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  • 1
    Online Resource
    Online Resource
    Wound healing in endoscopic sinus surgery: Phase 1 clinical trial evaluating the role of Chitogel with adjuvants
    Wiley ; 2023
    In:  Clinical Otolaryngology Vol. 48, No. 2 ( 2023-03), p. 158-166
    Details
    In: Clinical Otolaryngology, Wiley, Vol. 48, No. 2 ( 2023-03), p. 158-166
    Abstract: This study aimed to determine the safety and efficacy of Chitogel, with and without Deferiprone (Def) and Gallium Protoporphyrin (GaPP), as a promoter of wound healing to improve surgical outcomes after endoscopic sinus susgery. Design A double‐blinded, randomised control human clinical trial was conducted in patients undergoing ESS as a treatment for chronic rhinosinusitis. Participants underwent functional ESS or FESS with drill out as required and were randomised to receive test product Chitogel, Chitogel in combination with Def or Def‐GaPP versus no packing (control). Setting Ostial stenosis and persistent inflammation are the main reasons for revision endoscopic sinus surgery (ESS). Post‐operative (PO) dressings can improve PO wound healing and patient outcomes after ESS. Participants Eighty two patients were included in this study with 79 patients completing the study with 40 undergoing full house FESS and 39 FESS plus frontal drillout. Main Outcome Measures Patients were followed up at 2, 6 and 12 weeks PO, and outcome scores such as SNOT‐22, VAS and LKS, pre and post‐surgery (12 weeks) were compared. Results Seventy nine patients completed the study, there was a significant reduction in SNOT‐22 score and improvement of VAS at 12 weeks in patients treated with Chitogel compared to control ( p   〈  .05). In those patients, the mean ostium area for the Chitogel and the Chitogel + Def + GaPP groups was higher across all three sinuses compared to the no‐treatment control group, without statistical significance. Sphenoid sinus ostium was significantly more patent in patients treated with Chitogel compared to the control at the 12‐week time point ( p   〈  .05). Conclusion Chitogel as a PO dressing after ESS results in the best patient‐reported symptom scores and objective measurements. The combination of Def and GaPP to Chitogel though proving safe, had no effect on the ostium patency or mucosal healing.
    Type of Medium: Online Resource
    ISSN: 1749-4478 , 1749-4486
    URL: Issue
    URL: Article
    DOI: 10.1111/coa.v48.2
    DOI: 10.1111/coa.13996
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2206071-6
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  • 2
    Online Resource
    Online Resource
    A human nasal explant model to study Staphylococcus aureus biofilm in vitro
    Wiley ; 2013
    In:  International Forum of Allergy & Rhinology Vol. 3, No. 7 ( 2013-07), p. 556-562
    Details
    In: International Forum of Allergy & Rhinology, Wiley, Vol. 3, No. 7 ( 2013-07), p. 556-562
    Abstract: Staphylococcus aureus ( S. aureus ) biofilm has been associated with severe and recalcitrant cases of chronic rhinosinusitis (CRS). However, its role in the pathophysiology of this condition is not completely understood. This study aims to develop a sinonasal tissue explant model to analyze the interaction of S. aureus biofilm with the mucosa in vitro. Methods Sinonasal tissue samples from 5 control patients undergoing pituitary surgery were cultured with and without S. aureus biofilm in vitro. Confocal scanning laser microscopy (CSLM) using the Live/Dead Bac Light stain and histology were performed on the tissue explants after 24 hours of biofilm challenge. Measurements of IL‐6, at both the messenger RNA (mRNA) level (using quantitative reverse‐transcriptase polymerase chain reaction [qRT‐PCR]) and the protein level (using enzyme‐linked immunosorbent assay [ELISA] ), were undertaken to evaluate biofilm‐mucosa interaction. Results Viability of the explants after 24 hours was confirmed by CSLM and histology. Although light microscopy failed to identify S. aureus biofilms, its presence was confirmed in the biofilm‐challenged samples by CSLM. IL‐6 mRNA transcript levels were 4.9‐fold upregulated in biofilm‐treated tissue compared to controls ( p = 0.0485). A similar trend was observed at the protein level ( p = 0.0313). Conclusion The sinonasal tissue explant is a viable and functional model capable of analyzing direct biofilm‐mucosal interactions and can advance our understanding of the role played by S. aureus biofilm in sinus inflammation. Our model suggests that S. aureus biofilms in the initial phase of growth are not inert bystanders but elicit an immune response in the sinonasal mucosa.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Issue
    URL: Article
    DOI: 10.1002/alr.2013.3.issue-7
    DOI: 10.1002/alr.21146
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2604059-1
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  • 3
    Online Resource
    Online Resource
    Staphylococcus aureus biofilm activates the nucleotide‐binding oligomerization domain containing 2 (Nod2) pathway and proinflammatory factors on a human sinonasal explant model
    Wiley ; 2013
    In:  International Forum of Allergy & Rhinology Vol. 3, No. 11 ( 2013-11), p. 877-884
    Details
    In: International Forum of Allergy & Rhinology, Wiley, Vol. 3, No. 11 ( 2013-11), p. 877-884
    Abstract: The presence of Staphylococcus aureus biofilms on sinonasal mucosal surfaces is associated with recalcitrant chronic rhinosinusitis (CRS), but little is known about the innate immune response they trigger. We aimed to study the human pattern recognition receptor (PRR) nucleotide‐binding oligomerization domain containing 2 (Nod2) receptor and downstream pathway in response to initial S. aureus biofilm infection. Methods Using a validated protocol, sinonasal mucosae from 4 non‐CRS donors were cultured with and without S. aureus biofilms and planktonic cells. After 24 hours, RNA was extracted and gene expression was analyzed using a human antibacterial response polymerase chain reaction (PCR) array. Immunohistochemistry was performed to confirm the presence and determine the immunolocalization of selected proteins. Results C‐X‐C motif (CXC) chemokine ligands 1 and 2, interleukin‐6 (IL‐6), and genes related to the Nod2 pathway were significantly upregulated in biofilm‐treated tissues compared with control samples. Nod2 pathway–specific gene expression was increased in biofilm‐treated tissues compared with planktonic S. aureus –treated explants. Enhanced expression of Nod2 and nuclear factor kappa B1 (NF‐κB1) was also detected with immunohistochemistry in control and biofilm‐treated tissues. Conclusion S. aureus biofilms exerted a proinflammatory response in the mucosa and activation of the Nod2 pathway, indicating this receptor to be involved in the innate immune response to S. aureus biofilms. Further studies are required to elucidate the role of this pathway in CRS.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Issue
    URL: Article
    DOI: 10.1002/alr.2013.3.issue-11
    DOI: 10.1002/alr.21213
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2604059-1
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  • 4
    Online Resource
    Online Resource
    The international sinonasal microbiome study: A multicentre, multinational characterization of sinonasal bacterial ecology
    Wiley ; 2020
    In:  Allergy Vol. 75, No. 8 ( 2020-08), p. 2037-2049
    Details
    In: Allergy, Wiley, Vol. 75, No. 8 ( 2020-08), p. 2037-2049
    Abstract: The sinonasal microbiome remains poorly defined, with our current knowledge based on a few cohort studies whose findings are inconsistent. Furthermore, the variability of the sinus microbiome across geographical divides remains unexplored. We characterize the sinonasal microbiome and its geographical variations in both health and disease using 16S rRNA gene sequencing of 410 individuals from across the world. Although the sinus microbial ecology is highly variable between individuals, we identify a core microbiome comprised of Corynebacterium , Staphylococcus , Streptococcus , Haemophilus and Moraxella species in both healthy and chronic rhinosinusitis (CRS) cohorts. Corynebacterium (mean relative abundance = 44.02%) and Staphylococcus (mean relative abundance = 27.34%) appear particularly dominant in the majority of patients sampled. Amongst patients suffering from CRS with nasal polyps, a statistically significant reduction in relative abundance of Corynebacterium (40.29% vs 50.43%; P  = .02) was identified. Despite some measured differences in microbiome composition and diversity between some of the participating centres in our cohort, these differences would not alter the general pattern of core organisms described. Nevertheless, atypical or unusual organisms reported in short‐read amplicon sequencing studies and that are not part of the core microbiome should be interpreted with caution. The delineation of the sinonasal microbiome and standardized methodology described within our study will enable further characterization and translational application of the sinus microbiota.
    Type of Medium: Online Resource
    ISSN: 0105-4538 , 1398-9995
    URL: Issue
    URL: Article
    DOI: 10.1111/all.v75.8
    DOI: 10.1111/all.14276
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2003114-2
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