1,721,043 research outputs found
Atlante di citologia nasale per la diagnosi differenziale delle rinopatie
No full textLa citologia nasale è una diagnostica ancora poco utilizzata, ma che spesso si è dimostrata risolvente: permette di differenziare le rinopatie infiammatorie da quelle infettive, quelle vasomotorie allergiche da quelle non allergiche, le rinopatie batteriche da quelle virali e micotiche, oltre a diagnosticare, nello stesso paziente, le “sovrapposizioni” di più rinopatie. Non vanno poi tralasciati altri importanti aspetti che fanno della citologia una diagnostica pratica, alla portata di tutti i Servizi di rinoallergologia: la semplicità della tecnica e la scarsa invasività. Questo volume colma una lacuna: a tutt’oggi non esistono testi o atlanti che trattino questo specifico argomento. È indirizzato a tutti gli specialisti che si occupano di patologie delle vie respiratorie, quindi non soltanto Otorinolaringoiatri, ma anche Allergologi, Pneumologi, Pediatri, e vuole contribuire all’acquisizione delle basi teoriche della moderna citologia e della corretta metodologia, nonché al riconoscimento e all’interpretazione delle variazioni citologiche che si realizzano nel corso delle diverse patologie. L'Atlante è organizzato in otto capitoli e si avvale di 410 illustrazioni
Chronic rhinosinusitis with nasal polyposis: the role of personalized and integrated medicine
No full textChronic rhinosinusitis with nasal polyposis (CRSwNP) is a common disorder. From a clinical and immunopathological point of view, different phenotypes and endotypes have been identified. As asthma is frequent comorbidity, biological agents for treating CRSwNP associated with asthma may be an attractive strategy. Biological agents have several mechanisms, such as antagonizing IgE, interleukin (IL) 4, IL-5, and IL-13. However, a workup is mandatory, mainly concerning pheno-endotyping. In this regard, clinical cytological grading (CCG) has been proposed as a useful tool to manage patients with CRSwNP as it allows us to define clinical and immunopathological phenotypes able to identify the ideal candidate for biologics. In particular, the mixed cellular pattern, such as eosinophils and mast cells, could be sensitive to anti-IL-4 agents. There is still a need for well-established indications, criteria of responsiveness, duration, and safety. Moreover, personalized medicine could be opportunely integrated and/or alternated with intranasal corticosteroids to prevent relevant adverse events
Biofilm in sino-nasal infectious diseases: the role nasal cytology in the diagnostic work up and therapeutic implications
No full textBackgroud: Biofilm formation has been recently recognised as one of the most important etiopathological mechanisms underlying chronic rhinosinusitis (CRS) and its recalcitrance. In this context, nasal cytology (NC) has become an integral part of diagnostic work up of patients suffering from sino-nasal diseases, since it is an easy-to-apply, reproducible and non-invasive diagnostic tool that allows to assess both the nasal inflammatory infiltrate and the presence of biofilms on nasal mucosal surface, further orienting the therapeutic choices in case of infectious diseases for eradicating infections and biofilms. Nevertheless, biofilms are typically resistant to common antibiotic treatments and may trigger or maintain chronic inflammation. Hence, the importance of correctly detecting the presence of biofilm and identifying new effective treatments. Purpose: The aim of this brief review is to better clarify the role of biofilm in the pathogenesis and recurrence of sino-nasal disorders and to highlight the role of nasal cytology (NC) in the rhino-allergologic diagnostic path and in the evaluation of the effectiveness of new treatments
Chronic rhinosinusitis with nasal polyps recurrence: Not only eosinophils and neutrophils
No full textNasal cytology: description of a hyperchromatic supranuclear stria as a possible marker for the anatomical and functional integrity of the ciliated cell
No full textThe aim of this study was to describe a particular intracellular hyperchromatic formation located over the nucleus of normal nasal ciliated cells. This finding, never described in literature, very rarely occurs in pathological conditions
The Underestimated Role of Mast Cells in the Pathogenesis of Rhinopathies
No full textMast cells (MCs) are involved in several biological processes, such as defense against pathogens, immunomodulation, tissue repair after injury, and angiogenesis. MCs have been shown to change from protective immune cells to potent pro-inflammatory cells, influencing the progression of many pathological conditions, including autoimmune diseases and cancers. The role of MCs in the pathogenesis of rhinopathies has often been underestimated, since previous studies have focused their attention on eosinophils and neutrophils, while MCs were considered involved exclusively in allergic rhinitis. However, recent nasal cytology findings have shown the involvement of MCs in several rhinopathies, such as NARMA, NARESMA, and CRSwNP. These recent evidences highlight the crucial role that MCs play in orchestrating the inflammation of the nasal mucosa, through complex biological mechanisms, not yet fully understood. In this context, a better understanding of these mechanisms is fundamental for practicing Precision Medicine, which requires careful population selection and stratification into subgroups based on the phenotype/endotype of the patients, in order to guarantee the patient a tailored therapy. Based on this background, further studies are needed to understand the pathophysiological mechanisms involving MCs and, consequently, to develop targeted therapies aimed to obtain a selective inhibition of tissue remodeling and preventing MC-mediated immune suppression
Nasal cytology and histology in CRSwNP: Two sides of the same coin
Full text linkKnowledge of chronic rhinosinusitis with nasal polyps (CRSwNP) has increased rapidly over the past decade. However, the study of the histological features of nasal polyps has not gone hand in hand with the study of the inflammatory mechanisms underlying CRSwNP. Indeed, precisely because they are benign neoformations, nasal polyps have not attracted the attention of pathologists over the years. Nasal cytology has shown that CRSwNP, generally defined as a Type-2 disease, is characterized not only by eosinophilic but also mast cell inflammation and, in particular, the most severe forms of CRSwNP are precisely characterized by a mixed eosinophilic-mast cell inflammation. Interestingly, mast cells cannot be visualized by histology due to limitations in staining and magnification, and therefore are not commonly described in histological reports of nasal polyps. However, immunohistochemistry can highlight these latter cells and specifically this technique has recently demonstrated that mast cells are located in the lamina propria of almost all types of polyps and in the epithelial level of the most severe forms. Unfortunately, the latter technique is not commonly carried out in clinical practice by virtue of the high cost and time burden. On the other hand, nasal cytology is an easy-to-apply and economic diagnostic tool, commonly practiced in rhinological setting, which can effectively fill the gap between histology and immunohistochemistry, allowing to non-invasively establish the endotype of nasal polyps and to highlight all cytotypes, including mast cells, that cannot be visualized by the other two techniques. The recent demonstration of the close correlation between mast cell intraepithelial infiltrate and CRSwNP severity paves the way for new therapeutic possibilities aimed at reducing not only eosinophilic infiltration but also mast cell infiltration
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