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    Local allergic rhinitis – a narrative review
    (Verduci Editore s.r.l, 2024) Manole, F.; Muluk, N.B.; Oğuz, O.; Ulusoy, S.; Scadding, G.K.; Prokopakis, E.; Kalogjera, L.
    This narrative review aims to provide an up-to-date definition of local allergic rhinitis (LAR), its classification, mechanisms, comorbidities, recommendations for diagnosis and treatment, and define needs in this area. Both ‘PubMed’ and ‘Science Direct’ literature was reviewed systematically, and a manual search for studies not previously encountered in the databases was also carried out. Published studies were identified in PubMed covering the period from 1947 to 2022. The following keyword search strategy was used: (local allergic rhinitis* OR entopy* OR local Immunoglobulin E * OR nasal specific Immunoglobulin E). LAR involves Type 2 nasal inflammation with local IgE and cannot be diagnosed by systemic methods, such as skin prick or blood IgE tests. A nasal allergen challenge is necessary for diagnosis. LAR can respond to usual AR treatments, including allergen specific immunotherapy (AIT). LAR is a novel entity that requires additional investigation in terms of prevalence, proper diagnosis, treatment, and prognosis. The target outcomes and possible benefits of this review are to achieve a consensus for the study and diagnosis of LAR and increase interest in this area. © 2024 Verduci Editore s.r.l. All rights reserved.
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    Localization of T cells and subtypes in the paranasal sinus and turbinate mucosa in patients with chronic sinusitis
    (B C Decker Inc, 2004) Muluk, N.B.; Koc, C.; Atasoy, P.
    The aim of this study was to quantitate total T lymphocytes (total CD3+ cells) and T-lymphocyte subtypes (CD4+ [T helper] and CD8+ [T suppressor] cells) in patients with chronic sinusitis, who were treated with functional endoscopic sinus surgery (FESS) and to investigate the pathophysiology of persistent inflammation in chronic sinusitis. This prospective study was conducted in study and control groups. The study group consisted of 32 patients (20 male, 12 female) with chronic sinusitis who underwent FESS. The control group consisted of 8 nonsinusitis patients (5 male, 3 female) who underwent septoplasty. Specimens from the study group were excised from five regions: the uncinate process, maxillary and ethmoid sinuses, and middle and inferior turbinates. The specimens were examined with x10 magnification by light microscopy, and the slides with a severe inflammatory process were included. Punch biopsy of the control group was taken from the inferior turbinate with patients' written approval. The surgical specimens from the study and control groups were examined with an immunohistochemical staining technique with monoclonal antibodies against CD3, CD4, and CD8 surface antigens of T lymphocytes. In every specimen, the numbers of CD3+, CD4+, and CD8+ cells were-calculated in 3 to 4 high magnification field on light microscopy, and the mean number of these cells in the epithelium, subepithelial layer of the lamina propria, and deep paraglandular layer of the mucosa was determined. Statistical analysis by Kruskal-Wallis analysis of variance and the Mann-Whitney U test with Bonferroni correction revealed that the CD3 epithelial layer value of the inferior turbinate (p = .030) and the CD4 deep layer value of the middle turbinate (p = .048) were significantly higher than the corresponding values of the control group. In the epithelial (p = .018) and subepithelial (p = .012) layers of the uncinate process group, in the epithelial (p = .050) and subepithelial (p = .012) layers of the ethmoid sinus group, and in the subepithelial (p = .018) and deep paraglandular (p = .012) layers of the middle, turbinate group, the difference between the CD4+ and CD8+ cell counts was found to be statistically significant by the Wilcoxon signed rank test. The number of CD4+ cells was higher than the number of CD8+ cells. In conclusion, T cells play a role in the pathophysiology of chronic sinusitis. CD4+ T helper cells, in particular, are predominant at the initiation and regulation of inflammation. The uncinate process, ethmoid sinus, and middle and inferior turbinates have the main roles by T cells and subtypes in the defense system in chronic sinusitis.
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    Minnesota Multiphasic Personality Inventory Profile of patients with allergic rhinitis
    (B C Decker Inc, 2003) Muluk, N.B.; Oguzturk, O.; Koc, C.; Ekici, A.
    The aim of this study was to investigate the relationship between allergic rhinitis and personality traits in a nonpsychiatric population of proven allergic status. Subjects were assigned to the allergic group (n = 29) and the nonallergic group (n = 29) on the basis of the medical examination, allergic prick tests, and self-reported allergic status. Analysis of Minnesota Multiphasic Personality Inventory Profile (MMPI) profiles showed that male subjects with allergic rhinitis had significantly higher scores on depression, paranoia, and social introversion. Depression, hypochondriasis, and hysteria scores were significantly higher in female subjects. It may be concluded that patients with allergic rhinitis have poorer psychological function compared with the nonallergic subjects.