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Objective: To investigate the correlation between FCER2（2206A>G） gene polymorphism and the efficacy of inhaled corticosteroids（ICS） in patients with chronic rhinosinusitis（CRS）. Methods: A total of 208 CRS patients were routinely treated with functional endonasal sinus surgery and postoperative ICS. DNA extraction, PCR amplification and gene sequencing were performed to observe the FCER2（2206A>G） gene polymorphism and calculate the allele frequency. The visual analog scale（VAS） score, Lund-Kennedy score, and computed tomography（CT） Lund-Mackay score were determined 6 months after surgery among patients with different genotypes. Moreover, the polymorphism frequency was compared among different subgroups（chronic rhinosinusitis with nasal polyps versus chronic rhinosinusitis without nasal polyps, eosinophilic chronic rhinosinusitis versus non-eosinophilic chronic rhinosinusitis）. Results: There were FCER2（2206A>G） gene polymorphism in patients with CRS, and the phenotypes included 3 genotypes, AA, AG and GG, with distribution frequencies of 68（32.7%）, 116（55.8%） and 24（11.5%） cases, respectively. No significant differences were found in age, VAS score, nasal endoscopic Lund-Kennedy score and CT imaging Lund-Mackay score among patients with CRS of each genotype before surgery. In patients with the AA genotype, the changes in VAS score（5.74±1.10）, Lund Kennedy score（5.92 ± 1.14）, and CT imaging Lund-Mackay score（13.26±4.26） were significantly higher than in patients with the AG（4.37±0.86, 5.37±1.24, 10.82±3.77） and GG（4.26±0.80, 5.18±1.56, 10.10±3.53） genotype（ P <0.05）. However, there were no marked difference between patients with the AG genotype and those with the GG genotype（ P >0.05）. Compared with patients with non-eosinophilic sinusitis, Among them, the differences between the GG genotype and AG /AA genes were more significant in eosinophilic sinusitis compared to non-eosinophilic sinusitis（ P <0.01）. Conclusion: The FCER2（2206A>G） gene in patients with CRS has genetic polymorphism and is associated with the recovery of CRS patients after surgery, individual corticosteroid sensitivity, and subgroup variability., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Human nasal mucosa is susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and serves as a reservoir for viral replication before spreading to other organs (e.g. the lung and brain) and transmission to other individuals. Chronic rhinosinusitis (CRS) is a common respiratory tract disease and there is evidence suggesting that susceptibility to SARS-CoV-2 infection differs between the two known subtypes, eosinophilic CRS and non-ECRS (NECRS). However, the mechanism of SARS-CoV-2 infection in the human nasal mucosa and its association with CRS has not been experimentally validated. In this study, we investigated whether the human nasal mucosa is susceptible to SARS-CoV-2 infection and how different endotypes of CRS impact on viral infection and progression. Primary human nasal mucosa tissue culture revealed highly efficient SARS-CoV-2 viral infection and production, with particularly high susceptibility in the NECRS group. The gene expression differences suggested that human nasal mucosa is highly susceptible to SARS-CoV-2 infection, presumably due to an increase in ACE2-expressing cells and a deficiency in antiviral immune response, especially for NECRS. Importantly, patients with NECRS may be at a particularly high risk of viral infection and transmission, and therefore, close monitoring should be considered., (© 2022 Wiley-VCH GmbH.)

Background: Endoscopic surgery and postoperative glucocorticoids may effectively control inflammation in patients with chronic rhinosinusitis (CRS). However, some patients who are insensitive to glucocorticoids have a poor prognosis. Studies have shown that the GLCCI1 polymorphism is related to sensitivity to glucocorticoids, but no study has been conducted in China to investigate the relationship between GLCCI1 polymorphisms and postoperative prognosis of CRS., Methods: A total of 208 CRS patients received routine functional endonasal sinus surgery and then were treated with glucocorticoids. Polymerase chain reaction-restriction fragment length polymorphism was employed to detect the rs37973G/A polymorphism of GLCCI1. The visual analogue scale (VAS) score, Lund-Kennedy score, and computed tomography (CT) Lund-Mackay score were determined 6 months after surgery among patients with different genotypes. Moreover, the polymorphism frequency was compared among different subgroups., Results: There were no marked differences in VAS score, Lund-Kennedy score, or CT Lund-Mackay score among patients with different genotypes before surgery. In patients with the AA genotype, the changes in VAS score, Lund-Kennedy score, and CT Lund-Mackay scores were significantly higher than in patients with the GA/GG genotype (p < 0.05). However, there were no marked differences between patients with the GA genotype and those with the GG genotype (p > 0.05). Compared with patients with non-eosinophilic sinusitis, the difference between the AA genotype and the GA/GG genotype was more evident in patients with eosinophilic sinusitis (p < 0.01)., Conclusion: The rs37973 polymorphism is related to postoperative recovery from CRS for individual sensitivity to glucocorticoids. Furthermore, AA genotype was associated with better treatment response in CRS., (© 2018 ARS-AAOA, LLC.)

Objective: To study the change of endogenous hydrogen sulfide (hydrogen sulfide, H2S) and its rate-limiting enzyme Cystathionine-gamma-lyase (CSE) in allergic rhinitis through guinea pigs with intervention treatment., Method: Twenty-four guinea pigs were divide into 4 groups at random, one group were models of allergic rhinitis (AR) which were established by using ovalbumin, the second group were treated with NaHS after sensitized, the third group were treated with Propargylglycine (PPG) which was suppression of CSE after sensitized, and the last group were treated with saline for control. The concentration of eotaxin of nasal lavage and H2S in plasma were recorded, and then the expression of CSE in nasal mucosa was determined by real-time fluorescence RT-PCR., Result: The concentration of eotaxin in nasal lavage of sensitized group were higher than those of control (P < 0.01), and concentration of H2S in plasma and expression of CSE in nasal mucosa were lower than control (P < 0.05). The concentration of eotaxin decreased when treated with NaHS and increased when treated with PGG (P < 0.05). Level of H2S in plasma and expression of CSE increased when treated with NaHS and decreased when treated with PGG (P < 0.05), and the level of H2S was positive linear correlate with the expression of CSE., Conclusion: Endogenous H2S perhaps plays a significant role in the pathogenesis of allergic rhinitis, and it was mainly regulated by CSE.

Objective: To study the expression of a specific inhibitor of endogenous carbon monoxide (CO) generating enzyme Heme oxygenase-1 (HO-1) in allergic rhinitis guinea pigs., Method: Guinea pigs were divided into three groups,one were sensitized by using ovalbumin intraperitoneal and nasal challenge, the second group were treated with dexamethasone as therapy group, the third group were treated with saline for control. The infiltration of eosinophil (EOS) with HE staining and the expression of HO-1 by immunohistochemical staining were observed in nasal mucosa., Result: Most of infiltrating cell in mucosa were EOS and the amount of infiltrated EOS related to the level of inflammation,and HO-1 was found mainly located in cell plasma off glandular epithelium of mucosa. The sensitized groups showed that the highest optical densities of HO-1 (P <0. 01) and the most EOS (P < 0.01) were in epithelium, and the therapy group showed lower optical densities of HO-1 (P <0.01) and few of EOS (P <0.01) than sensitized group, but higher than the control group. There was a significant difference between the three groups (P <0.01)., Conclusion: HO-1 is mainly located in cell plasma of glandular epithelium of nasal mucosa, and the degrees of expression of HO-1 positive correlate with the process of inflammation in allergic rhinitis guinea pigs, which suggests that the endogenous carbon monoxide might play a significant role in the pathogenesis of allergic rhinitis.

Purpose: Chronic rhinitis (CR) is a common chronic inflammation of the nasal mucosa. Nasal saline irrigation has been demonstrated to be an effective treatment for CR. In this study, we investigated the beneficial effects of hydrogen-rich saline irrigation as an anti-inflammatory irrigation therapy for CR and compared its effectiveness over saline irrigation. Hydrogen-rich saline (HRS) was investigated due to its antioxidant and anti-inflammatory properties. Methods: A total of 120 patients with CR were randomly divided into two groups, patients irrigated with HR (HRS group) and the control group irrigated with saline (NS group). A randomized, double-blind control study was performed. The main observation index in this study was the total score of nasal symptoms (TNSS). In addition, eosinophilic protein (ECP) of the nasal secretions, nasal nitric oxide (nNO) levels, and levels of regulatory T cells (Treg) and regulatory B cells (Breg) were also compared between the two groups. Furthermore, patients with allergic rhinitis (AR) and non-allergic rhinitis (NAR) were also evaluated based on serum-specific IgE positivity. Results: After treatment, TNSS and nasal ECP in the two groups decreased significantly (P< 0.05), with patients in the HRS group showing significantly lower levels compared to the NS group (P< 0.05). There were no significant differences in Treg and Breg levels between the two groups. Subgroup analysis showed that TNSS in the AR-HRS group showed a more significant reduction compared to the AR-NS group (P< 0.05); however, there were no significant differences for the other inflammatory biomarkers (P> 0.05). ECP levels were reduced significantly in the NAR subgroup compared to NS irrigation (P< 0.05). There were no obvious adverse events observed in patients during the entire treatment period. Conclusion: Compared to saline irrigation, HRS nasal irrigation was found to improve CR clinical symptoms, especially in patients with AR. HRS could effectively be used for the clinical treatment of patients with CR. [ABSTRACT FROM AUTHOR]

• Feature-block proposed for reduction of dimension based on Hellinger Distance. • Label-links Classifier Chain proposed for performance improvement of MLC. • A novel fusion approach DS Theory based proposed for improvement of accuracy. Rhinitis is a common chronic inflammation of the upper respiratory tract with multiple symptoms and signs. The clinical classification of rhinitis is a multi-label classification, characterized by high dimensionality, poor correlation and class imbalance. Low recognition rate and poor generalization performance often occur for minority class instances. Therefore, this paper proposes a Feature-Block classification model, MBLCC based on Label-Links Classifier Chain. We apply kernel density estimation and Deborah Hellinger distance to partition allergic rhinitis instance with similar characteristics, calculate the correlation matrix of label characteristics, build an ordered classification chain for each block, and integrate the predictions of each block classifiers by evidence theory as the outcome. The cross-validation experiments conducted on 2231 cases of clinical rhinitis show that the evaluation indicators of MBLCC, i.e. sensitivity, specificity, accuracy, F1-score, and G-Mean, are 91.80 %, 96.8 %, 96.9 %, 0.925, and 0.941 respectively. In comparison with the other baselines, MBLCC achieves better generalization performance and is more effective and rapid in early clinical diagnosis of rhinitis. In addition, we calculate the feature importance ranking for rhinitis features via Label-Links Classifier Chain on the grounds of the purity of nodes in decision-making tree inside Random Forest and study the correlation between rhinitis features and classification that can provides the reference for the clinical rhinitis diagnosis. [ABSTRACT FROM AUTHOR]

It is well known that CD4+CD25+Foxp3+Treg cells play an important role in the development of allergic rhinitis (AR); the defect of cell numbers and functions contribute to AR. Hydrogen has been proven effective in alleviating symptoms of AR. We herein aim to verify the protective effects of hydrogen on CD4+CD25+Foxp3+Treg cells in guinea pigs with AR and to explore the effect of hydrogen-rich saline (HRS) on CD4+CD25+Foxp3+Treg cells in animals with AR and investigate the underlying anti-inflammatory mechanism. Eighteen guinea pigs were randomly divided into three groups (control group/AR group/AR-HRS group). The guinea pigs were injected with hydrogen-rich saline (AR-HRS group) for 10 days after sensitization. The control group was injected with an equal volume of normal saline. The number of sneezes, degree of runny nose, and nasal-rubbing movements were scored. Peripheral blood eosinophil count was recorded. The proportions of Th1/Th2 of the peripheral blood and the CD4+CD25+Foxp3+T cells in the CD4+T cells of the spleen and peripheral blood were determined by flow cytometry. The content of interleukin (IL)-10 and transforming growth factor (TGF)-β in the serum was detected by enzyme-linked immunosorbent assay (ELISA). The protein and mRNA expression of Foxp3, IL-10, and TGF-β were determined by Western blot, immunofluorescence, and real-time PCR analysis, respectively. Scores of symptoms, number of eosinophils,and nasal mucosa damage were dramatically reduced after HRS treatment. HRS increased the expression of Foxp3, IL-10, TGF-β, and number of CD4+CD25+Foxp3+Treg cells, which were reduced in AR. HRS also revised the dysregulation of Th1/Th2 balance. Both the number and biological activity of CD4+CD25+Foxp3+Treg cells increased with up-regulation of Th1/Th2 after HRS administration. HRS could play a protective role in attenuating AR through improving the proportion and functions of CD4+CD25+Foxp3+Treg cells. [ABSTRACT FROM AUTHOR]

Rhinitis is a kind of respiratory disease that is difficult to cure. Timely and accurate prediction in its early stage is an effective method for diagnosis of rhinitis. Machine learning is often applied in predicting clinical rhinitis. However, those problems like multi-label features, class imbalance, and poor generalization performance usually occur on rhinitis prediction. This paper introduces an ensemble neural network chain model with pre-training on rhinitis multi-label classification. We apply stacked autoencoders for denoising and feature dimensionality reduction, add pre-training networks to extract global correlations, and build neural network chain to extract local relevant information for single-label classification. This proposed model can use both global and local label correlations to reduce the influence of unreasonable label sequences on classification. A total of 2231 clinical rhinitis cases from Shanghai Tongji Hospital affiliated to Tongji University is conducted for training and test. The cross-validation results show that the average Hamming Loss, accuracy, recall and F1-score is 0.0195, 87.88%, 92.32% and 92.88%, respectively. Compared to various typical multi-label classifiers, the proposed model achieves better generalization performance in evaluation measures. In addition, we calculate the feature importance of rhinitis based on the purity of splitting nodes in Random Forest and study the correlations between rhinitis features and classification, which have a good reference value for diagnosis and treatment of clinical rhinitis. • We apply stacked autoencoder for denoising and feature dimensionality reduction, add pre-training networks to extract global correlations, and build neural chain to extract local relevant information for single-label classification. This proposed model can use both global and local label correlations to reduce the influence of unreasonable label sequences on classification. • A total of 2231 clinical rhinitis cases from Shanghai Tongji Hospital are conducted for training and test. The cross-validation results show compared to various typical multi-label classifiers, the proposed model achieves better generalization performance. • In addition, we calculate feature importance of rhinitis based on the purity of splitting nodes in Random Forest and study the correlations between rhinitis features and classification, which have a good reference value for diagnosis and treatment of clinical rhinitis. [ABSTRACT FROM AUTHOR]

• We propose a cascaded under-sampling ensemble learning method to construct multiple batch classifiers, each of which is composed of a number of base classifiers with different structures. Through batch-by-batch under-sampling, the instances of class imbalance gradually reach the equalization. • The average accuracy, true positive rate, and G-mean of the proposed model were 90.71 %, 87.44 %, and 88.18 %, respectively. Compared to typical classifiers, the proposed model has higher accuracy, true positive rate and lower missed diagnosis rate. • We calculate the feature importance for rhinitis features on the grounds of the purity of nodes in decision-making tree inside Random Forest and study the correlation between rhinitis features and classifications. Rhinitis is a prevalent respiratory disease. Clinical rhinitis instances are characterized by multi-label and class imbalance, which is difficult to be accurately classified by typical machine learning methods. We propose a cascaded under-sampling ensemble learning method (CUEL) to construct multiple batch classifiers, each of which is composed of a few base classifiers with different structures. Through batch-by-batch under-sampling, the correctly classified instances of majority class are removed, and the samples that are difficult to classify are kept to gradually reach the equalization of class imbalance. We assign different weights to each of the batch classifiers to construct the final integrated classifier. Cross validation was performed on 2231 clinical rhinitis instances from Shanghai Tongji Hospital Affiliated to Tongji University. The experiment showed that the average accuracy, true positive rate, and G-mean of the CUEL model were 90.71 %, 87.44 %, and 88.18 %, respectively. Compared to typical classifiers, the CUEL model has higher accuracy, true positive rate and lower missed diagnosis rate, and has stronger generalization performance. It can make full use of all rhinitis instances and effectively reduce the prediction deviation caused by class imbalance. Therefore, it has a good auxiliary effect for the prevention and diagnosis of clinical rhinitis. In addition, we calculate the feature importance for rhinitis features on the grounds of the purity of nodes in decision-making tree inside Random Forest and study the correlation between rhinitis features and classifications. [ABSTRACT FROM AUTHOR]