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
{"title":"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","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. Loftus","doi":"10.1002/alr.23448","DOIUrl":null,"url":null,"abstract":"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 (<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 (>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":null,"pages":null},"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. Loftus\",\"doi\":\"10.1002/alr.23448\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"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 (<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 (>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\":null,\"pages\":null},\"PeriodicalIF\":7.2000,\"publicationDate\":\"2024-09-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Forum of Allergy & Rhinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/alr.23448\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Forum of Allergy & Rhinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/alr.23448","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
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.
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.