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    Early life risk factors for chronic sinusitis: A longitudinal birth cohort study

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    Author
    Chang, Eugene H.
    Stern, Debra A.
    Willis, Amanda L.
    Guerra, Stefano
    Wright, Anne L.
    Martinez, Fernando D.
    Affiliation
    Univ Arizona, Dept Otolaryngol
    Univ Arizona, Asthma & Airway Dis Res Ctr
    Issue Date
    2018-04
    Keywords
    Sinusitis
    asthma
    allergy
    viral
    natural history
    
    Metadata
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    Publisher
    MOSBY-ELSEVIER
    Citation
    Chang, E. H., Stern, D. A., Willis, A. L., Guerra, S., Wright, A. L., & Martinez, F. D. (2018). Early life risk factors for chronic sinusitis: A longitudinal birth cohort study. Journal of Allergy and Clinical Immunology, 141(4), 1291-1297.
    Journal
    JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
    Rights
    © 2018 American Academy of Allergy, Asthma & Immunology
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Background: Chronic sinusitis is a commonly diagnosed condition in adults who frequently present with late-stage disease and irreversible changes to the sinus mucosa. Understanding the natural history of chronic sinusitis is critical in developing therapies designed to prevent or slow the progression of disease. Objective: We sought to determine early life risk factors for adult sinusitis in a longitudinal cohort study (Tucson Children's Respiratory Study). Methods: Physician-diagnosed sinusitis was reported at age 6. Adult sinusitis between 22 and 32 years was defined as self-reported sinusitis plus physician-ordered sinus radiologic films. Atopy was assessed by skin prick test. Individuals were grouped into 4 phenotypes: no sinusitis (n = 621), transient childhood sinusitis only (n = 57), late-onset adult sinusitis only (n = 68), and early onset chronic sinusitis (childhood and adult sinusitis, n = 26). Results: Sinusitis was present in 10.8% of children and 12.2% of adults. Childhood sinusitis was the strongest independent risk factor for adult sinusitis (odds ratio = 4.2; 95% CI: 2.5-7.1; P < .0001; n = 772). Early onset chronic sinusitis was associated with increased serum IgE levels as early as at 9 months of age, atopy (assessed by skin prick test reactivity), childhood eczema and allergic rhinitis, frequent childhood colds, maternal asthma, and with increased prevalence of concurrent asthma. No association was found between late-onset adult sinusitis and any of the early life risk factors studied. Conclusions: We identified an early onset chronic sinusitis phenotype associated with a predisposition to viral infections/colds in early life, allergies, and asthma. Elucidation of the molecular mechanisms for this phenotype may lead to future therapies to prevent the progression of the disease into adult sinusitis.
    Note
    12 month embargo; published online: 21 February 2018
    ISSN
    00916749
    PubMed ID
    29355680
    DOI
    10.1016/j.jaci.2017.11.052
    Version
    Final accepted manuscript
    Sponsors
    National Institutes of Health [NIH-R01 HL 132523]
    Additional Links
    http://linkinghub.elsevier.com/retrieve/pii/S0091674918300800
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jaci.2017.11.052
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