Inflammatory endotype of odontogenic sinusitis

Authors

John R. Craig, Henry Ford HealthFollow
Xiangguo Dai, Henry Ford HealthFollow
Stacey M. Bellemore, Henry Ford HealthFollow
Kimberley J. Woodcroft, Henry Ford HealthFollow
Carl P. Wilson, Henry Ford HealthFollow
Christian Keller, Henry Ford HealthFollow
Kevin R. Bobbit, Henry Ford HealthFollow
Mayur Ramesh, Henry Ford HealthFollow

Recommended Citation

Craig JR, Dai X, Bellemore S, Woodcroft KJ, Wilson C, Keller C, Bobbitt KR, and Ramesh M. Inflammatory endotype of odontogenic sinusitis. Int Forum Allergy Rhinol 2022.

Document Type

Article

Publication Date

10-29-2022

Publication Title

Int Forum Allergy Rhinol

Abstract

BACKGROUND: Odontogenic sinusitis (ODS) is distinct from non-odontogenic rhinosinusitis with regard to clinical features as well as diagnostic and therapeutic approaches. While numerous studies have explored immune profiles of chronic rhinosinusitis, very few studies have explored the inflammatory endotype of ODS.

METHODS: Odontogenic sinusitis was diagnosed by confirming infectious sinusitis adjacent to infectious maxillary odontogenic pathology. Maxillary sinus cultures and mucosal biopsies were obtained during endoscopic endonasal surgery in ODS and control patients. Controls were patients undergoing endoscopic skull base surgery with no sinus disease. Specimens were snap frozen in liquid nitrogen and stored at -80°C. Analysis was performed using a multiplex assay to measure Th-1 (TNFα, IFNγ, IL-2,12,18), Th-2 (IL-4,5,9,13), Th-17 (IL-17A,17F,22), and innate (CCL5,CXCL9,CXCL10, IL-6,8,10,12,23,27) immune pathways. Groups were compared via independent sample t-tests; if assumptions were violated, nonparametric Wilcoxon ranked sum tests were performed.

RESULTS: Specimens from 22 ODS patients were compared to nine controls. ODS mucosal tissue was sampled in the setting of the following dental pathologies: post-dental extraction (n = 15), untreated apical periodontitis (n = 2), apical periodontitis after root canal therapy (n = 2), and maxillary sinus bone grafting with or without dental implantation (n = 3). The following cytokines were significantly elevated in ODS compared to controls: IFNγ, TNFα, IL-6, 8, 10, 27, and CXCL9. IL-17 levels were similar in both ODS and controls. Therefore, ODS demonstrated heightened innate and Th1 immune activity.

CONCLUSION: ODS demonstrated both innate immune and Th1 inflammatory endotypes. Further studies are needed to explore ODS immunopathobiology and its potential impact on ODS management.

PubMed ID

36308740

ePublication

ePub ahead of print