Additive Effect of Blood and Tissue Eosinophilia on Chronic Rhinosinusitis With Nasal Polyps

Abstract

Purpose

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly heterogeneous disease with varied clinical features and treatment effects. This study aimed to investigate the additive effect of blood and tissue eosinophilia on patients with CRSwNP.

Methods

Based on the blood eosinophil (Beos) count and tissue eosinophil (Teos) count, we divided 144 CRSwNP patients into four groups, analysed their clinical features and histopathologic changes, and investigated their postoperative control.

Results

Patients in the Beos⁺Teos⁺ (blood eosinophil count > 0.3 × 10⁹/L, tissue eosinophil count > 10/HPF) group had a higher incidence of allergic rhinitis (AR) and asthma. Lund-Mackay (LM) scores, hyposmia visual analogue scale (VAS) scores and Global Osteitis Scoring Scale (GOSS) scores were higher in the Beos⁺Teos⁺ group than those in the other groups. Tissue remodelling, such as connective tissue oedema and basement membrane thickening was more severe in the Beos⁺Teos⁺ group compared with other groups. There were more uncontrolled patients after surgery in Beos⁺Teos⁺, Beos⁺Teos⁻ (blood eosinophil count > 0.3 × 10⁹/L, tissue eosinophil count ≤ 10/HPF)and Beos⁻Teos⁺ (blood eosinophil count ≤ 0.3 × 10⁹/L, tissue eosinophil count > 10/HPF)groups compared with the Beos⁻Teos⁻ group.

Conclusions

Eosinophilic inflammation both in blood and tissue was accompanied by more severe clinical features and tissue remodelling. Eosinophilia in blood or tissue indicated poorer disease control after surgery.