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Published in: Current Allergy and Asthma Reports 4/2017

01-04-2017 | Rhinosinusitis (J Mullol, Section Editor)

Impact of Respiratory Virus Infections in Exacerbation of Acute and Chronic Rhinosinusitis

Authors: Kai Sen Tan, Yan Yan, Hsiao Hui Ong, Vincent T. K. Chow, Li Shi, De-Yun Wang

Published in: Current Allergy and Asthma Reports | Issue 4/2017

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Abstract

Rhinosinusitis (RS) is a symptomatic disease classification of many causes and is a major economic burden worldwide. It is widely accepted that RS is further classified into acute (ARS) and chronic (CRS) rhinosinusitis based on the duration of the symptoms, and that viral infection plays a large role in initiating or potentiating the disease. In this review, we examine the role of respiratory virus infection in the exacerbation of ARS and CRS. We explore the epidemiology of viral exacerbation of ARS and CRS and highlight key viruses that may cause exacerbation. We also review the current understanding of viral infections in the upper airway to further explain the putative underlying mechanisms of inflammatory events in ARS and CRS exacerbation. Advances in accurate diagnosis of the etiologic respiratory viruses of ARS and CRS symptoms which can lead to better disease management are also surveyed. In addition to the current treatments which provide symptomatic relief, we also explore the potential of harnessing existing antiviral strategies to prevent ARS and CRS exacerbation, especially with improved viral diagnostic tools to guide accurate prescription of antivirals against causative respiratory viruses.
Literature
1.
go back to reference •• Hoggard M, Wagner Mackenzie B, Jain R, et al. Chronic rhinosinusitis and the evolving understanding of microbial ecology in chronic inflammatory mucosal disease. Clin Microbiol Rev. 2017;30:321–48. This review summarizes the current stage of understanding in the role of viruses in CRS and the current gaps in identifying the viral diversity in CRS microbiome CrossRefPubMed •• Hoggard M, Wagner Mackenzie B, Jain R, et al. Chronic rhinosinusitis and the evolving understanding of microbial ecology in chronic inflammatory mucosal disease. Clin Microbiol Rev. 2017;30:321–48. This review summarizes the current stage of understanding in the role of viruses in CRS and the current gaps in identifying the viral diversity in CRS microbiome CrossRefPubMed
2.
go back to reference •• Fokkens WJ, Lund VJ, Mullol J, et al. European position paper on rhinosinusitis and nasal polyps 2012. Rhinology Suppl. 2012;23:1–298. This article is the keynote article on rhinosinusitis and includes the latest understanding, mechanisms, findings, diagnosis and management of ARS and CRS •• Fokkens WJ, Lund VJ, Mullol J, et al. European position paper on rhinosinusitis and nasal polyps 2012. Rhinology Suppl. 2012;23:1–298. This article is the keynote article on rhinosinusitis and includes the latest understanding, mechanisms, findings, diagnosis and management of ARS and CRS
3.
go back to reference Li C, Shi L, Yan Y, et al. Gene expression signatures: a new approach to understanding the pathophysiology of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2013;13:209–17.CrossRefPubMed Li C, Shi L, Yan Y, et al. Gene expression signatures: a new approach to understanding the pathophysiology of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2013;13:209–17.CrossRefPubMed
4.
go back to reference •• Eloy P, Poirrier AL, De Dorlodot C, et al. Actual concepts in rhinosinusitis: a review of clinical presentations, inflammatory pathways, cytokine profiles, remodeling, and management. Curr Allergy Asthma Rep. 2011;11:146–62. This review summarizes the current understanding of ARS and CRS mechanism of exarcerbation, immune cells’ roles and profiles and the role of different microbes in the exacerbation CrossRefPubMed •• Eloy P, Poirrier AL, De Dorlodot C, et al. Actual concepts in rhinosinusitis: a review of clinical presentations, inflammatory pathways, cytokine profiles, remodeling, and management. Curr Allergy Asthma Rep. 2011;11:146–62. This review summarizes the current understanding of ARS and CRS mechanism of exarcerbation, immune cells’ roles and profiles and the role of different microbes in the exacerbation CrossRefPubMed
5.
go back to reference Wang DY, Wardani RS, Singh K, et al. A survey on the management of acute rhinosinusitis among Asian physicians. Rhinology. 2011;49:264–71.PubMed Wang DY, Wardani RS, Singh K, et al. A survey on the management of acute rhinosinusitis among Asian physicians. Rhinology. 2011;49:264–71.PubMed
6.
go back to reference Hamilos DL. Chronic rhinosinusitis: epidemiology and medical management. J Allergy Clin Immunol. 2011;128:693–707.CrossRefPubMed Hamilos DL. Chronic rhinosinusitis: epidemiology and medical management. J Allergy Clin Immunol. 2011;128:693–707.CrossRefPubMed
7.
go back to reference Shi JB, Fu QL, Zhang H, et al. Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy. 2015;70:533–9.CrossRefPubMedPubMedCentral Shi JB, Fu QL, Zhang H, et al. Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy. 2015;70:533–9.CrossRefPubMedPubMedCentral
8.
go back to reference Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe--an underestimated disease. A GA(2)LEN study. Allergy. 2011;66:1216–23.CrossRefPubMed Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe--an underestimated disease. A GA(2)LEN study. Allergy. 2011;66:1216–23.CrossRefPubMed
9.
go back to reference Orlandi RR, Kingdom TT, Hwang PH, et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol. 2016;6(Suppl 1):S22–209.CrossRefPubMed Orlandi RR, Kingdom TT, Hwang PH, et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol. 2016;6(Suppl 1):S22–209.CrossRefPubMed
10.
go back to reference Yan Y, Gordon WM, Wang DY. Nasal epithelial repair and remodeling in physical injury, infection, and inflammatory diseases. Curr Opin Otolaryngol Head Neck Surg. 2013;21:263–70.CrossRefPubMed Yan Y, Gordon WM, Wang DY. Nasal epithelial repair and remodeling in physical injury, infection, and inflammatory diseases. Curr Opin Otolaryngol Head Neck Surg. 2013;21:263–70.CrossRefPubMed
11.
go back to reference •• Vareille M, Kieninger E, Edwards MR, Regamey N. The airway epithelium: soldier in the fight against respiratory viruses. Clin Microbiol Rev. 2011;24:210–29. This review comprehensively covers the role of airway epithelial in responses against invading pathogen, and is used to reinforce the understanding of nasal antiviral immune responses in leading to ARS and CRS exacerbation CrossRefPubMedPubMedCentral •• Vareille M, Kieninger E, Edwards MR, Regamey N. The airway epithelium: soldier in the fight against respiratory viruses. Clin Microbiol Rev. 2011;24:210–29. This review comprehensively covers the role of airway epithelial in responses against invading pathogen, and is used to reinforce the understanding of nasal antiviral immune responses in leading to ARS and CRS exacerbation CrossRefPubMedPubMedCentral
12.
go back to reference • Braciale TJ, Sun J, Kim TS. Regulating the adaptive immune response to respiratory virus infection. Nat Rev Immunol. 2012;12:295–305. This review covers the comprehensive overview of innate and adaptive antiviral immune responses against respiratory viruese in the lungs; which were used as a basis to reinforce the understanding of nasal antiviral immune responses CrossRefPubMedPubMedCentral • Braciale TJ, Sun J, Kim TS. Regulating the adaptive immune response to respiratory virus infection. Nat Rev Immunol. 2012;12:295–305. This review covers the comprehensive overview of innate and adaptive antiviral immune responses against respiratory viruese in the lungs; which were used as a basis to reinforce the understanding of nasal antiviral immune responses CrossRefPubMedPubMedCentral
13.
go back to reference Deng Y, Yan Y, Tan KS, et al. MicroRNA-146a induction during influenza H3N2 virus infection targets and regulates TRAF6 levels in human nasal epithelial cells (hNECs). Exp Cell Res. 2017;352:184–92.CrossRefPubMed Deng Y, Yan Y, Tan KS, et al. MicroRNA-146a induction during influenza H3N2 virus infection targets and regulates TRAF6 levels in human nasal epithelial cells (hNECs). Exp Cell Res. 2017;352:184–92.CrossRefPubMed
14.
go back to reference •• Yan Y, Tan KS, Li C, et al. Human nasal epithelial cells derived from multiple subjects exhibit differential responses to H3N2 influenza virus infection in vitro. J Allergy Clin Immunol. 2016;138:276–81. This article provides the pathogenesis of influenza A virus and the mechanism of innate antiviral responses in the nasal epithelium to reinforce the understanding of respiratory viruses’ role in leading to ARS and CRS exacerbation CrossRefPubMed •• Yan Y, Tan KS, Li C, et al. Human nasal epithelial cells derived from multiple subjects exhibit differential responses to H3N2 influenza virus infection in vitro. J Allergy Clin Immunol. 2016;138:276–81. This article provides the pathogenesis of influenza A virus and the mechanism of innate antiviral responses in the nasal epithelium to reinforce the understanding of respiratory viruses’ role in leading to ARS and CRS exacerbation CrossRefPubMed
15.
go back to reference Mahdavinia M, Keshavarzian A, Tobin MC, et al. A comprehensive review of the nasal microbiome in chronic rhinosinusitis (CRS). Clin Exp Allergy. 2016;46:21–41.CrossRefPubMedPubMedCentral Mahdavinia M, Keshavarzian A, Tobin MC, et al. A comprehensive review of the nasal microbiome in chronic rhinosinusitis (CRS). Clin Exp Allergy. 2016;46:21–41.CrossRefPubMedPubMedCentral
16.
go back to reference Tacon CE, Wiehler S, Holden NS, et al. Human rhinovirus infection up-regulates MMP-9 production in airway epithelial cells via NF-kappaB. Am J Respir Cell Mol Biol. 2010;43:201–9.CrossRefPubMed Tacon CE, Wiehler S, Holden NS, et al. Human rhinovirus infection up-regulates MMP-9 production in airway epithelial cells via NF-kappaB. Am J Respir Cell Mol Biol. 2010;43:201–9.CrossRefPubMed
17.
go back to reference Othumpangat S, Regier M, Piedimonte G. Nerve growth factor modulates human rhinovirus infection in airway epithelial cells by controlling ICAM-1 expression. Am J Physiol Lung Cell Mol Physiol. 2012;302:L1057–66.CrossRefPubMedPubMedCentral Othumpangat S, Regier M, Piedimonte G. Nerve growth factor modulates human rhinovirus infection in airway epithelial cells by controlling ICAM-1 expression. Am J Physiol Lung Cell Mol Physiol. 2012;302:L1057–66.CrossRefPubMedPubMedCentral
18.
go back to reference van Kempen M, Bachert C, Van Cauwenberge P. An update on the pathophysiology of rhinovirus upper respiratory tract infections. Rhinology. 1999;37:97–103.PubMed van Kempen M, Bachert C, Van Cauwenberge P. An update on the pathophysiology of rhinovirus upper respiratory tract infections. Rhinology. 1999;37:97–103.PubMed
19.
go back to reference Pawelczyk M, Kowalski ML. The role of human parainfluenza virus infections in the immunopathology of the respiratory tract. Curr Allergy Asthma Rep. 2017;17:16.CrossRefPubMed Pawelczyk M, Kowalski ML. The role of human parainfluenza virus infections in the immunopathology of the respiratory tract. Curr Allergy Asthma Rep. 2017;17:16.CrossRefPubMed
20.
go back to reference Bianco A, Whiteman SC, Sethi SK, et al. Expression of intercellular adhesion molecule-1 (ICAM-1) in nasal epithelial cells of atopic subjects: a mechanism for increased rhinovirus infection? Clin Exp Immunol. 2000;121:339–45.CrossRefPubMedPubMedCentral Bianco A, Whiteman SC, Sethi SK, et al. Expression of intercellular adhesion molecule-1 (ICAM-1) in nasal epithelial cells of atopic subjects: a mechanism for increased rhinovirus infection? Clin Exp Immunol. 2000;121:339–45.CrossRefPubMedPubMedCentral
21.
go back to reference Chuang CY, Kao CL, Huang LM, et al. Human bocavirus as an important cause of respiratory tract infection in Taiwanese children. J Microbiol Immunol Infect. 2011;44:323–7.CrossRefPubMed Chuang CY, Kao CL, Huang LM, et al. Human bocavirus as an important cause of respiratory tract infection in Taiwanese children. J Microbiol Immunol Infect. 2011;44:323–7.CrossRefPubMed
22.
go back to reference Cho GS, Moon BJ, Lee BJ, et al. High rates of detection of respiratory viruses in the nasal washes and mucosae of patients with chronic rhinosinusitis. J Clin Microbiol. 2013;51:979–84.CrossRefPubMedPubMedCentral Cho GS, Moon BJ, Lee BJ, et al. High rates of detection of respiratory viruses in the nasal washes and mucosae of patients with chronic rhinosinusitis. J Clin Microbiol. 2013;51:979–84.CrossRefPubMedPubMedCentral
23.
go back to reference Costa C, Garzaro M, Boggio V, et al. Detection of herpesviruses 1-6 and community-acquired respiratory viruses in patients with chronic rhinosinusitis with nasal polyposis. Intervirology. 2014;57:101–5.CrossRefPubMed Costa C, Garzaro M, Boggio V, et al. Detection of herpesviruses 1-6 and community-acquired respiratory viruses in patients with chronic rhinosinusitis with nasal polyposis. Intervirology. 2014;57:101–5.CrossRefPubMed
24.
go back to reference •• Ginocchio CC, Mc Adam AJ. Current best practices for respiratory virus testing. J Clin Microbiol. 2011;49(Suppl 9):44–8. This review conveyed the different viral diagnostic tools available that can be applied in the diagnosis of respiratory virus type in ARS and CRS exacerbations CrossRef •• Ginocchio CC, Mc Adam AJ. Current best practices for respiratory virus testing. J Clin Microbiol. 2011;49(Suppl 9):44–8. This review conveyed the different viral diagnostic tools available that can be applied in the diagnosis of respiratory virus type in ARS and CRS exacerbations CrossRef
25.
go back to reference McAdam AJ, Riley AM. Developments in tissue culture detection of respiratory viruses. Clin Lab Med. 2009;29:623–34.CrossRefPubMed McAdam AJ, Riley AM. Developments in tissue culture detection of respiratory viruses. Clin Lab Med. 2009;29:623–34.CrossRefPubMed
26.
go back to reference Landry ML. Developments in immunologic assays for respiratory viruses. Clin Lab Med. 2009;29:635–47.CrossRefPubMed Landry ML. Developments in immunologic assays for respiratory viruses. Clin Lab Med. 2009;29:635–47.CrossRefPubMed
27.
go back to reference Dunn JJ, Ginocchio CC. Can newly developed, rapid immunochromatographic antigen detection tests be reliably used for the laboratory diagnosis of influenza virus infections? J Clin Microbiol. 2015;53:1790–6.CrossRefPubMedPubMedCentral Dunn JJ, Ginocchio CC. Can newly developed, rapid immunochromatographic antigen detection tests be reliably used for the laboratory diagnosis of influenza virus infections? J Clin Microbiol. 2015;53:1790–6.CrossRefPubMedPubMedCentral
28.
go back to reference Selvarangan R, Abel D, Hamilton M. Comparison of BD Directigen EZ RSV and Binax NOW RSV tests for rapid detection of respiratory syncytial virus from nasopharyngeal aspirates in a pediatric population. Diagn Microbiol Infect Dis. 2008;62:157–61.CrossRefPubMed Selvarangan R, Abel D, Hamilton M. Comparison of BD Directigen EZ RSV and Binax NOW RSV tests for rapid detection of respiratory syncytial virus from nasopharyngeal aspirates in a pediatric population. Diagn Microbiol Infect Dis. 2008;62:157–61.CrossRefPubMed
30.
go back to reference Mahony JB, Petrich A, Smieja M. Molecular diagnosis of respiratory virus infections. Crit Rev Clin Lab Sci. 2011;48:217–49.CrossRefPubMed Mahony JB, Petrich A, Smieja M. Molecular diagnosis of respiratory virus infections. Crit Rev Clin Lab Sci. 2011;48:217–49.CrossRefPubMed
31.
go back to reference Chen MI, Barr IG, Koh GC, et al. Serological response in RT-PCR confirmed H1N1-2009 influenza a by hemagglutination inhibition and virus neutralization assays: an observational study. PLoS One. 2010;5:e12474.CrossRefPubMedPubMedCentral Chen MI, Barr IG, Koh GC, et al. Serological response in RT-PCR confirmed H1N1-2009 influenza a by hemagglutination inhibition and virus neutralization assays: an observational study. PLoS One. 2010;5:e12474.CrossRefPubMedPubMedCentral
32.
go back to reference Cruz AT, Cazacu AC, Greer JM, Demmler GJ. Performance of a rapid assay (Binax NOW) for detection of respiratory syncytial virus at a children’s hospital over a 3-year period. J Clin Microbiol. 2007;45:1993–5.CrossRefPubMedPubMedCentral Cruz AT, Cazacu AC, Greer JM, Demmler GJ. Performance of a rapid assay (Binax NOW) for detection of respiratory syncytial virus at a children’s hospital over a 3-year period. J Clin Microbiol. 2007;45:1993–5.CrossRefPubMedPubMedCentral
33.
go back to reference Borek AP, Clemens SH, Gaskins VK, et al. Respiratory syncytial virus detection by Remel Xpect, Binax now RSV, direct immunofluorescent staining, and tissue culture. J Clin Microbiol. 2006;44:1105–7.CrossRefPubMedPubMedCentral Borek AP, Clemens SH, Gaskins VK, et al. Respiratory syncytial virus detection by Remel Xpect, Binax now RSV, direct immunofluorescent staining, and tissue culture. J Clin Microbiol. 2006;44:1105–7.CrossRefPubMedPubMedCentral
34.
go back to reference Chan Y, Kuhn FA. An update on the classifications, diagnosis, and treatment of rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2009;17:204–8.CrossRefPubMed Chan Y, Kuhn FA. An update on the classifications, diagnosis, and treatment of rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2009;17:204–8.CrossRefPubMed
35.
go back to reference Dong G, Peng C, Luo J, et al. Adamantane-resistant influenza a viruses in the world (1902-2013): frequency and distribution of M2 gene mutations. PLoS One. 2015;10:e0119115.CrossRefPubMedPubMedCentral Dong G, Peng C, Luo J, et al. Adamantane-resistant influenza a viruses in the world (1902-2013): frequency and distribution of M2 gene mutations. PLoS One. 2015;10:e0119115.CrossRefPubMedPubMedCentral
37.
go back to reference • Hayden FG. Advances in antivirals for non-influenza respiratory virus infections. Influenza Other Respir Viruses. 2013;7(Suppl 3):36–43. This review covers the types of treatments available for non-influenza rspiratory viral infections CrossRefPubMed • Hayden FG. Advances in antivirals for non-influenza respiratory virus infections. Influenza Other Respir Viruses. 2013;7(Suppl 3):36–43. This review covers the types of treatments available for non-influenza rspiratory viral infections CrossRefPubMed
38.
go back to reference •• Ison MG. Antiviral treatments. Clin Chest Med. 2017;38:139–53. This review comprehensively covers current available antiviral drugs against respiratory viral infections CrossRefPubMed •• Ison MG. Antiviral treatments. Clin Chest Med. 2017;38:139–53. This review comprehensively covers current available antiviral drugs against respiratory viral infections CrossRefPubMed
40.
go back to reference Sugrue RJ. Interactions between respiratory syncytial virus and the host cell: opportunities for antivirus strategies? Expert Rev Mol Med. 2006;8:1–17.CrossRefPubMed Sugrue RJ. Interactions between respiratory syncytial virus and the host cell: opportunities for antivirus strategies? Expert Rev Mol Med. 2006;8:1–17.CrossRefPubMed
42.
go back to reference Kiso M, Takahashi K, Sakai-Tagawa Y, et al. T-705 (favipiravir) activity against lethal H5N1 influenza A viruses. Proc Natl Acad Sci U S A. 2010;107:882–7.CrossRefPubMed Kiso M, Takahashi K, Sakai-Tagawa Y, et al. T-705 (favipiravir) activity against lethal H5N1 influenza A viruses. Proc Natl Acad Sci U S A. 2010;107:882–7.CrossRefPubMed
43.
go back to reference Baranovich T, Wong SS, Armstrong J, et al. T-705 (favipiravir) induces lethal mutagenesis in influenza A H1N1 viruses in vitro. J Virol. 2013;87:3741–51.CrossRefPubMedPubMedCentral Baranovich T, Wong SS, Armstrong J, et al. T-705 (favipiravir) induces lethal mutagenesis in influenza A H1N1 viruses in vitro. J Virol. 2013;87:3741–51.CrossRefPubMedPubMedCentral
44.
go back to reference Belser JA, Lu X, Szretter KJ, et al. DAS181, a novel sialidase fusion protein, protects mice from lethal avian influenza H5N1 virus infection. J Infect Dis. 2007;196:1493–9.CrossRefPubMed Belser JA, Lu X, Szretter KJ, et al. DAS181, a novel sialidase fusion protein, protects mice from lethal avian influenza H5N1 virus infection. J Infect Dis. 2007;196:1493–9.CrossRefPubMed
45.
go back to reference Moss RB, Hansen C, Sanders RL, et al. A phase II study of DAS181, a novel host directed antiviral for the treatment of influenza infection. J Infect Dis. 2012;206:1844–51.CrossRefPubMedPubMedCentral Moss RB, Hansen C, Sanders RL, et al. A phase II study of DAS181, a novel host directed antiviral for the treatment of influenza infection. J Infect Dis. 2012;206:1844–51.CrossRefPubMedPubMedCentral
46.
go back to reference DeVincenzo JP, Whitley RJ, Mackman RL, et al. Oral GS-5806 activity in a respiratory syncytial virus challenge study. N Engl J Med. 2014;371:711–22.CrossRefPubMed DeVincenzo JP, Whitley RJ, Mackman RL, et al. Oral GS-5806 activity in a respiratory syncytial virus challenge study. N Engl J Med. 2014;371:711–22.CrossRefPubMed
47.
go back to reference Mackman RL, Sangi M, Sperandio D, et al. Discovery of an oral respiratory syncytial virus (RSV) fusion inhibitor (GS-5806) and clinical proof of concept in a human RSV challenge study. J Med Chem. 2015;58:1630–43.CrossRefPubMed Mackman RL, Sangi M, Sperandio D, et al. Discovery of an oral respiratory syncytial virus (RSV) fusion inhibitor (GS-5806) and clinical proof of concept in a human RSV challenge study. J Med Chem. 2015;58:1630–43.CrossRefPubMed
48.
go back to reference Wang G, Deval J, Hong J, et al. Discovery of 4′-chloromethyl-2′-deoxy-3′,5′-di-O-isobutyryl-2′-fluorocytidine (ALS-8176), a first-in-class RSV polymerase inhibitor for treatment of human respiratory syncytial virus infection. J Med Chem. 2015;58:1862–78.CrossRefPubMed Wang G, Deval J, Hong J, et al. Discovery of 4′-chloromethyl-2′-deoxy-3′,5′-di-O-isobutyryl-2′-fluorocytidine (ALS-8176), a first-in-class RSV polymerase inhibitor for treatment of human respiratory syncytial virus infection. J Med Chem. 2015;58:1862–78.CrossRefPubMed
49.
go back to reference DeVincenzo J, Cehelsky JE, Alvarez R, et al. Evaluation of the safety, tolerability and pharmacokinetics of ALN-RSV01, a novel RNAi antiviral therapeutic directed against respiratory syncytial virus (RSV). Antivir Res. 2008;77:225–31.CrossRefPubMed DeVincenzo J, Cehelsky JE, Alvarez R, et al. Evaluation of the safety, tolerability and pharmacokinetics of ALN-RSV01, a novel RNAi antiviral therapeutic directed against respiratory syncytial virus (RSV). Antivir Res. 2008;77:225–31.CrossRefPubMed
Metadata
Title
Impact of Respiratory Virus Infections in Exacerbation of Acute and Chronic Rhinosinusitis
Authors
Kai Sen Tan
Yan Yan
Hsiao Hui Ong
Vincent T. K. Chow
Li Shi
De-Yun Wang
Publication date
01-04-2017
Publisher
Springer US
Published in
Current Allergy and Asthma Reports / Issue 4/2017
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-017-0693-2

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