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Sinus and adenoid inflammation in children with chronic rhinosinusitis and asthma

Antony Anfuso1, Hassan Ramadan1, Andrew Terrell1

  • 1Department of Otolaryngology, West Virginia University, Morgantown, West Virginia.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|January 28, 2015
PubMed

Insights

Children with chronic rhinosinusitis (CRS) and asthma exhibit more severe upper airway inflammation than those with CRS alone. This suggests treating sinus disease is key for managing pediatric asthma.

Area of Science:

  • Pediatric Allergy and Immunology
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Chronic rhinosinusitis (CRS) frequently co-occurs with asthma in children, but the underlying mechanisms remain unclear.
  • Direct measurements of upper airway mucosal inflammation are lacking in pediatric CRS and asthma studies.

Purpose of the Study:

  • To investigate the pathophysiologic mechanisms of coexisting CRS and asthma in children.
  • To analyze inflammatory cytokine and chemokine expression in sinus and adenoid tissues of pediatric patients with refractory CRS.

Main Methods:

  • Prospective study of 28 children (2-12 years) with CRS (with or without asthma) and 10 controls.
  • Surgical removal of sinus and adenoid tissues for analysis.
  • Multiplex assay used to measure mucosal expression of 40 inflammatory cytokines, normalized to total protein.

Main Results:

  • Children with CRS and asthma showed significantly higher sinus levels of tumor necrosis factor-alpha compared to those with CRS alone.
  • Elevated adenoid levels of epidermal growth factor, eotaxin, fibroblast growth factor-2, growth-related oncogene, and platelet-derived growth factor-AA were observed in children with CRS and asthma.

Conclusions:

  • The inflammatory response in pediatric CRS with asthma is more severe than in CRS without asthma.
  • Findings support the hypothesis that severe upper airway inflammation contributes to or exacerbates asthma in children.
  • Treating sinus disease is crucial for managing pediatric asthma, supported by direct airway inflammation measurements.
Abstract

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