Alcohol hyper-responsiveness in chronic rhinosinusitis with nasal polyps

作者：De Schryver Els; Derycke Lara; Campo Paloma; Gabriels Eline; Joos Guy F; Van Zele Thibaut; Bachert Claus; Hel Lings Peter W; Gevaert Philippe^*

来源：Clinical and Experimental Allergy, 2017, 47(2): 245-253.

DOI：10.1111/cea.12836

• airway hyper-responsiveness
• alcohol
• allergic rhinitis
• chronic rhinosinusitis patients without nasal polyps
• chronic rhinosinusitis with nasal polyps
• NSAID exacerbated respiratory disease

Background An important percentage of subjects diagnosed with chronic upper airway disease report alcohol-induced worsening of their symptoms. The prevalence and characteristics of respiratory reactions provoked by alcohol-containing drinks have not been fully investigated yet. Objective The aim of this study was to estimate the prevalence and characteristics of alcohol hyper-responsiveness in patients with chronic airway disease and healthy controls. Furthermore, nasal inflammation was evaluated in nasal polyp patients with and without hyper-responsiveness.
Methods We evaluated the prevalence and characteristics of alcohol-induced respiratory complaints in 1281 subjects. Chronic rhinosinusitis with nasal polyps (CRSwNP) patients with and without NSAID exacerbated respiratory disease (NERD), chronic rhinosinusitis patients without nasal polyps (CRSsNP), allergic rhinitis (AR) patients and healthy controls were approached by means of a questionnaire. Inflammatory markers (eosinophilic cationic protein (ECP), IL-5, IgE, SAE-specific IgE, IL-17, TNF alpha and IFN gamma) in tissue were then compared between alcohol hyper-responsive and non-hyper-responsive CRSwNP patients.
Results The highest prevalence of nasal and bronchial alcohol hyper-responsiveness was observed in patients with NERD, followed by CRSwNP, and less frequent in CRSsNP, AR and healthy controls. Alcohol hyper-responsiveness is significantly more prevalent in CRSwNP patients suffering from recurrent disease and in patients with severe symptomatology. In nasal tissue of the hyper-responsive CRSwNP group, we observed significantly higher nasal levels of the eosinophilic biomarker ECP.
Conclusion and Clinical Relevance Nasal hyper-responsiveness to alcohol is significantly more prevalent in severe eosinophilic upper airway disease.

• 出版日期2017-2