Mengyu Chen MD , Zhaofeng Xu MD , Yiwei Fu MD , Nan Zhang MD, PhD , Wendong Liu MD , Lishuo Shi PhD , Tong Lu PhD , Zhengqi Li PhD , Zhaoxu Tu PhD , Jian Li MD , Claus Bachert MD, PhD , Weiping Wen MD , Yihui Wen MD
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引用次数: 0
Abstract
Background
Chronic rhinosinusitis with nasal polyp (CRSwNP) is classified into type 2 and non-type 2 inflammation based on mucosal cytokine level. For 20 years, the type 2/non-type 2 ratio has increased, potentially influenced by air pollution and aeroallergens.
Objective
To investigate the association between long-term exposure to air pollutants and aeroallergens and the endotype shift in CRSwNP.
Methods
We enrolled 2358 patients with CRSwNP from Guangzhou and 416 from Ghent. Endotypes were defined using a diagnostic model or interleukin 5 levels in nasal polyps. Pollutant exposure was estimated based on residential ZIP code. Generalized additive models with restricted cubic splines and generalized linear mixed models were used to assess the effects of particulate matters (PMs) less than or equal to 2.5 µm, PM less than or equal to 10 µm, nitrogen dioxide, sulfur dioxide, ozone, and aeroallergen exposure on type 2 CRSwNP risk compared with non-type 2.
Results
Higher air pollutant exposure was linked to a lower type 2/non-type 2 ratio. In Guangzhou, every 1 μg/m3 increase in 3-year cumulative PMs less than or equal to 2.5 µm exposure was associated with an odds ratio of 0.97 (95% CI: 0.96-0.98, P < .001) for type 2 CRSwNP. In Ghent, the relative risk was 0.78 (95% CI: 0.65-0.94, P = .009) for the same exposure increase. Elevated total IgE and Dermatophagoides pteronyssinus sensitization increase type 2 risk than non-type 2 CRSwNP in Guangzhou, whereas allergic rhinitis, elevated total IgE, pollen sensitization, and multi-allergen sensitization increased type 2 CRSwNP risk in Ghent.
Conclusion
Decreasing long-term air pollution exposure and increasing allergen sensitization are associated with higher type 2/non-type 2 CRSwNP ratio, highlighting the role of environmental factors in endotype shifting.
Trial Registration
Chinese Clinical Trial Registry Identifier: ChiCTR2400082123.
期刊介绍：
Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.
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