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International Archives of Allergy and... 2022Mast cells (MCs) are involved in several biological processes, such as defense against pathogens, immunomodulation, tissue repair after injury, and angiogenesis. MCs... (Review)
Review
Mast 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.
Topics: Animals; Biomarkers; Cell Plasticity; Disease Management; Disease Susceptibility; Humans; Inflammation; Mast Cells; Neovascularization, Physiologic; Pharyngeal Diseases; Phenotype; Respiratory Physiological Phenomena; Respiratory System; Rhinitis
PubMed: 34551414
DOI: 10.1159/000518924 -
Medicine Feb 2019It was aimed to report 5 cases of pharyngeal hairy polyps, and to summarize the characteristics combined with literature review.Five cases with pathological diagnosis of... (Observational Study)
Observational Study
It was aimed to report 5 cases of pharyngeal hairy polyps, and to summarize the characteristics combined with literature review.Five cases with pathological diagnosis of pharyngeal hair polyps were diagnosed and treated in our department from June, 2006 to October, 2016, and retrospective analysis of their clinical data was performed. Among the 5 cases, there were 1 male and 4 female, with the age of 2 days to 26 months old. After birth, these patients were accompanied by stridor, difficulty breathing, snoring, feeding difficulties, and slow weight gain.Gray mass in the stem original from the pharynx was found in all 5 cases, with the surface hair-covering. The polyp resections were performed under general anesthesia, with the complete removal of polyp along the pars basilaris during surgery smoothly. The operation during was 5 to 20 minute, with an average of 12 minute, and there was little hemorrhage during operation. Symptoms disappeared completely after the surgery, and follow-up was performed for 1 year without recurrence shown.Pharyngeal hairy polyp is a rare non-malignant clinical disease, mainly caused by symptoms in respiratory tract obstruction. Complete removal of polyps along the pars basilaris is an effective treatment, with no recurrence case reported after surgery.
Topics: Child, Preschool; Female; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Pharyngeal Diseases; Polyps; Retrospective Studies
PubMed: 30702604
DOI: 10.1097/MD.0000000000014305 -
Sexually Transmitted Diseases Apr 2023Current guidance from the US Centers for Disease Control and Prevention recommends empiric treatment for persons exposed to sexually transmitted infections, including...
BACKGROUND
Current guidance from the US Centers for Disease Control and Prevention recommends empiric treatment for persons exposed to sexually transmitted infections, including Neisseria gonorrhoeae ( NG ). As an antimicrobial stewardship measure, some clinics now recommend a test and treat strategy, but reliance on urogenital testing only may miss cases.
METHODS
We conducted a descriptive analysis of pharyngeal NG infection in men who have sex with women (MSW) and women seeking care at a sexual health clinic in Seattle, WA, from February 2017 to July 2021 because of sexual contact to a partner diagnosed with gonorrhea. We also explored behavioral factors associated with pharyngeal NG positivity (by culture or nucleic acid amplification test by χ2 analysis.
RESULTS
Among 352 NG contacts tested for urogenital or pharyngeal infection, 34% were positive for NG at ≥1 anatomic site (27% for MSW and 40% for women). Among 161 NG contacts tested at the pharynx, 30% (n = 48) were positive: 20% of 54 MSW (n = 11) and 35% (n = 37) of 107 women. If only urogenital testing were performed, 36% of MSW NG infections (n = 5) and 19% of female NG infections (n = 9) would have remained unidentified.
CONCLUSIONS
Pharyngeal NG is relatively common among MSW and women who have been exposed to NG, and likely represents an underdiagnosed reservoir of NG infection. If empiric treatment is abandoned in favor of testing and treating, testing the throats of heterosexuals will be necessary.
Topics: Male; Female; Humans; Gonorrhea; Sexual Partners; Heterosexuality; Sexual Behavior; Neisseria gonorrhoeae; Pharynx; Homosexuality, Male; Chlamydia Infections; Pharyngeal Diseases
PubMed: 36548117
DOI: 10.1097/OLQ.0000000000001760 -
Ear, Nose, & Throat Journal Jan 2023
Topics: Humans; Pharyngeal Diseases; Cutaneous Fistula
PubMed: 33355000
DOI: 10.1177/0145561320984993 -
Sexually Transmitted Diseases Sep 2018The objective of this study was to examine the proportion of missed infections and correlates of pharyngeal gonorrhea among young people attending public sexually...
BACKGROUND
The objective of this study was to examine the proportion of missed infections and correlates of pharyngeal gonorrhea among young people attending public sexually transmitted disease (STD) clinics.
METHODS
We conducted a case-control study of 245 young men and women between April 2012 and May 2014. Participants were eligible for inclusion if they (1) were 15 to 29 years of age, (2) reported giving oral sex to a partner of the opposite sex in the past 90 days, and (3) attended 1 of 12 public STD clinics in Los Angeles County. Computer-assisted self-interviews were used to collect information on sexual behaviors and tests were conducted for pharyngeal and urogenital gonorrhea.
RESULTS
Most participants were younger than 25 years (69%) and more than half were female (56%). We identified a total of 64 cases (27%) of gonorrhea, of which 29 (45%) were a urogenital only infection, 18 (28%) were a pharyngeal only, and 17 (27%) were dually infected at both sites. Pharyngeal testing increased case finding by 39% from 46 to 64 cases. After adjusting for age, sex, and number of sex partners, those who reported consistent pharyngeal exposure to ejaculate/vaginal fluids were 3 times as likely to have pharyngeal gonorrhea as compared with those without this exposure (adjusted odds ratio, 3.1; 95% confidence interval, 1.3-7.5).
CONCLUSIONS
A large proportion of gonorrhea cases among young people would be missed in the absence of pharyngeal testing. These results have implications for those who provide medical care to clients at STD clinics and highlight the need for pharyngeal screening recommendations and counseling messages related to strategies to reduce exposure to infected fluids.
Topics: Adolescent; Adult; Ambulatory Care Facilities; California; Case-Control Studies; Female; Female Urogenital Diseases; Gonorrhea; Humans; Male; Male Urogenital Diseases; Mass Screening; Neisseria gonorrhoeae; Pharyngeal Diseases; Pharynx; Risk-Taking; Sexual Behavior; Sexual Partners; Young Adult
PubMed: 29485543
DOI: 10.1097/OLQ.0000000000000822 -
Otolaryngologic Clinics of North America Aug 2019Dysphonia is often blamed on laryngopharyngeal reflux (LPR) in the face of a normal flexible laryngoscopic examination. LPR remains primarily (and unfortunately) a... (Review)
Review
Dysphonia is often blamed on laryngopharyngeal reflux (LPR) in the face of a normal flexible laryngoscopic examination. LPR remains primarily (and unfortunately) a diagnosis of exclusion rather than inclusion in the face of vague throat complaints and laryngeal signs attributed to reflux. LPR remains misdiagnosed and overdiagnosed as the cause of many identical, vague throat symptoms and laryngeal complaints. Despite LPR being commonly implicated as the cause of a myriad of nonspecific pharyngeal symptoms, LPR as a physiologic process is common. Whether or not it is a contributor to a patient's symptoms, especially dysphonia, is the focus of this article.
Topics: Diagnosis, Differential; Dysphonia; Humans; Laryngopharyngeal Reflux; Laryngoscopy; Pharyngeal Diseases; Stroboscopy; Vocal Cords
PubMed: 31088696
DOI: 10.1016/j.otc.2019.03.015 -
European Annals of Otorhinolaryngology,... Nov 2019
Topics: Acute Disease; Calcinosis; Diagnosis, Differential; Fever; Humans; Male; Middle Aged; Pharyngeal Diseases; Tendinopathy; Tomography, X-Ray Computed; Torticollis
PubMed: 31582331
DOI: 10.1016/j.anorl.2019.09.012 -
The Journal of Dermatology Nov 2019Palmoplantar pustulosis (PPP) is characterized by symmetrical, erythematous, scaly plaques, with numerous, sterile, non-bacterial, pinpoint pustules, which are... (Review)
Review
Palmoplantar pustulosis (PPP) is characterized by symmetrical, erythematous, scaly plaques, with numerous, sterile, non-bacterial, pinpoint pustules, which are restricted to the palms and soles. Because several reports have described the efficacy of tonsillectomy for improvement in PPP skin lesions, we consider that PPP is tonsil-induced autoimmune/inflammatory syndrome (TIAS) while other factors are also involved in the pathogenesis of PPP. Here, the association between PPP pathogenesis and TIAS was examined, with a focus on results of previous studies. PPP patients show a hyperimmune response to indigenous bacteria such as α-streptococci, due to impaired immunological tolerance towards such organisms. Such a novel immune response leads to T-cell activation through the abnormal expression of secondary stimulation molecules, including cytotoxic T-lymphocyte-associated antigen 4, inducible T-cell co-stimulator and Smad7, in the tonsils of PPP patients. Activated tonsillar T cells express cutaneous lymphocyte antigen (CLA), CCR6 and β1-integrin, enter the blood circulation and are recruited to PPP skin lesions. Within lesions, T cells roll onto endothelial cells through the interaction between CLA and E-selectin, migrate into the extravascular area through β1-integrin-vascular cell adhesion molecule 1 binding, and assemble in the skin through CCL20-CCR6 binding. Hyperimmune responses to autoantigens such as keratin and heat shock proteins could also be involved in PPP pathogenesis, through the stimulation of the T-helper 17 reaction.
Topics: Autoimmune Diseases; Humans; Palatine Tonsil; Pharyngeal Diseases; Psoriasis; Tonsillectomy
PubMed: 31556151
DOI: 10.1111/1346-8138.15100 -
The American Journal of Gastroenterology Sep 2022
Topics: Deglutition Disorders; Esophageal Diseases; Esophageal Sphincter, Upper; Humans; Muscular Diseases; Pharyngeal Diseases; Rare Diseases
PubMed: 35973172
DOI: 10.14309/ajg.0000000000001888 -
Journal of the American Academy of... Nov 2017Pityriasis rosea (PR) is an exanthematous disease associated with the endogenous systemic reactivation of human herpesvirus-6 (HHV-6) and human herpesvirus-7 (HHV-7)....
BACKGROUND
Pityriasis rosea (PR) is an exanthematous disease associated with the endogenous systemic reactivation of human herpesvirus-6 (HHV-6) and human herpesvirus-7 (HHV-7). Oropharyngeal lesions may be associated with the exanthema, but anecdotal evidence suggests that few dermatologists are aware of their occurrence.
OBJECTIVE
Classifying oropharyngeal lesions in PR, establishing their prevalence, and assessing their possible association with different PR forms.
METHODS
The records of all PR cases diagnosed in the Dermatology Clinic of Genoa University between 2003 and 2016 were retrospectively reviewed to examine sex and age of the patients, PR type, presence of enanthema, systemic symptoms, specific anti-HHV-6 and or HHV-7 serology, and HHV-6 and/or HHV-7 DNA loads.
RESULTS
The oropharyngeal mucosa was carefully examined in 527 patients with PR. Painless oropharyngeal lesions were observed in 149 patients with PR (28%) and classified as erythematomacular, macular and papular, erythematovesicular, and petechial lesions. The petechial and macular and papular patterns were those most frequently observed. There was no statistically significant difference in the levels of HHV-6 and HHV-7 viremia in the plasma of patients with enanthema and those without.
LIMITATIONS
Because this was a retrospective study, biopsies on mucosal lesions were not performed.
CONCLUSION
Our findings showed that enanthemas are frequently associated with forms of PR different from the classic form.
Topics: Adult; Age Distribution; Child; Child, Preschool; Cohort Studies; Female; Herpesvirus 6, Human; Herpesvirus 7, Human; Humans; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Pharyngeal Diseases; Pharynx; Pityriasis Rosea; Prevalence; Prognosis; Registries; Retrospective Studies; Risk Assessment; Sex Distribution
PubMed: 28728872
DOI: 10.1016/j.jaad.2017.06.033