CRS is disabling and is associated with high direct and indirect costs, yet little is known about the epidemiology, etiologic heterogeneity, and individual and societal burden. There is a substantial gap in understanding how to frame research needs for CRS and improve patient outcomes. This project will complete a large-scale epidemiologic study of CRS by leveraging the unique data and population assets of the Geisinger Clinic, including a primary care population of 400,000 patients in over 30 counties in Pennsylvania. We will combine longitudinal self-reported and electronic health record data with new clinical and research measurements to address gaps in understanding. While relatively little is known about the natural history of CRS, it is clear that: many patients in the general population have nasal and sinus symptoms;some of these patients are diagnosed with allergic rhinitis or episodes of ARS (symptoms for 7d to 4wk, to eliminate patients with the common cold);some of these patients progress to CRS with symptoms present for at least 12 weeks;many patients with CRS have episodes of exacerbations, with a prominent worsening of symptoms over the baseline;many patients, especially those seen in tertiary centers, have recalcitrant CRS;and the natural history must include some therapeutic and probably spontaneous remissions. The incidence, prevalence, transition rates, and risk factors for each ofthe steps in the framework are not well known. Since relatively little research exists in population-based samples, it is likely that most studies have focused on patients who have failed therapy, the recalcitrant group. In the proposed research, we will estimate CRS prevalence, incidence, and remission using clinically validated criteria for general population samples that represent the full spectrum of CRS;describe patterns of CRS exacerbation and remission and the factors that explain variability;determine how CRS with and without nasal polyps cases differ from each other;evaluate a variety of community environmental risk factors for CRS using existing geospatial data on key environmental conditions;and estimate the direct and indirect costs of CRS.

Public Health Relevance

Chronic rhinosinusitis is a common condition that can cause severe symptoms in patients. It involves inflammation ofthe paranasal sinuses that results in facial pain/pressure, nasal and sinus drainage, smell loss, and nasal obstruction. Little is known however about how many people have the condition, who gets it, why they get it, and the best ways to treat it. The proposed research will address many of these issues.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Program--Cooperative Agreements (U19)
Project #
5U19AI106683-02
Application #
8713925
Study Section
Special Emphasis Panel (ZAI1)
Project Start
Project End
Budget Start
2014-08-01
Budget End
2015-07-31
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Northwestern University at Chicago
Department
Type
DUNS #
City
Chicago
State
IL
Country
United States
Zip Code
Rosati, Mariel G; Peters, Anju T (2016) Relationships among allergic rhinitis, asthma, and chronic rhinosinusitis. Am J Rhinol Allergy 30:44-7
Tan, Bruce K; Klingler, Aiko I; Poposki, Julie A et al. (2016) Heterogeneous inflammatory patterns in chronic rhinosinusitis without nasal polyps in Chicago, Illinois. J Allergy Clin Immunol :
Stevens, Whitney W; Schleimer, Robert P (2016) Aspirin-Exacerbated Respiratory Disease as an Endotype of Chronic Rhinosinusitis. Immunol Allergy Clin North Am 36:669-680
Stevens, Whitney W; Schleimer, Robert P; Kern, Robert C (2016) Chronic Rhinosinusitis with Nasal Polyps. J Allergy Clin Immunol Pract 4:565-72
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Poposki, Julie A; Keswani, Anjeni; Kim, Julie K et al. (2016) Tissue proteases convert CCL23 into potent monocyte chemoattractants in patients with chronic rhinosinusitis. J Allergy Clin Immunol 137:1274-1277.e9
Jairaman, Amit; Maguire, Chelsea H; Schleimer, Robert P et al. (2016) Allergens stimulate store-operated calcium entry and cytokine production in airway epithelial cells. Sci Rep 6:32311
Schleimer, Robert P; Schnaar, Ronald L; Bochner, Bruce S (2016) Regulation of airway inflammation by Siglec-8 and Siglec-9 sialoglycan ligand expression. Curr Opin Allergy Clin Immunol 16:24-30
Divekar, Rohit; Hagan, John; Rank, Matthew et al. (2016) Diagnostic Utility of Urinary LTE4 in Asthma, Allergic Rhinitis, Chronic Rhinosinusitis, Nasal Polyps, and Aspirin Sensitivity. J Allergy Clin Immunol Pract 4:665-70
Bose, Sumit; Grammer, Leslie C; Peters, Anju T (2016) Infectious Chronic Rhinosinusitis. J Allergy Clin Immunol Pract 4:584-9

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