1. Hot topics in Section’s area

The importance of the ENT Section in the scientific achievements of EAACI grows each year. Membership of the ENT section has been rising steadily from 221 in Amsterdam to 302 in Gothenburg. As many as 49 countries were represented, with Belgium, Turkey, Germany, Sweden, The Netherlands and Spain having between 15 and 30 members each. The ENT Section of EAACI is rapidly catching up on size of Dermatology section. The ENT Section is one of the co-founders of the European Otorhinolaryngology Academy.

During the ENT business meeting in Göteborg 2007, the election of the ENT Section Board 2007-9 including Glenis Scadding as chairperson and Livije Kalogjera as secretary was confirmed, Peter Hellings, Claus Bachert, Kees Van Drunen and Carlos Nunes were elected as members at large and Michael Rudenko as JMA representative.

The ENT Section board for 2007-9 is as follows:

The ENT section works in collaboration with GA2LEN - the Global Allergy and Asthma European Network, is a consortium of leading European research centres specialized in allergic diseases, which include asthma.

Hot topics of ENT science:

• upper and lower airways interaction
• viral infection and upper-lower airways hyperreactivity(www.who.int/entity/respiratory/gard/events/Interairways.pdf)
• bacterial superantigens
• phenotypes in chronic rhinosinusitis/nasal polyposis (is nasal polyposis part of CRS or is it disease per se)
• non-allergic rhinitis - diagnosis and treatment
• neurogenic inflammation
• reflexes the role of transient receptor potential cation channels
• patophysiology of olfaction* what is the correlation of subjective scores and objective findings (endoscopy, CT, parameters of inflammation) in rhinitis and rhinosinusitis
• proteomics and genomics
• sublingual immunotherapy and T regulatory cells in rhinitis

• Fast facts in rhinitis – Glenis Scadding & Wytske Fokkens
  A handbook covering allergic and non- allergic rhinitis plus rhinosinusitis and nasal polyposis. Published by Health Press , UK, 2007
• Paediatric ENT - John Graham, Glenis Scadding and Peter Ball. The first comprehensive textbook covering the whole of paediatric upper respiratory tract disorders. Published by Springer, 2007

An update of EP³OS has also been made by a committee involving members of the ENT section. It was published in 2007 in the June issue of Rhinology as a supplement and with a review in Allergy. The section members are grateful to an unrestricted grant from Schering Plough of 130,000 Euros to enable this activity.

The EAACI Position Paper on Rhinosinusitis and Nasal Polyps is available online (http://www.eaaci.net/media/PDF/R/Rhinosinusitis and nasal Polyps (complete doc).pdf).

Members of EAACI ENT section are involved in GA2LEN ENT projects like "Rhinosinusitis and nasal polyps", SANAS, and "HANNA", as well as GAARD.

The Sinusitis Cohort study aims to integrate ENT-specialists on a large pan-European scale into the GA²LEN network in collaboration with internal medicine, pneumologists and allergologists. The main objective of this project is to characterize patients with upper airway disease on the basis of clinical parameters, infectious agents, inflammatory mechanisms and remodeling processes. This collaborative research will result in better knowledge on patient phenotypes, pathomechanisms, and subtypes in chronic rhinosinusitis.

The goal of this cross-sectional multi-centre study is to have 800 patients and 200 controls included in the study. For all patients, blood samples will be collected and mucosal tissue will be gathered if surgery is planned independently from this study, resulting in a biobank. The collection of clinical information, blood, nasal secretions and sinus tissue samples has already resulted in an actual patient file and tissue database of approximately 250 patients and 60 tissue samples.

This WP represents the following members:

• Ghent University, Belgium : Claus Bachert, Nicholas Van Bruaene
• Academic Medical Center, Amsterdam, The Netherlands: Wytske Fokkens, Kees Van Drunen
• Charité, Berlin, Germany: Heidi Olze
• Hospital Clinic, IDIBAPS, Barcelona: Joaquim Mullol
• Helsinki University Hospital, Finland: Elina Toskala-Hannikainen
• Karolinska Institutet, Stockholm, Sweden: Lars-Olaf Cardell
• University College, London, United Kingdom: Valerie Lund, Glenis Scadding
• Imperial College, London, United Kingdom: Stephen Durham
• CMUJ Cracow, Poland: Andrej Szecklik, Monika Swierczynska, Ewa Nizankowska-Mogilnicka
• University of Lodz, Poland: Marek Kowalski, Magdalena Arcimowicz

The work package is structured in scientific modules. This comprises a basic module on parameters of mucosal inflammation, which will be available for all partners together with clinical data. In addition, several additional modules are active on T-regulatory cells, chemokines and adhesion molecules, remodelling in CRS with and without polyps, Staphylococcus aureus and the super-antigen linked inflammation, and genetic analyses, including a candidate gene and a whole genome scan approach, as well as the analysis of blood parameters. Based on these modules, a collaborative paper on the needs for research in the area of rhinosinusitis is currently being developed, called “Research perspectives and targets in chronic rhinosinusitis”. This paper summarizes the state-of-art on chronic rhinosinusitis and nasal polyposis, specifying what the current knowledge is in different aspects of the disease. It defines any potential gaps in the current research, and points to future research perspectives and targets.

The SANAS consortium (symptomatic and asymptomatic subjects with sensitization to Parietaria and birch pollen) aims to understand why some individuals with a proven sensitization for an allergen display allergic symptoms, while others do not. If we could identify the process that suppresses the allergic symptoms then new treatment option could be developed that specifically target this process. Two main candidates have been identified: (1) mast cell activity and (2) regulatory T lymphocytes. The SANAS consortium is composed of two groups of clinical institutes. One group in the South of Europe that focuses on Parietaria and one group in Mid and Northern Europe that focuses on Birch. Together with central laboratories in Berlin, Ghent, Paris, and Amsterdam different parameters related to mast cell activity and regulatory T lymphocytes will be measured and compared between symptomatic and asymptomatic individuals.

This WP represents the following members:

• Academic Medical Center, the Netherlands: Wytske Fokkens, Kees van Drunen
• Charité, Berlin, Germany: Marcus Maurer
• Consiglio Nazionale delle Ricerche, Palermo, Italy: Paolo Colombo
• Ghent University, Belgium : Claus Bachert, Nicholas Van Bruaene
• Institut Pasteur, Paris, France: Marc Daeron
• National and Kapodistrian University of Athens, Greece: Nikolaos Papadopoulos
• National Hospital, Oslo, Norway: Kai-Hkon Carlsen
• Padiglione Maragliano, Genoa, Italy: Giovanni Passalacqua
• University of Lodz, Poland: Marek Kowalski
• University de Coimbra, Coimbra, Portugal: Ana Todo-Bom

4. Related Tips and Resources
see EPOS 2007.

5. Related Upcoming events and postgraduate courses within the next year
In the forthcoming EAACI meeting in Barcelona 2008 symposia, MS1, MS2, MS3 and Practical courses have been planed.

Main Symposia

• Main Symposium - Phenotyping Chronic Rhinosinusitis
  on Monday, 9 June 2008 from 10:30 – 12:00
• Main Symposium - New Therapeutic Approaches to Nasal Polyps
  on Monday, 9 June 2008 from 15:30 – 17:00
• Main Symposium -Nose and Ear
  on Tuesday, 10 June 2008 from 10:30 to 12:00

Practical Courses

• Practical Course - Ear, Nose & Throat at a Glance: Rhinoscopy, Radiology, Nitric oxide, Rinomanometry, Endoscopy
  on Monday, 9 June 2008 from 13:30 – 15:00
  The ENT Section Business meeting will include a debate between Claus Bachert and Glenis Scadding on antibiotics in chronic rhinosinusitis.

Future EAACI congresses will be held as follows:

EAACI 2008 Barcelona
EAACI 2009 Warsaw
EAACI 2010 London
EAACI 2011 Istanbul

Members of the section are warmly invited to attend further meetings:

• European Rhinologic Society meeting (ERS-ISIAN) Crete, Greece June 2008
• 7th Symposium on Experimental Rhinology and Immunology of the Nose (SERIN) which is being organised by ENT section of EAACI (Livije Kalogjera presenting the Local organising committee), from 13 to 15 November 2008 in hotel "Excelsior" Dubrovnik, Croatia.
  The ENT section has received a grant from EAACI of 50.000 Euro for the SERIN meeting. JMA travel grants for SERIN in Dubrovnik are available for active participants from the JMA group, depending to other resources there may be up to 30 travel grants of 500 Eur.

SERIN meeting is a plenary meeting, so, oral presentations for young researchers will be fewer than on the meetings with parallel sessions. However, poster sessions and discussions of active JMA participants and senior colleagues and experts in the field, are planned, as well as short presentation of JMA posters selected according to their scientific contribution. The main topics of the meeting will include basic and clinical research on allergic and non-allergic rhinitis, rhino-sinusitis, nasal polyps, upper-lower airways interaction (infection, allergy, hyperreactivity), neurogenic inflammation, brain-nose axis, olfaction, neural regulation, novel approach to treatment of rhinosinusal disease, genomics and proteomics. Recent revisions of EAACI position papers (EPOS 2007 and ARIA 2008) will be presented

SERIN is expected to have a lot of JMA members and young researchers’ presentations. The link to SERIN 2008 web page will be available at EAACI ENT section website (www.hdorl.net/serin2008).

6. Relevant must read papers

Safety and efficacy of fluticasone furoate in pediatric patients with perennial allergic rhinitis.
Máspero JF, Rosenblut A, Finn A Jr, Lim J, Wu W, Philpot E. Otolaryngol Head Neck Surg. Fundacion CIDEA, Allergy and Respiratory Research Unit, Buenos Aires, Argentina. 2008 Jan;138(1):30-7

Fluticasone furoate: intranasal use in allergic rhinitis.
McCormack PL, Scott LJ. Wolters Kluwer Health | Adis, Auckland, New Zealand. demail@adis.co.nz Drugs. 2007;67(13):1905-15.

Omalizumab is more effective than suplatast tosilate in the treatment of Japanese cedar pollen-induced seasonal allergic rhinitis.
Nagakura T,Ogino S, Okubo K, Sato N, Takahashi M, Ishikawa T. The Allergy and Internal Medicine, Yoga Allergy Clinic, Tokyo, Japan. nagakura@yg-allergy.com Clin Exp Allergy. 2008 Feb;38(2):329-37. Epub 2007 Dec 7.

Histamine and leukotriene receptor antagonism in the treatment of allergic rhinitis : an update.
Van Hoecke H, Vandenbulcke L, Van Cauwenberge P. Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium. Drugs. 2007; (18):2717-26.

Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis: a randomized controlled trial.
Williamson IG, Rumsby K, Benge S,Moore M, Smith PW, Cross M, Little P. Department of Medicine, University of Southampton, Southampton, England. igw@soton.ac.uk

Onset and duration of action of nasal sprays in seasonal allergic rhinitis patients: olopatadine hydrochloride versus mometasone furoate monohydrate.
Patel D, Garadi R, Brubaker M, Conroy JP, Kaji Y, Crenshaw K, Whitling A, Wall GM. Allied Research International, Inc., Mississauga, Ontario, Canada.

7. Important relevant research centers across Europe

• Pan-European Organisations
• National Organisations

8. Task forces and other scientific activities of the group in question

The taskforce of the ENT section on rhinosinusitis, called EPOS document (European position paper on rhinosinusitis and nasal polyps, first version 2005), is available on http://www.rhinologyjournal.com/epos2007/epos.pdf, and the document contains algorithms for rhino-sinusitis and nasal polyps diagnostics and treatment, and another revision is expected in 2009.
"Tools and methods in the diagnosis and investigation of rhinitis and rhinosinusitis" is another approved taskforce directed by Joaquim Mullol.

New EAACI ENT members including junior members are very welcome.

ENT Board 2007-2009

Contact information

Website of EAACI ENT section: http://www.eaaci.net/site/content.php?l1=91&sel=223

Website of EAACI Junior members: http://www.eaaci.net/site/content.php?l1=201