BACKGROUND Chronic rhinitis, pharyngitis and sinusitis are common health problems with a significant impact on public health, and are suspected to be influenced by ageing factors. Nasal inhalation with thermal water may be used to reduce symptoms, inflammation and drug intake. A pre-post clinical study was conducted in 183 consecutive adult and elderly patients with chronic rhinitis, pharyngitis or sinusitis, to evaluate whether thermal water nasal inhalations could improve their symptoms, clinical signs and rhinomanometry measurements, and influence inflammatory biomarkers levels in nasal epithelial cells. RESULTS Participants profile revealed that they were aged on average (mean age and SD 60.6 ± 15.2 years, median 65, range 20-86, 86 aged ≤ 65 years (47%), 96 aged > 65 years (53%)) and extremely concerned about wellbeing. Older age was associated with better compliance to inhalation treatment. Total symptom and clinical evaluation scores were significantly ameliorated after treatment (p < 0.001), with no substantial difference according to age, while rhinomanometry results were inconsistent. Persistence of symptom improvement was confirmed at phone follow up 1 year later (n = 74). The training set of 48 inflammatory genes (40 patients) revealed a strong increase of CXCR4 gene expression after nasal inhalations, confirmed both in the validation set (143 patients; 1.2 ± 0.68 vs 3.3 ± 1.2; p < 0.0001) and by evaluation of CXCR4 protein expression (40 patients; 1.0 ± 0.39 vs 2.6 ± 0.66; p < 0.0001). CXCR4 expression was consistently changed in patients with rhinitis, pharyngitis or sinusitis. The increase was smaller in current smokers compared to non-smokers. Results were substantially unchanged when comparing aged subjects (≥ 65 years) or the eldest quartile (≥ 71 years) to the others. Other genes showed weaker variations (e.g. FLT1 was reduced only in patients with sinusitis). CONCLUSIONS These results confirm the clinical impact of thermal water nasal inhalations on upper respiratory diseases both in adults and elders, and emphasize the role of genes activating tissue repair and inflammatory pathways. Future studies should evaluate CXCR4 as possible therapeutic target or response predictor in patients with chronic rhinitis, pharyngitis or sinusitis. TRIAL REGISTRATION Communication to Italian Ministry of Health - ICPOM 000461. Registered 10/11/2014.

中文翻译：

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CXCR4基因和蛋白在成人和老年慢性鼻炎、咽炎或鼻窦炎患者热水鼻吸入中的表达。

背景技术慢性鼻炎、咽炎和鼻窦炎是常见的健康问题，对公众健康有重大影响，怀疑受衰老因素影响。用热水鼻吸入可用于减轻症状、炎症和药物摄入。对 183 名患有慢性鼻炎、咽炎或鼻窦炎的成人和老年患者进行了一项前后临床研究，以评估热水鼻吸入是否可以改善他们的症状、临床体征和鼻测压测量，并影响鼻上皮细胞中的炎症生物标志物水平. 结果 参与者概况显示，他们的平均年龄（平均年龄和 SD 60.6 ± 15.2 岁，中位数 65，范围 20-86，86 岁≤65 岁（47%），96 岁 > 65 岁（53%））和极端关心幸福。年龄越大对吸入治疗的依从性越好。治疗后总症状和临床评估评分显着改善（p < 0.001），根据年龄没有显着差异，而鼻测压结果不一致。1 年后通过电话随访确认症状持续改善（n = 74）。48 个炎症基因（40 名患者）的训练集显示鼻吸入后 CXCR4 基因表达显着增加，这在验证集（143 名患者；1.2 ± 0.68 对 3.3 ± 1.2；p < 0.0001）和 CXCR4 评估中均得到证实蛋白表达（40 名患者；1.0 ± 0.39 对 2.6 ± 0.66；p < 0.0001）。CXCR4 表达在鼻炎、咽炎或鼻窦炎患者中持续变化。与非吸烟者相比，当前吸烟者的增幅较小。将年龄较大的受试者（≥ 65 岁）或年龄最大的四分位数（≥ 71 岁）与其他受试者进行比较时，结果基本不变。其他基因表现出较弱的变异（例如 FLT1 仅在鼻窦炎患者中减少）。结论 这些结果证实了热水鼻吸入对成人和老年人上呼吸道疾病的临床影响，并强调了基因激活组织修复和炎症途径的作用。未来的研究应评估 CXCR4 作为慢性鼻炎、咽炎或鼻窦炎患者可能的治疗靶点或反应预测因子。试用注册 与意大利卫生部的通讯 - ICPOM 000461。注册于 2014 年 10 月 11 日。其他基因表现出较弱的变异（例如 FLT1 仅在鼻窦炎患者中减少）。结论 这些结果证实了热水鼻吸入对成人和老年人上呼吸道疾病的临床影响，并强调了基因激活组织修复和炎症途径的作用。未来的研究应评估 CXCR4 作为慢性鼻炎、咽炎或鼻窦炎患者可能的治疗靶点或反应预测因子。试用注册 与意大利卫生部的通讯 - ICPOM 000461。注册于 2014 年 10 月 11 日。其他基因表现出较弱的变异（例如 FLT1 仅在鼻窦炎患者中减少）。结论 这些结果证实了热水鼻吸入对成人和老年人上呼吸道疾病的临床影响，并强调了基因激活组织修复和炎症途径的作用。未来的研究应评估 CXCR4 作为慢性鼻炎、咽炎或鼻窦炎患者可能的治疗靶点或反应预测因子。试用注册 与意大利卫生部的通讯 - ICPOM 000461。注册于 2014 年 10 月 11 日。并强调基因激活组织修复和炎症通路的作用。未来的研究应评估 CXCR4 作为慢性鼻炎、咽炎或鼻窦炎患者可能的治疗靶点或反应预测因子。试用注册 与意大利卫生部的通讯 - ICPOM 000461。注册于 2014 年 10 月 11 日。并强调基因激活组织修复和炎症通路的作用。未来的研究应评估 CXCR4 作为慢性鼻炎、咽炎或鼻窦炎患者可能的治疗靶点或反应预测因子。试用注册 与意大利卫生部的通讯 - ICPOM 000461。注册于 2014 年 10 月 11 日。