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Chen J, Zhou Y, Zhang L, et al. Individualized Treatment of Allergic Rhinitis According to Nasal Cytology. Allergy Asthma Immunol Res. 2017;9(5):403-409doi: 10.4168/aair.2017.9.5.403.
Chen, J., Zhou, Y., Zhang, L., Wang, Y., Pepper, A. N., Cho, S. H., & Kong, W. (2017). Individualized Treatment of Allergic Rhinitis According to Nasal Cytology. Allergy, asthma & immunology research, 9(5), 403-409. https://doi.org/10.4168/aair.2017.9.5.403
Chen, Jianjun, et al. "Individualized Treatment of Allergic Rhinitis According to Nasal Cytology." Allergy, asthma & immunology research vol. 9,5 (2017): 403-409. doi: https://doi.org/10.4168/aair.2017.9.5.403
Chen J, Zhou Y, Zhang L, Wang Y, Pepper AN, Cho SH, Kong W. Individualized Treatment of Allergic Rhinitis According to Nasal Cytology. Allergy Asthma Immunol Res. 2017 Sep;9(5):403-409. doi: 10.4168/aair.2017.9.5.403. PMID: 28677353; PMCID: PMC5500694.
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Allergy Asthma Immunol Res. 2017 Sep;9(5):403-409. doi: 10.4168/aair.2017.9.5.403.

Individualized Treatment of Allergic Rhinitis According to Nasal Cytology.

Allergy, asthma & immunology research

Jianjun Chen, Yue Zhou, Li Zhang, Yanjun Wang, Amber N Pepper, Seong H Cho, Weijia Kong

Affiliations

  1. Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  2. Division of Allergy, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
  3. Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [email protected].

PMID: 28677353 PMCID: PMC5500694 DOI: 10.4168/aair.2017.9.5.403

Abstract

PURPOSE: Nasal cytology is important in the diagnosis and treatment of nasal inflammatory diseases. Treatment of allergic rhinitis (AR) according to nasal cytology has not been fully studied. We plan to explore the individualized treatment of AR according to nasal cytology.

METHODS: Nasal cytology from 468 AR patients was examined for inflammatory cell quantity (grade 0-5) and the percentage of neutrophils and eosinophils. Results were subdivided into the following categories: AR(Eos), eosinophil ≥50% of the whole inflammatory cells; AR(Neu), neutrophils ≥90%; AR(Eos/Neu), 10%≤ eosinophil <50%; AR(Low), grade 0/1 inflammatory cell quantity. Nasal cytology-guided treatment was implemented: all AR(Eos) patients (n=22) and half of the AR(Neu) patients (AR[Neu1], n=22) were treated with mometasone furoate spray and oral loratadine. Another half of the AR(Neu) patients (AR[Neu2], n=22) were treated with oral clarithromycin. Visual analog scale (VAS), symptom scores, and nasal cytology were evaluated 2 weeks before and after treatment.

RESULTS: There were 224/468 (47.86%) AR(Eos), 67/468 (14.32%) AR(Neu), 112/468 (23.93%) AR(Eos/Neu), and 65/468 (13.89%) AR(Low) of the AR patients studied. There were no significant differences in clinical characteristics among these subgroups, except that the nasal blockage score was higher in AR(Eos) patients than in AR(Neu) patients (1.99 vs 1.50, P=0.02). Comparing AR(Eos) patients with AR(Neu1) patients 2 weeks after treatment, nasal symptoms and VAS were significantly lower in AR(Eos) patients, except for nasal blockage symptoms (P<0.05 of nasal itching and sneezing; P<0.01 for nasal secretion, total scores, and VAS). Comparing AR(Neu1) with AR(Neu2) patients, nasal symptoms, and VAS were significantly lower in AR(Neu2), except for nasal blockage and nasal itching symptoms (P<0.05 for nasal secretions, sneezing, total score, and VAS).

CONCLUSIONS: Nasal cytology may have important value in subtyping AR and optimizing AR treatment. Treating neutrophils is very important in AR patients with locally predominant neutrophils.

Copyright © 2017 The Korean Academy of Asthma, Allergy and Clinical Immunology · The Korean Academy of Pediatric Allergy and Respiratory Disease

Keywords: Nasal cytology; allergic rhinitis; neutrophils

Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

References

  1. J Allergy Clin Immunol. 2005 Feb;115(2):280-6 - PubMed
  2. Clin Exp Allergy. 2016 Jun;46(6):785-92 - PubMed
  3. PLoS One. 2014 Sep 22;9(9):e105814 - PubMed
  4. Asian Pac J Allergy Immunol. 2014 Sep;32(3):235-9 - PubMed
  5. PLoS One. 2008 Apr 02;3(4):e1921 - PubMed
  6. J Allergy Clin Immunol. 2000 Aug;106(2):307-12 - PubMed
  7. J Allergy Clin Immunol. 2007 May;119(5):1282-6 - PubMed
  8. Clin Exp Allergy. 1994 Oct;24(10):930-9 - PubMed
  9. J Allergy Clin Immunol. 1994 Oct;94(4):708-15 - PubMed
  10. J Allergy Clin Immunol. 2012 Nov;130(5):1049-62 - PubMed
  11. Acta Otolaryngol. 2004 Jun;124(5):616-20 - PubMed
  12. J Allergy Clin Immunol. 2015 Sep;136(3):531-45 - PubMed
  13. Am J Otolaryngol. 2009 Sep-Oct;30(5):312-7 - PubMed
  14. J Allergy Clin Immunol. 2003 Jul;112(1):58-63 - PubMed
  15. J Allergy Clin Immunol. 1995 Dec;96(6 Pt 1):971-9 - PubMed
  16. Allergy. 1998 Mar;53(3):326-8 - PubMed
  17. J Allergy Clin Immunol. 1995 Feb;95(2):515-23 - PubMed
  18. Pediatr Allergy Immunol. 1999 Aug;10(3):178-85 - PubMed
  19. J Inflamm Res. 2014 Mar 28;7:39-44 - PubMed
  20. Am J Respir Crit Care Med. 1997 Mar;155(3):826-32 - PubMed
  21. J Laryngol Otol. 2011 Oct;125(10):1028-32 - PubMed
  22. FASEB J. 2001 Apr;15(6):940-9 - PubMed
  23. Eur Respir J. 1988 Oct;1(9):856-62 - PubMed

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