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CNAA / Theses / 2021 / June /

The impact of oxidative stress in the pathogenesis of chronic rhinosinusitis with nasal polyps


Author: Istratenco Ala
Degree:doctor of medicine
Speciality: 14.00.04 - Otorhinolaryngology
Year:2021
Scientific advisers: Vasile Cabac
doctor, associate professor (docent), Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Anatolie Vişnevschi
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 30 June, 2021
Approved by NCAA on the 4 October, 2021

Abstract

Adobe PDF document – 0.95 Mb / in romanian

Thesis

CZU 616.211/.216-002-006.5-036.12:612.015.39(043.2)

Adobe PDF document 6.04 Mb / in romanian
162 pages

Keywords

chronic rhinosinusitis with nasal polyps, nasal polyposis, oxidative stress, oxidants, antioxidants, proinflammatory cytokines, anti-inflammatory cytokines, endotype

Summary

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b>Structure of the thesis: introduction, 5 chapters, general conclusions and recommendations, bibliography with 239 references, 123 pages of the basic text, 30 tables, 39 figures and 7 annexes. The results of the research are presented in 14 scientific publications.

Aim of the study: Research on the involvement of oxidative stress (OS) and oxidative inflammation in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) in order to optimize the therapeutic attitude.

Objectives: Assessment of serum and sinonasal markers of OS, antioxidant system, nitric oxide derivatives (NOD) and pro- and anti-inflammatory cytokines; Estimation of clinical and functional manifestations, and quality of life of patients and their correlation with the markers of OS, antioxidant system, NOD and inflammatory pattern; Finding of the association between the inflammatory pattern and markers of OS, antioxidant system and NOD; Determination of the histopathological changes of the sinonasal mucosa and their correlation with the markers of OS, antioxidant system and the inflammatory pattern; Elucidation of the role of OS and inflammation in CRSwNP in order to optimize the therapeutic attitude.

Novelty and scientific originality: A complex retrospective-prospective case-control study was performed to establish the impact of OS and oxidative inflammation in the pathogenesis of CRSwNP including the elucidation of the correlation between OS, antioxidant system, NOD, the inflammatory pattern and clinical and functional aspects, and quality of life of patients. It was established the predominant endotype of CRSwNP for the first time in the Republic of Moldova by evaluating serum and tissue cytokine profile and by quantifying the histopathological aspects of the sinonasal mucosa.

Scientific problem solved in the respective field. The study demonstrated the impact of OS and oxidative inflammation on the pathogenesis of CRSwNP. The type of predominant inflammation was established, respectively the predominant endotype for the Republic of Moldova, which is of interest in therapeutic strategies and the prognosis of recurrences.

The theoretical significance of the study. The study represents an important scientific support, which opens ways towards new research directions in the field, related to the diagnosis of CRS endotypes and the targeted drug treatment of patients with CRSwNP.

Applicative value of the study. The research results will be used in the planning of measures for the prophylaxis of CRSwNP recurrences, as well as the optimal therapeutic management of patients with CRSwNP and comorbidities, which induce "difficulty to treat".

Scientific results are implementedin the activity of otorhinolaryngologists from ENT (Ear Nose Throat) departments and consultative offices, providing methodological support in the treatment of patients with CRSwNP, as well as in the didactic activity of the Department of Otorhinolaryngology of State University of Medicine and Pharmacy "Nicolae Testemitanu". Three acts of implementation of our results were recorded.