CCAD or eCRS: Defining Eosinophilic Subpopulations in Chronic Rhinosinusitis.

IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY American Journal of Rhinology & Allergy Pub Date : 2023-07-01 DOI:10.1177/19458924231155012
Andrea Sit, Raquel Alvarado, Peter Earls, Janet Rimmer, Larry Kalish, Raewyn Campbell, William Sewell, Richard J Harvey
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引用次数: 2

Abstract

Background: Central compartment atopic disease (CCAD) and eosinophilic chronic rhinosinusitis (eCRS) are two clinical phenotypes of primary diffuse type 2 chronic rhinosinusitis (CRS) defined in the European Position Paper on Rhinosinusitis 2020 classification. Currently, the distinction between these subtypes relies on phenotypic features alone.

Objective: This study aimed to investigate whether eosinophil activation differed between CCAD and eCRS.

Methods: A cross-sectional study was conducted of adult patients presenting with CCAD and eCRS who had undergone functional endoscopic sinus surgery. Routine pathology results were obtained from clinical records. Eosinophils were counted on haematoxylin and eosin-stained formalin-fixed paraffin-embedded sinonasal tissue. Eotaxin-3, eosinophil peroxidase and immunoglobulin E levels were assessed using immunohistochemistry.

Results: 38 participants were included (51.7 ± 15.6 years, 47.4% female), of whom 36.8% were diagnosed with CCAD and 63.2% with eCRS. The eCRS group was characterised by older age (55.8 ± 16.3 vs 44.5 ± 11.8 years, p = 0.029), and on histology exhibited a higher degree of tissue inflammation (τb = 0.409, p = 0.011), greater proportion of patients with >100 eosinophils/high power field (87.5% vs 50%, p = 0.011), and higher absolute tissue eosinophil count (2141 ± 1947 vs 746 ± 519 cells/mm2, p = 0.013). Eotaxin-3 scores were higher in the eCRS group (5.00[5.00-6.00] vs 6.00[6.00-6.75], p= 0.015). Other outcomes were similar.

Conclusions: Eosinophil and eotaxin-3 levels were elevated in eCRS compared with CCAD, suggesting a greater degree of eosinophil stimulation and chemotaxis. Patients with CCAD were younger. Future investigation and biomarkers may better distinguish CRS subpopulations.

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CCAD或eCRS:定义慢性鼻窦炎嗜酸性粒细胞亚群。
背景:中央室特应性疾病(CCAD)和嗜酸性粒细胞性慢性鼻窦炎(eCRS)是欧洲鼻窦炎2020分类立场文件中定义的原发性弥漫性2型慢性鼻窦炎(CRS)的两种临床表型。目前,这些亚型之间的区别仅依赖于表型特征。目的:本研究旨在探讨CCAD与eCRS之间嗜酸性粒细胞激活是否存在差异。方法:一项横断面研究对CCAD和eCRS的成人患者进行了功能性内窥镜鼻窦手术。常规病理结果来源于临床记录。嗜酸性粒细胞计数的鼻窦组织的苏木精和伊红染色固定石蜡包埋福尔马林。免疫组化法检测Eotaxin-3、嗜酸性过氧化物酶和免疫球蛋白E水平。结果:纳入38例受试者(51.7±15.6岁,女性47.4%),其中36.8%诊断为CCAD, 63.2%诊断为eCRS。eCRS组的特点是年龄较大(55.8±16.3岁vs 44.5±11.8岁,p = 0.029),组织学上表现出较高的组织炎症程度(τb = 0.409, p = 0.011), >100嗜酸性粒细胞/高倍视野的患者比例较大(87.5% vs 50%, p = 0.011),组织嗜酸性粒细胞绝对计数较高(2141±1947 vs 746±519细胞/mm2, p = 0.013)。eCRS组Eotaxin-3评分较高(5.00[5.00-6.00]vs 6.00[6.00-6.75], p = 0.015)。其他结果相似。结论:与CCAD相比,eCRS的嗜酸性粒细胞和eotaxin-3水平升高,表明eCRS的嗜酸性粒细胞刺激程度和趋化性更大。CCAD患者较年轻。未来的研究和生物标志物可能会更好地区分CRS亚群。
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来源期刊
CiteScore
5.60
自引率
11.50%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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