title: Alcohol hyper-responsiveness in chronic rhinosinusitis with nasal polyps.
abstract: 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, TNFα and IFNγ) 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.
  
  
  CONCLUSIONS
  Nasal hyper-responsiveness to alcohol is significantly more prevalent in severe eosinophilic upper airway disease.
authors: Upper Airways Research Laboratory, Department Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
authors: Els
authors: E
authors: De Schryver
authors: Upper Airways Research Laboratory, Department Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
authors: Lara
authors: L
authors: Derycke
authors: Unidad de Gestión Clínica Allergy-IBIMA, University Hospital, Málaga, Spain.
authors: Paloma
authors: P
authors: Campo
authors: Upper Airways Research Laboratory, Department Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
authors: Eline
authors: E
authors: Gabriels
authors: Laboratory for Translational Research in Obstructive Pulmonary diseases, Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
authors: Guy F
authors: GF
authors: Joos
authors: Upper Airways Research Laboratory, Department Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
authors: Thibaut
authors: T
authors: Van Zele
authors: Upper Airways Research Laboratory, Department Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.|Division of ENT Diseases, Clintec, Karolinska Institutet, Stockholm, Sweden.
authors: Claus
authors: C
authors: Bachert
authors: Clinical Division of ENT, Head & Neck Surgery, Laboratory of Clinical Immunology, University Hospitals Leuven, Leuven, Belgium.|Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands.
authors: Peter W
authors: PW
authors: Hellings
authors: Upper Airways Research Laboratory, Department Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
authors: Philippe
authors: P
authors: Gevaert
mesh_terms: D000328:Adult; D000438:Alcohols / Q000009:adverse effects*; D015415:Biomarkers; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D004327:Drinking Behavior; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D015995:Prevalence; D012220:Rhinitis / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D012307:Risk Factors; D012852:Sinusitis / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*
chemical_list: D000438:Alcohols; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators
keywords: NSAID exacerbated respiratory disease; airway hyper-responsiveness; alcohol; allergic rhinitis; chronic rhinosinusitis patients without nasal polyps; chronic rhinosinusitis with nasal polyps