HYGIENE  ENDOTOXIN  EARLY INTERVENTION  CHILDHOOD ASTHMA  INNER CITY ASTHMA  RHINOSINUSITIS  NATURAL HISTORY Andrew H. Liu, M.D. Staff Contact in association with:

click to enlarge Rhinosinusitis is common in children, especially those with recurrent wheezing problems such as asthma. For many older children with rhinosinusitis, their sinus pathology is similar to that seen in adults with hyperplastic sinusitis: eosinophilic inflammation and tissue remodeling. In younger children, however, the picture is typically different. We have had a multi-disciplinary pediatric sinus clinic at The Children's Hospital in Denver (with Dr. Kenny Chan, Director and ENT Division Head, and Dr. Mark Abzug, Infectious Diseases). We have found that younger children comprise most children seen with chronic or recurrent rhinosinusitis. We have been the first to report that younger children with chronic rhinosinusitis have pathologically different sinus tissue when compared with the adult hyperplastic form of this disease: click to enlarge click to enlarge Chronic sinusitis pathology in young children (vs. adults) characterized by: Pan-immune inflammation Lack of eosinophilic inflammation Lack of epithelial desquamation Lack of basement membrane thickening Lack of mucous gland hypertrophy and hyperplasia LiuLab publications Review: Chan KH, Abzug MJ, Fakhri S, Hamid QA, Liu AH. "Sinusitis in Children," in Pediatric Allergy: Principles & Practice, 1st ed. Leung DYM ed. Elsevier (2003), pp. 309-20. Article: Chan/Liu J Pediatr 2004: first report that, in younger children with chronic rhinosinusitis, tissue pathology differs from that seen in older children and adults Related Hygiene Hypothesis — Nature's Immunotherapy for allergies & asthma? Endotoxin, a prototypical microbial exposure in health and disease Natural history of allergies & asthma in childhood Early Intervention for allergies & asthma Coming Paper on immune characterization of sinus tissue in young children with chronic sinusitis