Judy Fan

All Publications

• Blood IgE and Eosinophils are not Reliable Predictors of Nasal Tissue Eosinophils in Chronic Rhinosinusitis with Nasal Polyposis. International archives of otorhinolaryngology Fan, J., Daniels, W., Pascual, A., Ryu, C., Sarafan, M., Tepedino, M. S., Voegels, R. L., Fornazieri, M. A., Sin, D., Pezato, R., Thamboo, A. 2025; 29 (2): 1-5

  Abstract

  Introduction  Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a chronic inflammatory condition of the paranasal sinuses that is mainly associated with type-2 inflammation. Immunoglobulin E (IgE) and eosinophils in blood and nasal tissue have been suggested as biomarkers for the prognosis and severity of CRSwNP as well as indications for biological treatment. Objective  The present study aims to assess the relationships between blood IgE concentration, blood eosinophil count, and nasal polyp eosinophil count in CRSwNP patients. Methods  The present study is retrospective. Nasal polyps from CRSwNP patients (n = 73) were fixed and embedded in paraffin for hematoxylin and eosin stain. Blood was collected to measure IgE concentration and eosinophil count. Results  Weak correlations were found between blood and tissue eosinophil counts ( p  = 0.004, r = 0.367) as well as blood IgE concentration and blood eosinophil count ( p  = 0.007, r = 0.372). There was no statistically significant correlation between blood IgE concentration and tissue eosinophil count. When dividing patients based on nasal polyp eosinophil count, blood eosinophil level was higher in the severely eosinophilic group than in the mildly eosinophilic group ( p  = 0.002). Conclusion  Blood IgE and eosinophils are not reliable biomarkers to predict the inflammatory condition in CRSwNP. Further research is needed on the clinical roles of these biomarkers.

  View details for DOI 10.1055/s-0044-1801316

  View details for PubMedID 40291367

  View details for PubMedCentralID PMC12020605

• SinoNasal Microbiota Transfer to treat recalcitrant chronic rhinosinusitis: A case series. International forum of allergy & rhinology Gill, S. K., Hernaiz-Leonardo, J. C., Edens, T. J., Pascual, A., Tang, C., Fan, J., Thamboo, A., Mullings, W., Alsaleh, S., Alim, B. M., Javer, A. R., Manges, A. R. 2024

  Abstract

  SinoNasal Microbiota Transfer (SNMT) was safe with immediate benefit in all recipients, with sustained improvement in two of three recipients for up to 180 days. The addition of antimicrobial photodynamic therapy worsened chronic rhinosinusitis. These promising SNMT results warrant further study of safety and efficacy.

  View details for DOI 10.1002/alr.23352

  View details for PubMedID 38616557

• Development and validation of the Sinonasal Endoscopic Score (SiNES) for chronic rhinosinusitis. Rhinology Hernaiz-Leonardo, J. C., Alim, B. M., Pascual, A., Aldossari, K., Fan, J., Alsaleh, S., Javer, A. R. 2024

  Abstract

  Although there are several endoscopic grading systems for chronic rhinosinusitis (CRS), they are limited in their range and applicability. We developed a SiNonasal Endoscopic Score (SiNES) that builds upon the strengths of previous systems while addressing their limitations.The SiNES system was developed by consensus after multiple rounds of guided discussions. Face, content, and convergent validity were investigated. It was validated using an independent sample of 79 CRS individuals from two referral centres from September 2021 to February 2022. Each patient underwent a sinonasal endoscopy and filled PROM questionnaires. Three independent rhinologists graded endoscopic videos using the SiNES and modified Lund-Kennedy (MLK) scores. Inter-rater and test-retest reliability were assessed via the intraclass correlation coefficient (ICC). SiNES and MLK scores were correlated with PROMs using a Spearman correlation and canonical correlation analysis (CCA).The SiNES system evaluates five anatomical spaces regarding edema, discharge, and scarring. Face, content, and convergent validity were deemed satisfactory by the study authors and an independent panel of Otolaryngologists. Inter-rater reliability was excellent for the SiNES and good for the MLK score. Test-retest reliability was excellent for both systems. Total SiNES was correlated with self-reported smell loss.The SiNES system is an accurate and reliable grading framework applicable to all CRS subtypes. It can be utilized in clinical and research settings and improves upon previously published systems.

  View details for DOI 10.4193/Rhin23.434

  View details for PubMedID 38598348

• Comparison between upper and lower airway microbiome profiles in chronic rhinosinusitis patients. International forum of allergy & rhinology Hernaiz-Leonardo, J. C., Ryu, C., Pascual, A., Fan, J., Caray, M., Pezato, R., Yang, J., Sin, D., Thamboo, A. 2024

  Abstract

  Dysregulation of the airway microbiota is thought to contribute to airway inflammation in both chronic rhinosinusitis (CRS) and asthma. However, the relationship between the upper and lower airway microbiome remains unclear.Sinus and lung brushes were collected from 29 CRS participants undergoing sinus surgery. DNA was extracted and submitted for 16s rRNA microbiome sequencing. Alpha and beta diversity metrics, taxonomic composition, and differences between individual taxa were compared for paired sinus and bronchial samples.Twenty-three out of 29 participants had sufficient samples for analysis. The mean (standard deviation) age was 51.59 (14.57) years, and 10 (44%) patients were female. Twelve (52%) patients had comorbid asthma. Sinus brushes had significantly higher alpha diversity indexes (Shannon and Faith) compared to bronchial brushes (p < 0.001). Beta diversity metrics were significantly different between the sinus and bronchial samples. Principal coordinate analysis showed no clustering of paired nasal and bronchial samples. Sinus brushes had significantly more Lawsonella, Corynebacterium, and Staphylococcus compared to bronchia brushes, while the latter were enriched in Tropheryma and Sphingomonas, among others (false discovery rate [FDR]-adjusted p < 0.01). Finally, CRS patients with comorbid asthma had significantly higher Pseudomonas and Peptoniphilus in sinus brushes and lower Prevotella in bronchial brushes when compared to non-asthmatics (FDR-adjusted p < 0.01).The sinus and bronchial bacterial microbiomes differ in important ways. Our study suggests that migration of bacteria from the sinus into the lower airways is unlikely in patients with CRS.

  View details for DOI 10.1002/alr.23335

  View details for PubMedID 38343306

• The efficacy of silastic sheet nasal splints in endoscopic nasal septal repair surgery: a prospective, randomized, single-blinded controlled trial INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY Alasousi, F., Fan, J., Pascual, A., Hernaiz-Leonardo, J., Javer, A. R. 2021; 11 (9): 1381-1383

  View details for DOI 10.1002/alr.22791

  View details for Web of Science ID 000630773700001

  View details for PubMedID 33742768

• Anatomic Sphenoid Cell Variants: Introduction of the Retrosphenoid Cell and Relevance in the Presentation and Management of Sinus Disease AMERICAN JOURNAL OF RHINOLOGY & ALLERGY Dadgostar, A., Hashmi, A., Fan, J., Javer, A. R. 2020; 34 (2): 170-175

  View details for DOI 10.1177/1945892419881837

  View details for Web of Science ID 000491430500001

  View details for PubMedID 31623450