Otitis media with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is an autoimmune middle ear disease, which manifests as a subtype of ANCA-associated vasculitis (AAV). Approximately 60%, 20%, and 20% of the cases were MPO-ANCA-positive, PR3-ANCA-positive, and ANCA-negative, respectively. This article provides an overview of the current diagnostic and therapeutic approaches for OMAAV. The diagnostic criteria for AAV include the EMEA algorithm, Ministry of Health, Labour and Welfare diagnostic criteria, and 2022 ACR/EULAR classification criteria. However, the classification of MPO-ANCA-positive OMAAV cases remains challenging. Particularly, diagnosing cases that are ANCA-negative or limited to ear lesions without pulmonary or renal involvement is challenging, and applying the OMAAV diagnostic criteria is effective. For ANCA-negative cases, careful exclusion of differential diagnoses is essential, and diagnostic treatment with glucocorticoids (GC) may occasionally be considered based on the clinical response. According to standard AAV treatment protocols, remission induction with GC combined with rituximab or cyclophosphamide is recommended. In 2022, the introduction of avacopan, a selective C5a receptor inhibitor, offers benefits in reducing GC use and its associated side effects. Developing effective management strategies for OMAAV is crucial considering these diagnostic processes and treatment strategies.

Eosinophil extracellular trap cell death (EETosis) is characterized by the release of nuclear or mitochondrial DNA by eosinophils, forming complex structures with granular proteins to capture pathogens and modulate tissue damage. Recent findings have highlighted EETosis as a key mechanism in various pathological conditions, such as in excessive mucus formation and tissue injury in eosinophilic chronic rhinosinusitis, and its antitumor effects in diseases such as colorectal cancer. Additionally, the involvement of eosinophil-specific proteins, such as galectin-10 and Charcot-Leyden crystals, has garnered attention along with the development of cfDNA scavengers and the advent of single-cell RNA sequencing techniques, both of which are driving advances in understanding the molecular basis of EETosis and its regulatory pathways. This review provides an overview of the historical context, molecular mechanisms, and pathological significance of EETosis in diverse immune and inflammatory responses, including tumor immunity. Furthermore, the potential for novel therapeutic strategies targeting EETosis is discussed, shedding light on future directions for managing chronic inflammatory diseases and malignancies.

We report a case of chronic rhinosinusitis with nasal polyps (CRSwNP) that recurred after endoscopic nasal sinus surgery (ESS), resulting in postoperative recurrence, persistent nasal congestion, and olfactory dysfunction. Dupilumab—an anti-interleukin (IL)-4/13 monoclonal antibody (mAb)—is a promising therapeutic agent for such cases. We investigated the initiation and therapeutic effects of dupilumab in 30 patients with postoperative CRSwNP recurrence between July 2020 and June 2024, for whom dupilumab was considered appropriate. Among the 27 patients observed for more than six months, 17 underwent dupilumab treatment, 10 did not, and two of them opted for surgery during the follow-up period. In the dupilumab-treated group, the mean observation period was 31.1 months. Significant improvements were observed in the nasal polyp, nasal congestion, anosmia, postnasal drip, and self-administered odor question, as well as Lund-Mackay computed tomography score, at both 24 weeks and the final visit. Furthermore, dupilumab was associated with only minor complications and led to a reduction in the number of patients requiring oral corticosteroid therapy. In conclusion, dupilumab was highly effective improving both subjective symptoms and objective findings in patients with severe CRSwNP that recurred after ESS and may reduce dependence on systemic steroid. A literature review of related adverse events was also conducted.

We encountered cases of head and neck cancer with recurrent or distant metastases that responded well to long-term nivolumab treatment. In contrast, a certain number of cases had to discontinue treatment due to immune-related adverse events (irAEs) or other reasons. However, there have been few reports on the clinical course of such cases. Therefore, we retrospectively analyzed the treatment outcomes and clinical course of long-term nivolumab administration.

A total of 53 patients were included, with 16 undergoing long-term administration (more than one year). The 5-year overall survival (OS) rate for all patients was 27.3%, whereas the OS rate for long-term administration was significantly extended to 72.12%. Similarly, the 5-year progression-free survival (PFS) rate was 18.34% for all cases, whereas it was significantly higher (72.12%) in the long-term administration cases. The incidence of irAEs was higher in the long-term drug administration group. Additionally, 8 cases had to discontinue treatment for reasons other than disease progression, such as irAEs, with 6 of these cases being from the long-term administration group. In the long-term administration cases, all patients who discontinued treatment remained without disease progression for 4–40 months after discontinuation.

Furthermore, among the cases in which only part of the treatment target showed progression, three were judged to be eligible for local treatment. All three patients underwent local treatment and had a favorable prognosis.

These findings suggest that long-term administration is significantly associated with improved OS and PFS. Tumor shrinkage maintained over an extended period may reduce the likelihood of regrowth after treatment discontinuation. Additionally, in cases where only part of the treatment target shows progression and where local treatment is feasible, aggressive intervention may be a viable option.