title: Impact of chronic rhinosinusitis on severe asthma patients.
abstract: Coexistence of chronic rhinosinusitis (CRS) with asthma appears to impair asthma control. Type-2 innate lymphoid cells (ILC2s) respond to the cytokines of thymic stromal lymphopoietin (TSLP), interleukin (IL)-25 and IL-33, thus contributing to airway diseases such as CRS and asthma. We investigate whether the augmented Th2-cytokines in CRS might be related to sinonasal tract ILC2s corresponding to enhanced IL-25, IL-33 and TSLP release in severe asthmatics, and be involved in asthma control. Twenty-eight asthmatics (12 non-severe and 16 severe) with CRS receiving nasal surgery were enrolled. The predicted FEV1 inversely associated with CRS severity of CT or endoscopy scores. Higher expression of Th2-driven cytokines (IL-4, IL-5, IL-9, and IL-13), TSLP, IL-25 and IL-33 in nasal tissues was observed in severe asthma. Severe asthmatics had higher ILC2 cell counts in their nasal tissues. ILC2 counts were positively correlated with Th2-cytokines. Nasal surgery significantly improved asthma control and lung function decline in severe asthma and CRS. The higher expression of IL-33/ILC2 axis-directed type 2 immune responses in nasal tissue of CRS brought the greater decline of lung function in severe asthma. ILC2-induced the upregulated activity of Th2-related cytokines in asthmatics with CRS may contribute to a recalcitrant status of asthma control.
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ta-Jen
authors.initials: TJ
authors.lastname: Lee
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chia-Hsiang
authors.initials: CH
authors.lastname: Fu
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chi-Che
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chien-Chia
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Po-Hung
authors.initials: PH
authors.lastname: Chang
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chia-Chen
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Wu
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Han-Pin
authors.initials: HP
authors.lastname: Kuo
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D002908:Chronic Disease; D016207:Cytokines / Q000235:genetics / Q000378:metabolism; D004724:Endoscopy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020381:Interleukin-17 / Q000235:genetics / Q000378:metabolism; D000067596:Interleukin-33 / Q000235:genetics / Q000378:metabolism; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism / Q000473:pathology; D009298:Nasal Polyps / Q000378:metabolism / Q000473:pathology; D060888:Real-Time Polymerase Chain Reaction; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000094632:Thymic Stromal Lymphopoietin
chemical_list: D016207:Cytokines; D020381:Interleukin-17; D000067596:Interleukin-33; D000094632:Thymic Stromal Lymphopoietin