2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T73c,We aim to highlight recent advancements on the evolving chronic rhinosinusitis (CRS) phenotype: acute exacerbations of chronic rhinosinusitis (AECRS). We focused on studies that expanded the current understanding of its pathophysiology, patient characteristics, and disease burden. Defining AECRS has been a topic of discussion for many years. A recent regulatory definition of AECRS in the literature incorporates a > 3 day requirement of worsened symptoms and an escalation of treatment. It is important not to rely on patient-reported rescue medication frequency as it was recently demonstrated these are only obtained for 1/3 of reported AECRS episodes. The pathophysiology behind AECRS is still being evaluated but it appears irritants such as viral insult to the sinonasal microbiome can create a dysbiosis and worsens host immune system breakdown, facilitating a subsequent bacterial infection. Many studies are using loose definitions of AECRS because no formal definition has existed until recently. Clinical trials and other studies are relying on patient-reported illnesses, CRS-related antibiotics, and CRS-related corticosteroids to determine an episode of AECRS. Formally defining AECRS is vital in order to conduct future literature on its etiology and clinical outcomes so results may be translatable. Additionally, our review demonstrates that CRS patients with asthma and/or concomitant allergic rhinitis appear to be at an increased risk for developing AECRS and future research should continue to investigate their interplay. Many patients are being overprescribed antibiotics and corticosteroids for reported AECRS episodes. This increases total healthcare spending and increases the risk for adverse effects from corticosteroids and antibiotic resistance. Future research should investigate methods to mitigate this practice.31:T932,Abstract Purpose of Review We aim to highlight recent advancements on the evolving chronic rhinosinusitis (CRS) phenotype: acute exacerbations of chronic rhinosinusitis (AECRS). We focused on studies that expanded the current understanding of its pathophysiology, patient characteristics, and disease burden. Recent Findings Defining AECRS has been a topic of discussion for many years. A recent regulatory definition of AECRS in the literature incorporates a > 3 day requirement of worsened symptoms and an escalation of treatment. It is important not to rely on patient-reported rescue medication frequency as it was recently demonstrated these are only obtained for 1/3 of reported AECRS episodes. The pathophysiology behind AECRS is still being evaluated but it appears irritants such as viral insult to the sinonasal microbiome can create a dysbiosis and worsens host immune system breakdown, facilitating a subsequent bacterial infection. Summary Many studies are using loose definitions of AECRS because no formal definition has existed until recently. Clinical trials and other studies are relying on patient-reported illnesses, CRS-related antibiotics, and CRS-related corticosteroids to determine an episode of AECRS. Formally defining AECRS is vital in order to conduct future literature on its etiology and clinical outcomes so results may be translatable. Additionally, our review demonstrates that CRS patients with asthma and/or concomitant allergic rhinitis appear to be at an increased risk for developing AECRS and future research should continue to investigate their interplay. Many patients are being overprescribed antibiotics and corticosteroids for reported AECRS episodes. This increases total healthcare spending and increases the risk for adverse effects from corticosteroids and antibiotic resistance. Future research should investigate methods to mitigate this practice. 32:T78d,Balloon sinus dilation (BSD) is a tool for treating patients with chronic rhinosinusitis or recurrent acute rhinosinusitis. The use of BSD has increased exponentially since its introduction, with concerns for potential misuse. Expert consensus reports that most patients who are candidates for BSD do not need to have all 6 sinuses dilated (bilateral frontal, maxillary, and sphenoid). To determine the percentage of patients who are undergoing 6-sinus BSD, evaluate factors associated with this practice, and explore outlier practice patterns when performing 6-sinus BSD. This cross-sectional, retrospective review of a Medicare claims database from January 2022 to December 2023 included otolaryngologists (US Centers for Medicare & Medicaid Services code 04) who performed at least 11 BSDs during the study period, who were defined as high-volume BSD clinicians (>10 BSDs per year). Data were analyzed in July 2024. The primary outcome defined before data collection as the percentage of patients billed for 6-sinus BSD. Physician variables were explored for potential association with 6-sinus BSD. Of the 522 otolaryngologists (mean [SD] age, 52 [9.3] years), most physicians were male (489 [94%]), practiced in a group setting (428 [82%]), and were in an urban environment (474 [91%]). A total of 21 290 unique BSD procedures were performed, and 12 799 procedures (60%) involved all 6 sinuses. Of the 522 otolaryngologists, 40 (8%) performed 6-sinus BSD in 100% of their BSD procedures, while 54 (10%) performed no 6-sinus BSDs. Practice patterns varied substantially, with 8 physicians (2%) responsible for 10% of 6-sinus BSDs (n = 2152). The results of this cross-sectional study suggest that the high volume of 6-sinus BSD suggests the potential for overuse of BSD. Substantial variations in care emphasize the need for clear guidelines and indications for multisinus BSD to optimize the utilization and value of BSD.33:Tbcc, Importance Balloon sinus dilation (BSD) is a tool for treating patients with chronic rhinosinusitis or recurrent acute rhinosinusitis. The use of BSD has increased exponentially since its introduction, with concerns for potential misuse. Expert consensus reports that most patients who are candidates for BSD do not need to have all 6 sinuses dilated (bilateral frontal, maxillary, and sphenoid). Objective To determine the percentage of patients who are undergoing 6-sinus BSD, evaluate factors associated with this practice, and explore outlier practice patterns when performing 6-sinus BSD. Design, Setting, and Participants This cross-sectional, retrospective review of a Medicare claims database from January 2022 to December 2023 included otolaryngologists (US Centers for Medicare &amp; Medicaid Services code 04) who performed at least 11 BSDs during the study period, who were defined as high-volume BSD clinicians (&gt;10 BSDs per year). Data were analyzed in July 2024. Main Outcomes and Measures The primary outcome defined before data collection as the percentage of patients billed for 6-sinus BSD. Physician variables were explored for potential association with 6-sinus BSD. Results Of the 522 otolaryngologists (mean [SD] age, 52 [9.3] years), most physicians were male (489 [94%]), practiced in a group setting (428 [82%]), and were in an urban environment (474 [91%]). A total of 21 290 unique BSD procedures were performed, and 12 799 procedures (60%) involved all 6 sinuses. Of the 522 otolaryngologists, 40 (8%) performed 6-sinus BSD in 100% of their BSD procedures, while 54 (10%) performed no 6-sinus BSDs. Practice patterns varied substantially, with 8 physicians (2%) responsible for 10% of 6-sinus BSDs (n = 2152). Conclusions and Relevance The results of this cross-sectional study suggest that the high volume of 6-sinus BSD suggests the potential for overuse of BSD. Substantial variations in care emphasize the need for clear guidelines and indications for multisinus BSD to optimize the utilization and value of BSD. 34:T469,The analysis included 258 245 participants, of whom 38.4% were male and 61.6% were female and most (57.3%) were 50 years or older. After controlling for covariates, female sex was associated with an increased odds of CRSsNP among those younger than 60 years (odds ratio [OR], 1.44; CI with Holm-Bonferroni correction [CIH-B], 1.35 to 1.54) and 60 years or older (OR, 1.32; CIH-B, 1.23 to 1.40), but a lower odds of CRSwNP (OR, 0.63; CIH-B, 0.52-0.76) compared to males. Compared to male participants, female participants had a lower concentration of serum eosinophils (β, -0.35; CIH-B, -0.44 to -0.25) and IgE (β, -99.73; CIH-B, -190.49 to -8.96) among participants with CRSsNP after controlling for covariates, as well as lower eosinophils among participants with CRSwNP (β, -0.41; CIH-B, -0.80 to -0.01). Analyzing CRS prevalence by age group revealed a downtrend among female participants 60 years or older, despite an upward trend at younger age groups, with regression analysis demonstrating a negative interaction effect between female sex and age 60 years or older with odds of CRSsNP (OR, 0.91; CIH-B, 0.84 to 0.99).35:T94e,The inflammation-modulating properties of sex hormones provide a pathophysiological basis for anticipating sex-based differences in chronic rhinosinusitis (CRS), but the role of biological sex has not been thoroughly studied. To investigate sex differences in CRS diagnosis and biomarkers. This cross-sectional study used data from the All of Us Research Program, a large national dataset of US adults, collected from partner health care organizations including academic medical centers, Veterans Affairs facilities, and community health centers. From May 2018 to October 2023, a total of 393 596 participants with electronic health records were considered for inclusion; those with incomplete data were excluded. Data analysis was conducted from April to September 2025. Participant sex was the primary exposure, and covariates included demographics, socioeconomic status, risk factors, and comorbidities. CRS diagnosis, stratified into CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP), and CRS biomarkers. The analysis included 258 245 participants, of whom 38.4% were male and 61.6% were female and most (57.3%) were 50 years or older. After controlling for covariates, female sex was associated with an increased odds of CRSsNP among those younger than 60 years (odds ratio [OR], 1.44; CI with Holm-Bonferroni correction [CIH-B], 1.35 to 1.54) and 60 years or older (OR, 1.32; CIH-B, 1.23 to 1.40), but a lower odds of CRSwNP (OR, 0.63; CIH-B, 0.52-0.76) compared to males. Compared to male participants, female participants had a lower concentration of serum eosinophils (β, -0.35; CIH-B, -0.44 to -0.25) and IgE (β, -99.73; CIH-B, -190.49 to -8.96) among participants with CRSsNP after controlling for covariates, as well as lower eosinophils among participants with CRSwNP (β, -0.41; CIH-B, -0.80 to -0.01). Analyzing CRS prevalence by age group revealed a downtrend among female participants 60 years or older, despite an upward trend at younger age groups, with regression analysis demonstrating a negative interaction effect between female sex and age 60 years or older with odds of CRSsNP (OR, 0.91; CIH-B, 0.84 to 0.99). This cross-sectional study found that female sex was associated with a higher odds of CRSsNP, but a lower odds of CRSwNP compared to males. Biomarker analysis indicated a possible female disposition for nontype 2 inflammation.36:Te35, Importance The inflammation-modulating properties of sex hormones provide a pathophysiological basis for anticipating sex-based differences in chronic rhinosinusitis (CRS), but the role of biological sex has not been thoroughly studied. Objectives To investigate sex differences in CRS diagnosis and biomarkers. Design, Setting, and Participants This cross-sectional study used data from the All of Us Research Program, a large national dataset of US adults, collected from partner health care organizations including academic medical centers, Veterans Affairs facilities, and community health centers. From May 2018 to October 2023, a total of 393 596 participants with electronic health records were considered for inclusion; those with incomplete data were excluded. Data analysis was conducted from April to September 2025. Exposures Participant sex was the primary exposure, and covariates included demographics, socioeconomic status, risk factors, and comorbidities. Main Outcomes and Measures CRS diagnosis, stratified into CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP), and CRS biomarkers. Results The analysis included 258 245 participants, of whom 38.4% were male and 61.6% were female and most (57.3%) were 50 years or older. After controlling for covariates, female sex was associated with an increased odds of CRSsNP among those younger than 60 years (odds ratio [OR], 1.44; CI with Holm-Bonferroni correction [CIH-B], 1.35 to 1.54) and 60 years or older (OR, 1.32; CIH-B, 1.23 to 1.40), but a lower odds of CRSwNP (OR, 0.63; CIH-B, 0.52-0.76) compared to males. Compared to male participants, female participants had a lower concentration of serum eosinophils (β, −0.35; CIH-B, −0.44 to –0.25) and IgE (β, −99.73; CIH-B, −190.49 to –8.96) among participants with CRSsNP after controlling for covariates, as well as lower eosinophils among participants with CRSwNP (β, −0.41; CIH-B, −0.80 to –0.01). Analyzing CRS prevalence by age group revealed a downtrend among female participants 60 years or older, despite an upward trend at younger age groups, with regression analysis demonstrating a negative interaction effect between female sex and age 60 years or older with odds of CRSsNP (OR, 0.91; CIH-B, 0.84 to 0.99). Conclusions and Relevance This cross-sectional study found that female sex was associated with a higher odds of CRSsNP, but a lower odds of CRSwNP compared to males. Biomarker analysis indicated a possible female disposition for nontype 2 inflammation. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Chronic Rhinosinusitis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Chronic Rhinosinusitis (condition). Clinician-written summaries and actionable practice insights. 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pooled EDS-FLU doses (186 µg and 372 µg) are combined in the abstract's subgroup comparisons.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"warning","value":"The brand name 'Xhance' is assumed for EDS-FLU (fluticasone propionate exhalation delivery system); the paper does not explicitly name the brand.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"warning","value":"The paper does not distinguish between CRS with and without nasal polyps (CRSwNP vs CRSsNP), which is a clinically important distinction that may affect generalizability.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"warning","value":"This is a subgroup analysis of two RCTs (ReOpen1, ReOpen2); randomization was not stratified by the subgroups examined, so treatment-by-subgroup interaction results should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"This pooled subgroup analysis of the ReOpen1 and ReOpen2 RCTs (N=547) evaluated whether baseline blood eosinophil count (0–299 vs ≥300 cells/µL), comorbid asthma, or environmental allergy modified the response to EDS-FLU (186 µg or 372 µg twice daily) vs EDS-placebo over 24 weeks in adults with CRS.","key_result":"EDS-FLU significantly improved composite symptom scores vs placebo at week 12 across all subgroups (all P<0.01): asthma (−2.12 vs −1.36), no asthma (−2.40 vs −1.52), allergy (−2.12 vs −1.24), no allergy (−2.37 vs −1.60), EOS 0–299 cells/µL (−2.11 vs −1.56), and EOS ≥300 cells/µL (−2.48 vs −1.36); SNOT-22 and PGIC results were consistent, with no significant treatment-by-subgroup interaction.","limitations":"- Subgroup analysis was post hoc and not pre-specified for primary inference, limiting causal conclusions.\n- Eosinophil and comorbidity subgroups were defined by self-report or a single blood draw, which may not reflect true endotype.\n- Authors explicitly note further investigation is warranted, suggesting underpowering within individual subgroups.","practice_takeaway":"Clinicians can expect meaningful symptom benefit from EDS-FLU in CRS patients regardless of whether they have comorbid asthma, environmental allergy, or elevated blood eosinophils—endotype profiling should not delay or withhold this treatment. Both doses were effective, so choice may be guided by tolerability and formulary access."}},{"doi":"10.1002/ppul.71810","pmid":"42643099","title":"Evaluation of Pulmonary and Otological Manifestations in Primary Ciliary Dyskinesia and Their Effect on Quality of Life","journal_title":"Pediatric Pulmonology","journal_issn":"8755-6863","published_at":"2026-08-26T00:00:00.000Z","url":"https://doi.org/10.22541/au.174789764.47378366/v1","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-06T06:22:52.237Z","updated_at":"2026-09-06T06:22:52.237Z","tags":[{"paper_doi":"10.1002/ppul.71810","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"condition","value":"Bronchiectasis","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"condition","value":"Conductive Hearing Loss","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"condition","value":"Otitis Media With Effusion","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"condition","value":"Primary Ciliary Dyskinesia","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"sample_size","value":"n=56","value_numeric":56},{"paper_doi":"10.1002/ppul.71810","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"warning","value":"No multiple testing correction was applied; several exploratory comparisons should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"warning","value":"Speech-in-noise impairment rate (64.3%) is novel — this is the first study to apply this test in PCD — so reference ranges and clinical thresholds in this population are not yet established.","value_numeric":null},{"paper_doi":"10.1002/ppul.71810","tag_type":"warning","value":"The study is single-center with n=56; 17 of 73 eligible patients were excluded due to refusal or missed appointments, introducing potential selection bias.","value_numeric":null}],"summaries":{"what_studied":"This cross-sectional study (Jan 2023–Jan 2024) evaluated 56 PCD patients aged ≥6 years (mean age 15.2 years) for otologic, pulmonary, and sinonasal manifestations and their impact on health-related QOL (QOL-PCD), using pure-tone audiometry, DPOAE, tympanogram, speech-in-noise testing (TUR-Matrix), spirometry, and SNOT-22.","key_result":"Pathologic hearing was found in 46.4% (26/56) and abnormal speech-in-noise (TUR-Matrix) in 64.3% (36/56). Patients with pathologic hearing had significantly worse FEV1 z-scores (−1.7 vs. −0.8, p=0.01), more abnormal DPOAE (25 vs. 11, p<0.001), and worse tympanograms (26 vs. 12, p<0.001). Adults had significantly lower QOL scores in social, upper, and lower respiratory domains than children and adolescents (p<0.001, 0.02, and 0.01, respectively).","limitations":"- Single-center design with a small sample (n=56) limits generalizability.\n- No multiple testing correction applied despite numerous comparisons.\n- Cross-sectional design prevents causal inference between hearing loss and pulmonary decline.","practice_takeaway":"Nearly half of PCD patients have measurable hearing loss, and nearly two-thirds struggle with speech understanding in noise — both often go unreported. Routine multidisciplinary assessment including objective audiologic testing (not just symptom inquiry) should be standard in PCD care, especially in patients with lower FEV1."}},{"doi":"10.1183/23120541.01397-2025","pmid":"42445230","title":"The association between chronic rhinosinusitis, bronchiectasis and type 2 inflammation: an EMBARC registry analysis","journal_title":"ERJ Open Research","journal_issn":"2312-0541","published_at":"2026-07-13T00:00:00.000Z","url":"https://doi.org/10.1183/23120541.01397-2025","source_score":6,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-18T13:39:56.711Z","updated_at":"2026-07-18T13:39:56.711Z","tags":[{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"condition","value":"Bronchiectasis","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"condition","value":"Immunodeficiency","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"condition","value":"Nasal Polyposis","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"condition","value":"Primary Ciliary Dyskinesia","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"modality","value":"Biologic / Monoclonal Antibody (Type 2-Directed)","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"sample_size","value":"n=16640","value_numeric":16640},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"study_design","value":"Registry-Based Observational Study","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"warning","value":"CRS and nasal polyp status were recorded by site investigators without formal EPOS criteria validation, which may introduce differential ascertainment across the 30+ countries in the registry.","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"warning","value":"'Practice_changing' flag applied cautiously — the study identifies a biomarker-enriched phenotype relevant to trial design, but no interventional data for biologics in this specific population are yet available.","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"warning","value":"The chief editor of the publishing journal (ERJ Open Research) is a co-author (J.D. Chalmers), which is a potential conflict of interest noted in the paper itself.","value_numeric":null},{"paper_doi":"10.1183/23120541.01397-2025","tag_type":"warning","value":"The level of evidence is assigned as 3 (prospective cohort/registry); it is not a randomised trial and causality cannot be inferred.","value_numeric":null}],"summaries":{"what_studied":"This EMBARC registry analysis examined the prevalence and impact of chronic rhinosinusitis with (CRSwNP) and without nasal polyps (CRSnNP) in 16,640 adults with bronchiectasis, and whether comorbid CRS is linked to type 2 inflammatory biomarkers (elevated blood eosinophil count or total IgE ≥150 IU/mL) across different bronchiectasis aetiologies (idiopathic, post-infective, PCD, immune deficiency, and others).","key_result":"CRSnNP was present in 20.9% and CRSwNP in 7.3% of patients. Both subtypes were linked to worse respiratory symptoms, more exacerbations, but **lower hospitalisation rates and mortality** compared to no CRS. CRSwNP independently predicted elevated type 2 biomarkers (OR ~2.1 for elevated eosinophils or IgE), but this association held only in idiopathic and post-infective bronchiectasis — not in PCD or immune deficiency.","limitations":"- CRS and nasal polyp diagnoses were investigator-reported from a registry field, not validated against established EPOS criteria, introducing potential misclassification.\n- Blood eosinophils and total IgE were not available for all patients (~46% had eosinophil data), and more granular type 2 markers (sputum eosinophils, fractional exhaled NO, specific IgE) were absent.\n- Immunodeficiency was grouped as a single category despite heterogeneous underlying mechanisms.","practice_takeaway":"In bronchiectasis patients with nasal polyps, actively check for elevated eosinophils and IgE — this phenotype may benefit from type 2-directed biologics. Conversely, CRS in PCD or immune deficiency is unlikely to signal type 2 inflammation, so routine biomarker screening in those groups is less warranted."}},{"doi":"10.1183/16000617.0326-2025","pmid":"42419777","title":"Genetic susceptibility to respiratory health effects from outdoor air pollution: a structured narrative review","journal_title":"European Respiratory Review","journal_issn":"0905-9180","published_at":"2026-07-08T00:00:00.000Z","url":"https://doi.org/10.1183/16000617.0326-2025","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-14T13:24:20.302Z","updated_at":"2026-07-14T13:24:20.302Z","tags":[{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"condition","value":"Bronchitis","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"condition","value":"Chronic Obstructive Pulmonary Disease","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"modality","value":"Genetic Risk Stratification","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"modality","value":"Polygenic Risk Score","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"sample_size","value":"n=48","value_numeric":48},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"study_design","value":"Systematic/Narrative Review","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"warning","value":"Level of evidence assigned as 3 (narrative review of heterogeneous observational studies); a formal systematic review with meta-analysis was not feasible due to study heterogeneity.","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"warning","value":"Sample size tag reflects the number of included studies (n=48), not individual participants—patient-level N varies widely across studies and is not aggregated in this review.","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"warning","value":"Study design labeled 'Systematic/Narrative Review' as the authors self-describe a 'structured narrative review' with PRISMA-guided search but narrative rather than quantitative synthesis.","value_numeric":null},{"paper_doi":"10.1183/16000617.0326-2025","tag_type":"warning","value":"The majority of included studies focused on European-ancestry populations; SNP associations may not generalise to other ethnic groups.","value_numeric":null}],"summaries":{"what_studied":"A structured narrative review of 48 peer-reviewed human gene–environment interaction studies (2014–2024) examining how genetic polymorphisms modify the respiratory effects of outdoor air pollutants (primarily PM2.5, PM10, and NO2), covering outcomes including asthma, COPD, and lung function measures across all age groups.","key_result":"40 of 48 studies found at least one statistically significant gene–environment interaction; 89 significant SNPs were identified across 53 genes. Replicated variants included rs1695 and rs1138272 (GSTP1), rs2266637 (GSTT1) in oxidative stress pathways, and rs1800629 (TNF), rs3804099 (TLR2), and rs848 (IL13) in inflammatory pathways—all consistently modifying pollution-related lung function decline and airway inflammation. GSTM1 and GSTT1 null genotypes were most frequently linked to adverse respiratory outcomes.","limitations":"- 75% of studies focused on European-ancestry populations, limiting generalisability to other ethnic groups.\n- Heterogeneity across study designs, exposure metrics, and outcome definitions precluded meta-analysis.\n- Restriction to English-language publications and four databases introduces language and publication bias; null results are likely underreported (only 8 of 48 studies reported null or suggestive findings).","practice_takeaway":"Clinicians managing patients with asthma or COPD should recognize that pollution-related respiratory risk is not uniform—GST family variants (especially GSTM1/GSTT1 null genotypes) and TLR/TNF pathway SNPs can amplify harm from PM2.5, NO2, and diesel exhaust. Incorporating environmental exposure history alongside emerging genetic risk scores may help stratify high-risk patients for targeted exposure-reduction counseling."}},{"doi":"10.1016/j.jaci.2026.04.011","pmid":null,"title":"The Editors’ Choice","journal_title":"Journal of Allergy and Clinical Immunology","journal_issn":"0091-6749","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaci.2026.04.011","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:34.477Z","updated_at":"2026-06-16T13:54:29.328Z","tags":[{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Eosinophilic Chronic Rhinosinusitis with Nasal Polyps","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Food Protein-Induced Enterocolitis Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Haploinsufficiency of A20","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Inborn Errors of Immunity","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"generic","value":"thalidomide","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"COVID-19 Vaccine","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"IL-1 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"IL-4/IL-13 Receptor Antagonist","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"study_design","value":"Editors' Choice / Multi-Study Summary","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"Sample sizes reported are from individual highlighted studies; a single aggregate sample_size tag was not assigned due to the multi-study nature of this article.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The 'level of evidence' tag reflects the editorial/summary format and not the designs of the individual underlying studies, which range from prospective cohort to retrospective multicenter.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The paper provided contains only metadata (DOI, URL, journal name, and publication date). No abstract, methods, results, or conclusions were included. Structured summary fields, tags, and impact flags cannot be populated without source content. Please provide the full text or abstract for a complete extraction.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The paper provided contains only metadata (DOI, URL, journal name, and publication date) with no abstract, methods, results, or other substantive content. No summaries, tags, or evidence-based outputs can be reliably generated without the actual paper text. Please provide the full text or abstract for a complete extraction.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The provided source contains only bibliographic metadata (DOI, journal, publication date, and title 'The Editors' Choice') with no abstract, methods, results, or discussion text. No content-based extraction is possible. All summary fields and tags have been left null or empty to avoid speculation. Please provide the full paper text for a complete structured summary.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The provided source text contains only metadata (DOI, URL, journal name, and publication date) with no abstract, body text, or results. All summary fields have been set to null because no clinical content can be extracted or verified. Please provide the full paper text for a complete structured summary.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The provided source text contains only metadata (DOI, URL, journal name, publication date, and title). No abstract, methods, results, or discussion are included. All summary fields have been set to null because there is insufficient content to extract structured clinical information. Full-text access is required for a meaningful summary.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The study design label is non-standard given this is a multi-topic Editors' Choice editorial rather than a single study.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The title 'The Editors' Choice' is a section label, not a specific study title — the actual paper content and topic are unknown from the provided information.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"This is an editorial summary of six distinct original articles; individual study-level data (full methods, complete results, effect sizes) are not available from this publisher page alone.","value_numeric":null}],"summaries":{"what_studied":"This Editors' Choice issue summarizes six original studies covering: squamous metaplasia in eCRSwNP (n=844 specimens), complement C3 in allergic rhinitis remodeling, PM2.5 and CRS inflammatory endotypes (n=634), gut microbiota in FPIES (n=56 children vs. 43 controls), HA20 clinical phenotypes (n=185 patients, 41 clinics, 7 countries), and COVID-19 vaccine immune memory in antibody-deficient IEI patients.","key_result":"Key findings across studies: (1) Squamous metaplasia was significantly more prevalent in eCRSwNP vs. non-eosinophilic CRS, and dupilumab reversed IL-4/IL-13–driven epithelial changes in vitro. (2) Complement C3/C3aR signaling drives macrophage lipid reprogramming and TGF-β1–mediated airway remodeling in allergic rhinitis. (3) Higher PM2.5 exposure linked to a mixed type 2/type 3 cytokine endotype (β=1.17, P<0.0001) in CRS patients. (4) FPIES children had reduced *Bifidobacterium* and Verrucomicrobiota vs. healthy controls. (5) HA20 clusters into age-dependent autoinflammatory (children) and autoimmune (adults) phenotypes; TNF/IL-1 inhibitors broadly effective. (6) Most IEI patients with antibody deficiency generated memory B and/or T cells after COVID-19 vaccination despite reduced neutralizing antibody titers.","limitations":"All six studies are summarized via an editorial overview rather than full-text reporting; individual study limitations (e.g., retrospective design for HA20, single-timepoint microbiota sampling in FPIES, and lack of long-term outcomes for IEI vaccine data) are not detailed here. The CRS/PM2.5 study relies on modeled rather than directly measured pollution exposure.","practice_takeaway":"Clinicians managing eCRSwNP should recognize squamous metaplasia as a common, biologic-reversible remodeling feature—dupilumab may address more than inflammation alone. For IEI patients, COVID-19 vaccination still builds memory B and T cell responses even when antibody titers are low, supporting continued booster strategies and assessment of cellular immunity in this group."}},{"doi":"10.1001/jamaoto.2026.1176","pmid":"42207538","title":"Traffic and Industrial Pollutants and Chronic Rhinosinusitis","journal_title":"JAMA Otolaryngology–Head & Neck Surgery","journal_issn":"2168-6181","published_at":"2026-05-28T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13220150/","source_score":38,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:23:46.483Z","updated_at":"2026-06-10T14:23:46.483Z","tags":[{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"modality","value":"Environmental Exposure / Air Pollutant","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"sample_size","value":"n=92","value_numeric":92},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"study_design","value":"Case-Control Study","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"warning","value":"Controls were skull-base surgery patients rather than healthy individuals, which may not represent a true disease-free population and could bias cytokine comparisons.","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"warning","value":"Pollutant exposures were modeled from residential addresses only; occupational and indoor exposures were not captured, which may underestimate or misclassify true exposure.","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.1176","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — findings are hypothesis-generating given the small single-center case-control design; replication in larger prospective cohorts is needed before clinical practice changes are firmly warranted.","value_numeric":null}],"summaries":{"what_studied":"This case-control study examined whether long-term residential exposure to traffic- and industry-related air pollutants (NO₂, benzene, lead, and others) was linked to CRS risk and sinonasal cytokine profiles in 92 adults (62 CRS cases, 30 surgical controls) at a tertiary center, using 5-year average pollutant exposures from a land use regression model.","key_result":"Each SD increase in NO₂ was associated with 132% higher CRS odds (aOR 2.32; 95% CI 1.09–4.93); benzene with 115% higher odds (aOR 2.15; 95% CI 1.05–4.38); and lead with 248% higher odds (aOR 3.48; 95% CI 1.36–8.88). NO₂ was linked to a type 2 cytokine signature (↑IL-4, IL-5, IL-13, TNF-α), while benzene and lead were associated with non-type 2 (innate/neutrophilic) profiles.","limitations":"- Small sample (n=92) from a single tertiary center limits generalizability.\n- Case-control design prevents causal inference; residual confounding by unmeasured factors (e.g., indoor air quality, occupational exposure) is possible.\n- Controls were skull-base surgery patients, not healthy volunteers, which may introduce selection bias.","practice_takeaway":"Clinicians evaluating CRS patients should consider asking about long-term residential proximity to traffic and industrial pollution sources, as NO₂, benzene, and lead exposure each independently associate with meaningfully higher CRS odds. The distinct cytokine signatures suggest pollutant type may influence endotype (type 2 vs. non-type 2), which could inform targeted therapy decisions."}},{"doi":"10.1002/clt2.70177","pmid":"42173692","title":"Staphylococcus aureus\n and\n Staphylococcus lugdunensis\n Act in Concert to Disrupt the Nasal Epithelial Barrier","journal_title":"Clinical and Translational Allergy","journal_issn":"2045-7022","published_at":"2026-05-22T00:00:00.000Z","url":"https://doi.org/10.1002/clt2.70177","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-28T13:24:19.989Z","updated_at":"2026-05-28T13:24:19.989Z","tags":[{"paper_doi":"10.1002/clt2.70177","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"generic","value":"Staphylococcus aureus exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"generic","value":"Staphylococcus epidermidis exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"generic","value":"Staphylococcus lugdunensis exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"modality","value":"Microbial Exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"sample_size","value":"n=22","value_numeric":22},{"paper_doi":"10.1002/clt2.70177","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"study_design","value":"In Vitro Experimental Study","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"warning","value":"Patient sex and age distributions are not specified in the abstract; the 'mixed' sex tag is an assumption based on typical CRS study populations.","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"warning","value":"The level of evidence (5) reflects an in vitro mechanistic study without a clinical comparator arm; some hierarchies may classify this differently.","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"warning","value":"The study design is in vitro only; no clinical outcomes (e.g., symptom scores, treatment response) are reported, limiting direct clinical translation.","value_numeric":null}],"summaries":{"what_studied":"This in vitro study examined how exoproteins from *S. aureus*, *S. epidermidis*, and *S. lugdunensis* — isolated from the same CRS and control patients — affect nasal epithelial barrier function, cytotoxicity, and inflammation using primary human nasal epithelial cells (HNECs) cultured at air-liquid interface (ALI).","key_result":"15 of 22 *S. aureus* exoproteins significantly increased cytotoxicity, reduced TEER, and raised paracellular permeability (p < 0.05); *S. epidermidis* and *S. lugdunensis* exoproteins had mild or negligible barrier effects alone, but *S. lugdunensis* drove significantly higher IL-6, and correlation analysis showed *S. aureus* + *S. lugdunensis* from the same patient acted in concert to disrupt the barrier.","limitations":"- In vitro ALI model may not fully replicate the in vivo sinonasal environment or polymicrobial biofilm dynamics.\n- Small sample size (22 patients, 44 isolates) limits generalizability.\n- Exoproteins were tested at a single fixed concentration (20 µg/mL), so dose-response relationships are unknown.","practice_takeaway":"Clinicians managing recalcitrant CRS should be aware that co-colonization with *S. aureus* and *S. lugdunensis* may synergistically worsen mucosal barrier breakdown — not just *S. aureus* alone. This supports thorough microbiome profiling of sinonasal swabs in CRS patients, especially in refractory cases."}},{"doi":"10.1111/all.70332","pmid":"42011838","title":"Meta‐Analysis on the Harm of Systemic Glucocorticosteroids in Inflammatory Upper Airway Disease and Asthma: An EAACI Task Force","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-04-21T00:00:00.000Z","url":"https://doi.org/10.1111/all.70332","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:37.793Z","updated_at":"2026-05-09T13:22:37.793Z","tags":[{"paper_doi":"10.1111/all.70332","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"Exact total sample size (N) was not reported in the abstract; the sample_size tag has been omitted.","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"Study scope is limited to inflammatory airway diseases; generalizability to other sGCS indications is uncertain.","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"The 500 mg–1 g prednisolone-equivalent threshold is a pooled meta-analytic signal — individual patient risk may vary based on comorbidities, genetics, and concurrent medications.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis evaluated adverse effects (AEs) of systemic glucocorticosteroids (sGCS) in chronic inflammatory upper and lower airway diseases (rhinitis, rhinosinusitis, asthma), examining both short- and long-term risks and whether a dose-response relationship exists between daily/cumulative sGCS dosage and AE occurrence.","key_result":"Cumulative sGCS doses between 500 mg and 1 g prednisolone-equivalent significantly increased the risk of most AEs, with risk rising incrementally with higher doses — including risks from repeated short courses, not just long-term continuous use.","limitations":"The review focuses on airway diseases, so findings may not generalize to sGCS use in other conditions. Heterogeneity across included studies in dosing definitions and AE reporting may affect pooled estimates. The acceptable cumulative threshold remains empirically uncertain given variable individual susceptibility.","practice_takeaway":"Avoid cumulative sGCS exposure reaching 500 mg prednisolone-equivalent by prioritizing steroid-sparing therapies (e.g., biologics) early. Even repeated short courses carry meaningful harm — steroid stewardship should be applied rigorously in rhinitis, rhinosinusitis, and asthma management."}},{"doi":"10.1007/s11882-025-01239-0","pmid":"41420663","title":"Acute Exacerbations of Chronic Rhinosinusitis","journal_title":"Current Allergy and Asthma Reports","journal_issn":"1529-7322","published_at":"2025-12-20T00:00:00.000Z","url":"https://doi.org/10.1007/s11882-025-01239-0","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-24","doi":"10.1007/s11882-025-01239-0","days":"30","issn":"1529-7322","rank":"1","field":"Clinical Medicine","score":"19","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1007/s11882-025-01239-0","title":"Acute Exacerbations of Chronic Rhinosinusitis.","journal":"Current allergy and asthma reports","methods":"","results":"","abstract":"$30","keywords":["Acute","Antibiotics","Chronic rhinosinusitis","Corticosteroids","Exacerbation"],"pubmed_id":"41420663","conclusions":"","publication_date":"2025-12-20T00:00:00"},"crossref":{"DOI":"10.1007/s11882-025-01239-0","URL":"https://doi.org/10.1007/s11882-025-01239-0","ISSN":["1529-7322","1534-6315"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1007/s11882-025-01239-0.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1007/s11882-025-01239-0","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1007/s11882-025-01239-0.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Acute Exacerbations of Chronic Rhinosinusitis"],"author":[{"given":"Robert M.","family":"Frederick","sequence":"first","affiliation":[]},{"given":"Kent","family":"Lam","sequence":"additional","affiliation":[]},{"given":"Joseph K.","family":"Han","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,12]]},"member":"297","prefix":"10.1007","source":"Crossref","volume":"25","created":{"date-time":"2025-12-20T04:33:56Z","timestamp":1766205236000,"date-parts":[[2025,12,20]]},"indexed":{"date-time":"2025-12-20T06:25:55Z","timestamp":1766211955833,"date-parts":[[2025,12,20]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000,"date-parts":[[2025,12,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000,"date-parts":[[2025,12,20]]},"delay-in-days":19,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1007/s11882-025-01239-0"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"27 October 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":2,"value":"23 November 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":3,"value":"20 December 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"},"order":2,"value":"None."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights"},"order":3,"value":"This article does not contain any studies with human or animal subjects performed by any of the authors."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"},"order":4,"value":"The authors declare no competing interests."}],"deposited":{"date-time":"2025-12-20T04:33:57Z","timestamp":1766205237000,"date-parts":[[2025,12,20]]},"issn-type":[{"type":"print","value":"1529-7322"},{"type":"electronic","value":"1534-6315"}],"published":{"date-parts":[[2025,12]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.4193/Rhin23.415","key":"1239_CR1","year":"2024","issue":"3","author":"WJ Fokkens","volume":"62","first-page":"287","unstructured":"Fokkens WJ, De Corso E, Backer V, et al. 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Rescue medication fills occurred in only about one-third of patient‑reported AECRS episodes; patients with CRS and asthma and/or allergic rhinitis appear at higher risk, and antibiotics and corticosteroids are often overprescribed.","limitations":"Many included studies used loose or inconsistent AECRS definitions and proxies (patient‑reported illness, CRS‑related antibiotic/corticosteroid use), limiting comparability. The pathophysiology remains under active study and is not fully defined.","practice_takeaway":"When diagnosing AECRS, apply the >3‑day worsening plus treatment‑escalation criterion and avoid relying on rescue‑medication fills alone. Be cautious with routine antibiotics or corticosteroids, and recognize asthma/allergic rhinitis as risk markers."}},{"doi":"10.1001/jamaoto.2025.4017","pmid":"41231509","title":"Evaluation of Practice Patterns for 6-Sinus Balloon Sinus Dilation","journal_title":"JAMA Otolaryngology–Head & Neck Surgery","journal_issn":"2168-6181","published_at":"2025-11-13T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12616529/","source_score":15,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-10","doi":"10.1001/jamaoto.2025.4017","days":"7","issn":"2168-6181","rank":"8","field":"Clinical Medicine","score":"15","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1001/jamaoto.2025.4017","title":"Evaluation of Practice Patterns for 6-Sinus Balloon Sinus Dilation.","journal":"JAMA otolaryngology-- head & neck surgery","methods":"","results":"Of the 522 otolaryngologists (mean [SD] age, 52 [9.3] years), most physicians were male (489 [94%]), practiced in a group setting (428 [82%]), and were in an urban environment (474 [91%]). 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Among 522 physicians, 40 (8%) performed 6-sinus BSD in 100% of their cases, 54 (10%) performed none, and 8 (2%) accounted for 10% of all 6-sinus cases (n=2,152).","limitations":"Claims-based, cross-sectional, retrospective design. Restricted to Medicare data and high-volume otolaryngologists (>10 BSDs/year), which may limit generalizability.","practice_takeaway":"High rates and wide variation in 6-sinus BSD suggest potential overuse. 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Essential role of estrogen receptor a expression in hematopoietic cells.","journal-title":"Eur J Immunol","doi-asserted-by":"crossref"},{"DOI":"10.1073/pnas.1402468111","key":"ooi250067r35","year":"2014","issue":"27","author":"Kissick","volume":"111","first-page":"9887","unstructured":null,"article-title":"Androgens alter T-cell immunity by inhibiting T-helper 1 differentiation.","journal-title":"Proc Natl Acad Sci U S A","doi-asserted-by":"crossref"},{"DOI":"10.1371/journal.pone.0243732","key":"ooi250067r36","year":"2020","issue":"12","author":"Espersen","volume":"15","first-page":null,"unstructured":null,"article-title":"Level of sex hormones and their association with acetylsalicylic acid intolerance and nasal polyposis.","journal-title":"PLoS ONE","doi-asserted-by":"crossref"},{"DOI":"10.1136/thoraxjnl-2011-201249","key":"ooi250067r37","year":"2012","issue":"7","author":"Leynaert","volume":"67","first-page":"625","unstructured":null,"article-title":"Gender differences in 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Epidemiol","doi-asserted-by":"crossref"},{"DOI":"10.1023/A:1020016922473","key":"ooi250067r50","year":"2001","issue":"11","author":"Korkeila","volume":"17","first-page":"991","unstructured":null,"article-title":"Non-response and related factors in a nation-wide health survey.","journal-title":"Eur J Epidemiol","doi-asserted-by":"crossref"}],"short-title":[],"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Otolaryngology–Head & Neck Surgery"],"published-print":{"date-parts":[[2026,1,1]]},"reference-count":50,"published-online":null,"references-count":50,"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1001/jamaoto.2025.3734","is_oa":true,"title":"Biological Sex and Chronic Rhinosinusitis Diagnosis and Biomarkers","updated":"2025-12-25T00:49:48+00:00","published_date":"2025-10-23","best_oa_location":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12550736/","pmh_id":"oai:pubmedcentral.nih.gov:12550736","url_for_pdf":null,"url_for_landing_page":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12550736/"}}},"created_at":"2026-01-14T18:30:49.575Z","updated_at":"2026-01-17T09:03:27.421Z","tags":[{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"sample_size","value":"n=258,245","value_numeric":258245},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"warning","value":"Biomarker units and baseline values are not specified in the abstract.","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"warning","value":"Only adjusted odds and beta coefficients are reported; absolute prevalence or event counts are not provided.","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2025.3734","tag_type":"warning","value":"Sex was the exposure, but details on gender identity or hormone status are not described.","value_numeric":null}],"summaries":{"what_studied":"A cross-sectional analysis of All of Us electronic health records (US adults) from May 2018 to October 2023 examined associations between participant sex and chronic rhinosinusitis (CRS) phenotypes (CRSwNP vs CRSsNP) and serum biomarkers, adjusting for demographics, socioeconomic factors, risk factors, and comorbidities. The analysis included 258,245 participants.","key_result":"Female sex was associated with higher odds of CRSsNP in those <60 years (OR 1.44; CIH-B 1.35-1.54) and ≥60 years (OR 1.32; CIH-B 1.23-1.40), but lower odds of CRSwNP (OR 0.63; CIH-B 0.52-0.76) versus males. Females had lower serum eosinophils (β −0.35; CIH-B −0.44 to −0.25) and IgE (β −99.73; CIH-B −190.49 to −8.96) among CRSsNP, and lower eosinophils among CRSwNP (β −0.41; CIH-B −0.80 to −0.01); a negative interaction between female sex and age ≥60 was observed for CRSsNP odds (OR 0.91; CIH-B 0.84-0.99).","limitations":"Cross-sectional design limits causal inference. Exclusion of participants with incomplete data may introduce selection bias.","practice_takeaway":"Expect sex differences in CRS: women had greater odds of CRSsNP and lower odds of CRSwNP than men, with lower eosinophils and IgE. Consider sex when interpreting CRS subtype and biomarker profiles, noting the declining odds of CRSsNP in women aged ≥60 years."}}],"initialOffset":11,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Chronic Rhinosinusitis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Chronic Rhinosinusitis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Chronic Rhinosinusitis"}}}]]

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