诊室取样检测嗜酸性粒细胞过氧化物酶以诊断嗜酸性粒细胞慢性鼻炎

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-09-13 DOI:10.1002/alr.23448
Jacquelyn K. Callander, Annabelle R. Charbit, Kritika Khanna, John V. Fahy, Monica Tang, Maude Liegeois, Steven D. Pletcher, Andrew N. Goldberg, Jose G. Gurrola, Andrew H. Murr, Anna Butrymowicz, Patricia A. Loftus
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Findings were correlated with clinical data.ResultsForty‐two subjects were enrolled, including 31 CRS subjects and 11 controls. Median EPX levels were 125.0 ng/mL (standard deviation [SD] 1745.8) and 6.5 ng/mL (SD 99.0) for CRS group and controls, respectively (<jats:italic>p</jats:italic> = 0.003). EPX levels were associated with history of asthma (<jats:italic>p</jats:italic> = 0.015), allergies (<jats:italic>p</jats:italic> = 0.028), polyps (<jats:italic>p</jats:italic> = 0.0006), smell loss (<jats:italic>p</jats:italic> = 0.006), and systemic eosinophilia or elevated immunoglobulin E (<jats:italic>p</jats:italic> ≤ 0.0001). Twenty‐eight subjects from both the CRS and control groups had prior pathology for comparison, with histologic confirmation of local tissue eosinophilia (&gt;10 eosinophils/hpf) in 11 subjects. This subgroup had a median EPX level of 967.5 ng/mL compared to 10.6 ng/mL in 17 subjects without local tissue eosinophilia (<jats:italic>p</jats:italic> = 0.0008). EPX levels were positively correlated to interleukin‐5 levels (<jats:italic>p</jats:italic> = 0.0005).ConclusionEPX levels can be measured via well‐tolerated in‐clinic collection of nasal mucus. EPX levels are associated with clinical markers of type 2 inflammation and tissue eosinophilia and may provide a valuable diagnostic tool to delineate eosinophilic CRS.","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"48 1","pages":""},"PeriodicalIF":7.2000,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"In office sampling of eosinophil peroxidase to diagnose eosinophilic chronic rhinosinusitis\",\"authors\":\"Jacquelyn K. Callander, Annabelle R. Charbit, Kritika Khanna, John V. Fahy, Monica Tang, Maude Liegeois, Steven D. Pletcher, Andrew N. Goldberg, Jose G. Gurrola, Andrew H. Murr, Anna Butrymowicz, Patricia A. 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引用次数: 0

摘要

背景用于描述慢性鼻炎(CRS)内型特征的实用生物标志物仍未出现,妨碍了临床应用。嗜酸性粒细胞过氧化物酶(EPX)是活化的嗜酸性粒细胞释放的一种酶。本研究的目的是评估作为嗜酸性粒细胞 CRS 标志物的临床 EPX 检测方法。方法前瞻性地招募了在三级医院鼻科门诊就诊的患有和未患有 CRS 的受试者,并在门诊鼻内窥镜检查期间从中耳采集了鼻腔细胞学刷片。ELISA检测法用于量化EPX水平,定制的多重免疫测定法用于量化炎症细胞因子介质。结果42名受试者参加了研究,包括31名CRS受试者和11名对照组。CRS组和对照组的EPX水平中位数分别为125.0纳克/毫升(标准差[SD] 1745.8)和6.5纳克/毫升(SD 99.0)(P = 0.003)。EPX水平与哮喘病史(p = 0.015)、过敏(p = 0.028)、息肉(p = 0.0006)、嗅觉减退(p = 0.006)、全身嗜酸性粒细胞增多或免疫球蛋白E升高(p ≤ 0.0001)有关。CRS 组和对照组中均有 28 名受试者进行了病理对比,其中 11 名受试者的局部组织嗜酸性粒细胞增多(>10 个嗜酸性粒细胞/hpf)得到了组织学证实。该亚组的 EPX 水平中位数为 967.5 纳克/毫升,而 17 例无局部组织嗜酸性粒细胞增多的受试者的 EPX 水平中位数为 10.6 纳克/毫升(p = 0.0008)。EPX水平与白细胞介素-5水平呈正相关(p = 0.0005)。EPX水平与2型炎症和组织嗜酸性粒细胞增多症的临床标记物相关,可为确定嗜酸性粒细胞增多症CRS提供有价值的诊断工具。
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In office sampling of eosinophil peroxidase to diagnose eosinophilic chronic rhinosinusitis
BackgroundPractical biomarkers for endotypic characterization of chronic rhinosinusitis (CRS) remain elusive, hindering clinical utility. Eosinophil peroxidase (EPX) is an enzyme released by activated eosinophils. The objective of this study was to evaluate a clinic EPX assay as a marker of eosinophilic CRS.MethodsSubjects with and without CRS presenting to a tertiary care rhinology clinic were prospectively enrolled, and nasal cytology brushings were collected from the middle meatus during in‐clinic nasal endoscopy. ELISA assay was used to quantify EPX levels, and a customized multiplex immunoassay was used to quantify inflammatory cytokine mediators. Findings were correlated with clinical data.ResultsForty‐two subjects were enrolled, including 31 CRS subjects and 11 controls. Median EPX levels were 125.0 ng/mL (standard deviation [SD] 1745.8) and 6.5 ng/mL (SD 99.0) for CRS group and controls, respectively (p = 0.003). EPX levels were associated with history of asthma (p = 0.015), allergies (p = 0.028), polyps (p = 0.0006), smell loss (p = 0.006), and systemic eosinophilia or elevated immunoglobulin E (p ≤ 0.0001). Twenty‐eight subjects from both the CRS and control groups had prior pathology for comparison, with histologic confirmation of local tissue eosinophilia (>10 eosinophils/hpf) in 11 subjects. This subgroup had a median EPX level of 967.5 ng/mL compared to 10.6 ng/mL in 17 subjects without local tissue eosinophilia (p = 0.0008). EPX levels were positively correlated to interleukin‐5 levels (p = 0.0005).ConclusionEPX levels can be measured via well‐tolerated in‐clinic collection of nasal mucus. EPX levels are associated with clinical markers of type 2 inflammation and tissue eosinophilia and may provide a valuable diagnostic tool to delineate eosinophilic CRS.
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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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