{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:15:46Z","timestamp":1788552946790,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T00:00:00Z","timestamp":1476748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Finnish Defense Forces"},{"name":"Medical Research Foundation of the University of Oulu"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To illuminate the pathophysiology of acute rhinosinusitis (ARS) with sequential monitoring of inflammatory biomarkers during an ARS episode and to clarify their diagnostic usability in bacterial ARS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Inception cohort study with 50 conscripts with ARS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected peripheral blood high\u2010sensitive C\u2010reactive protein (hs\u2010CRP), white blood cell (WBC), procalcitonin, and nasal nitric oxide (nNO) counts at 2 to 3 and 9 to 10 days of symptoms during an ARS episode. We simultaneously gathered various clinical parameters and microbiological samples. Bacterial ARS was confirmed with a positive culture of sinus aspirate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Reciprocal correlations and a significant change in biomarker levels between the two visits suggest that ARS involves a local and systemic inflammatory response that was strongest at 2 to 3 days. High\u2010sensitive CRP and nNO reflected responses best (52% had increased CRP levels at 2\u20133 days; 66% had decreased nNO levels). White blood cell and procalcitonin counts rarely exceeded the reference range. Increased local and systemic inflammatory response were linked to multiple, adenoviral, or influenza A viral etiology or the detection of bacterial ARS. Local response correlated with imaging findings of wide paranasal sinus involvement and ostiomeatal complex occlusion. At 9 to 10 days, elevated (\u2265 11 mg\/L) and moderately elevated (\u2265 49 mg\/L) hs\u2010CRP predicted bacterial ARS well (likelihood ratio [LR]+ 3.3 and LR+ 15.8, respectively), but the sensitivity for both findings remained low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acute rhinosinusitis (particularly bacterial ARS) involves a local and systemic inflammatory response that is strongest at the beginning of symptoms. Elevated hs\u2010CRP supports the diagnosis of bacterial ARS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 2016 127:E55\u2013E61, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26344","type":"journal-article","created":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T06:04:16Z","timestamp":1476770656000},"source":"Crossref","is-referenced-by-count":19,"title":["Longitudinal analysis of inflammatory biomarkers during acute rhinosinusitis"],"prefix":"10.1002","volume":"127","author":[{"given":"Timo J.","family":"Autio","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Oulu University Hospital Oulu Finland"},{"name":"PEDEGO Research Unit University of Oulu Oulu Finland"},{"name":"Medical Research Center Oulu Oulu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Koskenkorva","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Oulu University Hospital Oulu Finland"},{"name":"PEDEGO Research Unit University of Oulu Oulu Finland"},{"name":"Medical Research Center Oulu Oulu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomo K.","family":"Leino","sequence":"additional","affiliation":[{"name":"Air Force Command Finland Finnish Defense Forces Tikkakoski Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petri","family":"Koivunen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Oulu University Hospital Oulu Finland"},{"name":"PEDEGO Research Unit University of Oulu Oulu Finland"},{"name":"Medical Research Center Oulu 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