establishment of IgG4-related rhinosinusitis as a new eitity

• Project/Area Number: 16K11217
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Otorhinolaryngology
• Research Institution: Tokyo Women's Medical University
• Principal Investigator: nonaka manabu 東京女子医科大学, 医学部, 教授 (70271351)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2016: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
• Keywords: 慢性鼻副鼻腔炎 / IgG4関連疾患 / クラススイッチ / 慢性副鼻腔炎 / 耳鼻咽喉科

Outline of Final Research Achievements

It is reported that IgG4related diseases often show nasal manifestations with chronic rhinosinisitis (CRS). Thus, this type of sinusitis may be a new clinical entity of nasal disease. Activation-induced cytidine deaminase (AID) is required for both class switch recombination (CSR) and somatic hypermutation (SHM). AID is expressed not only in lacrimal glands of IgG4 related diseases like Mikuliz’s disease (MD) but also in nasal mcosa of allergic rhinitis. We demonstrated that the expression of AID was significantly increased in sinus mucosa of IgG4-related disease patients with CRS as compared to controls. This implies that IgG4-related disease has distinctive CRS.

Academic Significance and Societal Importance of the Research Achievements

慢性鼻副鼻腔炎は，鼻閉，鼻漏，後鼻漏，嗅覚障害，頭重感などを主訴とし，Quality of Lifeを著しく低下させる。多くの原因で発症するmultifactorial diseaseで，副鼻腔局所の細菌感染のみを原因とする慢性化膿性鼻副鼻腔炎をはじめ，アスピリン過敏症と関連する鼻副鼻腔炎，気管支喘息と関連する鼻副鼻腔炎，アレルギ－性鼻炎と関連する鼻副鼻腔炎，真菌と関連する鼻副鼻腔炎，非アレルギ－性慢性下気道疾患 (びまん性汎気管支炎，慢性気管支炎，気管支拡張症，嚢胞性線維症)と関連する鼻副鼻腔炎などがある。今回の結果から新たにIgG4関連副鼻腔炎という独立した疾患概念が確立する可能性がある。