (RS) is a significant global health problem that is both very common and very costly to treat. Previous reports reveal variability in histology and mechanism of inflammation in patients with chronic rhinosinusitis with and without polyp (CRScNP and CRSsNP, respectively). There are various methods and hypothesis that try to explain this variability. Accordingly, the aim of this study was to investigate the incidence of each type of sinonasal inflammation among patients diagnosed with CRScNP or CRSsNP using transcription factor analysis (TFA). This study included mucosa specimens from nose/paranasal sinuses from patients with chronic rhinitis (CR), CRSsNP, or CRScNP that were obtained at the Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during the June 2009 to May 2012 study period. TFA was employed to measure the following transcription factors: T-box transcription factor (T-bet) for Th1, GATA binding protein 3 (GATA-3) for Th2, retinoic acid-related orphan receptor C (RORC) for Th17, and forkhead box P3 (FOXP3) for Treg. Forty-one subjects (22 males, 19 females) were enrolled, with a mean age of 45.93 ± 13 years. Twenty-six patients were diagnosed with CRScNP, 7 with CRSsNP, and 8 with CR (controls). The majority of CRScNP specimens (76.9%) had eosinophil count greater than 100 cells/high-power field (HPF). Mean eosinophil count was 930.08 ± 1,399 cells/HPF (range: 17–5,570). Th2 transcription factor (GATA-3) was statistically significantly higher in the CRScNP group than in the CRS and control groups (p < 0.001); whereas, Treg transcription factor (FOXP3) was statistically significantly lower in the CRScNP group than in the CRSsNP and control groups (p < 0.001). The transcription factors for Th1 and Th17 (T-bet and RORC, respectively) were not significantly different among the three groups. The result of transcription factor analysis revealed hyperfunction of Th2 in patients with CRScNP, which might result in hypereosinophilic infliltration in the polyps. One explanation for this finding is the decreased activity of Treg. Although environment-host interaction is the most probable hypothesis, the etiology of aberrant adaptive immunity needs to be elucidated

Is Non-Contrast Enhanced CT of Paranasal Sinus Adequate for the Diagnosis of Complicated Sinusitis?

Objective: To evaluate the accuracy of NECT compared with CECT of PNS for the detection of complicated sinusitis. Methods: A retrospective review of 96 patients (mean age, 51.78; range 20-84 years), including 44 men and 52 women, with clinically suspicious complicated sinusitis who underwent both NECT and CECT of PNS. Analysis and comparison between CT PNS on NECT and CECT for detection of complicated sinusitis were performed. Results: Complicated sinusitis was detected in 7 out of 96 patients. Orbital complications alone in 5 patients and 2 patients with both orbital and intracranial complications were found. Detection of orbital complication on NECT was 5 out of 7 patients, giving a sensitivity of 71.4% and specificity of 100%. Detection of orbital complication on CECT was 6 out of 7 patients, giving a sensitivity of 85.7% and specificity of 100%. In this presented study NECT could not demonstrate intracranial complication such as cavernous sinus invasion and brain parenchymal lesion. Conclusion: NECT of PNS shows high accuracy for the diagnosis of orbital complication, but low sensitivity for the detection of intracranial complication. Abbreviations: Contrast enhanced computed tomography (CECT) and non-contrast enhanced computed tomography (NECT), paranasal sinus (PNS), Hounsfield unit (HU

Thai SNOT-22

This is the data used in validity and reliability study of Thai SNOT-22 questionnair

raw data.xls

This data was used in our study "Reliability and validity study of Sino-Nasal Outcome test 22 (Thai version) in chronic rhinosinusitis"

Factors Affecting Unfavourable Results from a Sinonasal Inverted Papilloma Surgery

Objective: Sinonasal inverted papilloma (SNIP) is the most common nasal benign tumor, but locally invasive. The standard treatment is to identify origins of the tumor and total removal. Unfavourable results are finding postoperative residual or recurrent tumors. The aim of this study is to determine factors affecting postoperative residual or recurrent tumors and a rate of getting postoperative residual or recurrent tumors from SNIP surgeries. Methods: A retrospective study in patients with SNIPs was conducted. Relationships between demographic data, tumor sites, tumor stages by Krouse classification, surgical approaches, surgeons’ experience, using microdebrider assisted surgery, operative time, intraoperative blood loss, histopathology, Epstein Barr virus (EBV), human papillomavirus (HPV) infection, time to detect tumor after surgery and unfavourable results were evaluated. HPV and EBV were detected by in situ hybridization. Results: 73 patients were included in this study. Unfavourable results were found in 27 patients (36.99%). 50% of patients received unfavourable results after postoperative duration of 115 months. 5 years of a disease-free survival rate was 64.3% (95% CI: 51.9% to 76.7%). The patients with external surgical approaches got worse results than those with endoscopic sinus surgery (p = 0.01, a hazard ratio of 3.88, 95% CI: 1.39 to 10.87). The patients operated without using microdebrider assisted surgery got worse results than those with using the device (p < 0.001, an adjusted hazard ratio of 5.09, 95% CI: 2.08 to 12.45). The patients with abnormal pathological changes (tissue dysplasia and malignant transformation) had worse results than those without changes (p = 0.02, an adjusted hazard ratio of 3.42, 95% CI: 1.24 to 9.38).   Conclusion: Non-endoscopic nasal surgery, non-using microdebrider assisted surgery, and abnormal pathological changes may be some of the causes of unfavourable results from SNIP surgeries. Long postsurgical surveillance should be done, because of 36.99% of patients received unfavourable results from SNIP surgeries

In situ hybridization of H5N1 AIV-infected (upper) and non-infected (lower) polyp tissues.

<p>The hybridization signal is shown in red-brown color in the epithelial cells on the mucosal surface of infected tissue.</p

Mortality Rate and Predictive Factors for Invasive Fungal Rhinosinusitis: Experience in Siriraj Hospital

Objective: To elucidate the mortality rate and prognostic factors in patients with invasive fungal rhinosinusitis in Siriraj Hospital. Methods: Thirty-nine patients with a definitive diagnosis of invasive fungal rhinosinusitis were recruited from October 2003 to September 2014. The mortality rate was retrieved, and the impacts of underlying diseases, clinical presentation, disease extension, fungal types, antifungal drugs, and time to treatment were statistically analyzed. Results: The overall mortality rate was 23.1%. All patients except one were immunocompromised. Cranial nerve involvement was the most common symptom. The ethmoid sinus was the most commonly affected intranasal site (46.2%), and the majority of extranasal lesions were located in the orbit (17.9%). Most patients were affected by Aspergillus spp. (64.1%). Alteration of consciousness and periorbital pain were significant negative prognostic factors [adjusted odds ratio (95% confidence interval), 10.37 (1.31–82.07) and 8.67 (1.30–57.88), respectively]. Other factors such as time to treatment, age, and central nervous system involvement had no effect on mortality. Conclusion: The mortality rate of invasive fungal rhinosinusitis in this study was 23.1%. Negative prognostic factors were alteration of consciousness and periorbital pain. Clinicians must have a high index of suspicion for invasive fungal rhinosinusitis, and aggressive treatment should be considered

Correlation between the percentages of lectin-positive cells and the viral titers.

<p>Dot plots of percentages of lectin-positive cells versus maximum viral titers produced from the same tissue samples show linear correlation with Pearson correlation coefficient of 0.889 for SNA (p = 0.003) and 0.859 for MAA I (p = 0.006). The data were derived from the same experiments shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012973#pone-0012973-g001" target="_blank">Figure 1</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012973#pone-0012973-g002" target="_blank">2</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012973#pone-0012973-g004" target="_blank">4</a>.</p