Evidence map›Paper›PMID 28132798›Full record

ArticleThe journal of allergy and clinical immunology. In practice

The Clinical Significance of Specific Antibody Deficiency (SAD) Severity in Chronic Rhinosinusitis (CRS).

Anjeni Keswani, Neha M Dunn, Angelica Manzur, Sara Kashani, Xavier Bossuyt, Leslie C Grammer, David B Conley, Bruce K Tan, Robert C Kern, Robert P Schleimer and 1 more

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Article in The journal of allergy and clinical immunology. In practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Primary Antibody Deficiency in Patients With Chronic Rhinosinusitis: A Call for Immunologic Evaluation Prior to Biologic Therapy.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2026
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  16. Diagnostic Vaccination in Clinical Practice.Frontiers in immunology · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Anjeni KeswaniDivision of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill. Electronic address: akeswani@mfa.gwu.edu.
Neha M DunnDivision of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Angelica ManzurDivision of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Sara KashaniDivision of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Xavier BossuytDepartment of Microbiology and Immunology, Experimental Laboratory Immunology, KU Leuven, Leuven, Belgium; Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
Leslie C GrammerDivision of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
David B ConleyDepartment of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Bruce K TanDepartment of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Robert C KernDepartment of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Robert P SchleimerDivision of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Anju T PetersDivision of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Northwestern University · USKU Leuven · BE

Funding

Systems Genetics Approach to Gene Discovery in Chronic RhinosinusitisU19AI106683 · NIAID · NORTHWESTERN UNIVERSITY AT CHICAGO · PI KERN, ROBERT C · 2014 to 2017
$7.9M
Glucocorticosteroid Action In Inflammatory DiseaseR37HL068546 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI SCHLEIMER, ROBERT P · 2009 to 2018
$3.5M
NHLBI NIH HHS R37 HL068546NIAID NIH HHS U19 AI106683
6 · The paper itself

Abstract

backgroundDespite the increased identification of specific antibody deficiency (SAD) in chronic rhinosinusitis (CRS), little is known about the relationship between SAD severity and the severity and comorbidities of CRS. The prevalence of an impaired antibody response in the general population is also unknown.

objectiveThe objective of this study was to determine if the SAD severity stratification applies to real-life data of patients with CRS.

methodsAn electronic health record database was used to identify patients with CRS evaluated for humoral immunodeficiency with quantitative immunoglobulins and Streptococcus pneumoniae antibody titers before and after pneumococcal vaccine. SAD severity was defined, according to the guidelines, based on the numbers of titers ≥1.3 μg/dL after vaccination: severe (≤2 serotypes), moderate (3-6 serotypes), and mild (7-10 serotypes). Comorbidities and therapeutic response were assessed. The prevalence of an impaired antibody response in a normal population was assessed.

resultsTwenty-four percent of the patients with CRS evaluated for immunodeficiency had SAD, whereas 11% of a normal population had an impaired immune response to polysaccharide vaccination (P < .05). When evaluated by the practice parameter definition, 239 of 595 (40%) met the definition of SAD. Twenty-four (10%) had severe SAD, 120 (50%) had moderate SAD, and 95 (40%) had mild SAD. Patients with moderate-to-severe SAD had worse asthma, a greater likelihood of pneumonia, and more antibiotic courses in the 2 years after vaccination than patients with mild SAD.

conclusionsThis study provides real world data supporting stratification of SAD by severity, demonstrating a significant increase in the comorbid severity of asthma and infections in CRS patients with moderate-to-severe SAD compared with those with mild SAD and those without SAD.

Indexed as

Immunologic Deficiency SyndromesRhinitisSinusitisAdolescentAdultAgedAged, 80 and overAntibodies, BacterialChronic DiseaseFemaleHumansImmunoglobulinsMaleMiddle AgedPneumococcal VaccinesSeverity of Illness IndexAntibodies, BacterialImmunoglobulinsPneumococcal VaccinesChronic rhinosinusitisImmune deficiencySpecific antibody deficiency

Identifiers

PMID28132798
PMCPMC5503775
OpenAlexW2011991479

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.