A breakthrough report published in the journal Rheumatic & Musculoskeletal Diseases Open, has shed light on the significant correlation between preceding sinusitis and increased occurrence of rheumatic diseases. This finding suggests a potential role for sinus inflammation in the development of these conditions, marking a crucial step forward in understanding their pathogenesis.
The comprehensive population-based case-control investigation led by Kronzer et al. encompassed individuals meeting rheumatic disease classification criteria spanning from 1995 to 2014. For each case identified, three controls were meticulously matched, resulting in a dataset comprising 1729 incident rheumatic disease cases and 5187 matched controls, with a mean age of 63 and 67% female representation, and a median electronic health record history spanning 14 years.
The researchers observed a notable increase in the risk for antiphospholipid syndrome (odds ratio [OR] 7.0, 95% confidence interval [CI] 1.8 to 27), Sjögren’s disease (OR 2.4, 95% CI 1.1 to 5.3), vasculitis (OR 1.4, 95% CI 1.1 to 1.9), and polymyalgia rheumatica (OR 1.4, 95% CI 1.0 to 2.0). Additionally, acute sinusitis demonstrated an elevated risk association with seronegative rheumatoid arthritis (RA) (OR 1.8, 95% CI 1.1 to 3.1). Sinusitis exhibited the strongest association with any rheumatic disease within 5-10 years preceding disease onset (OR 1.7, 95% CI 1.3 to 2.3). Individuals with seven or more sinusitis diagnostic codes were found to have the highest risk for developing rheumatic diseases (OR 1.7, 95% CI 1.3 to 2.4). The study also noted a crucial association between sinusitis and incident rheumatic diseases among non-smokers, with the highest point estimates observed (OR 1.7, 95% CI 1.3 to 2.2).
Research has consistently indicated a relation between upper respiratory tract ailments like sinusitis and increased susceptibility to both seropositive and seronegative RA. This correlation appears most robust during the 5–10 years preceding the onset of RA, with acute sinusitis demonstrating a fourfold increase in RA risk. This association finds plausibility in the established link between sinusitis and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Moreover, upper respiratory tract disorders have been implicated in the onset of myositis, as supported by existing literature. Additionally, infections have been linked to giant cell arteritis, Sjögren’s disease, and systemic lupus erythematosus.
The findings of the present study strongly suggest that sinusitis may indeed play a pivotal role in the development of rheumatic diseases. The study findings underscore the significance of sinusitis as a potential target for both preventive measures and treatment strategies in the realm of rheumatology. By recognizing the potential impact of sinus inflammation on the pathogenesis of these conditions, the new study may pave the way for innovative approaches aimed at mitigating the onset and progression of rheumatic diseases, thereby enhancing patient outcomes and quality of life.
Reference
Kronzer VL, Davis JM, Hanson AC, Sparks JA, Myasoedova E, Duarte-Garcia A, et al. Association between sinusitis and incident rheumatic diseases: a population-based study. RMD Open. 2024 Feb 22;10(1):e003622.