Analysis of Histopathological Endotyping for Chronic Rhinosinusitis Phenotypes Based on Comorbid Asthma and Allergic Rhinitis

Background An emerging trend in clinical research has centered on improving the characteristics of chronic rhinosinusitis (CRS) according to phenotypes and endotypes. The objective of this study is to utilize histopathological markers to better characterize CRS phenotypes that are defined by the pre...

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Bibliographic Details
Published in:American journal of rhinology & allergy 2019-09, Vol.33 (5), p.507-512
Main Authors: Radabaugh, Jeffrey P., Han, Joseph K., Moebus, Rachel G., Somers, Evan, Lam, Kent
Format: Article
Language:English
Subjects:
Adult
Aged
Asthma - diagnosis
Asthma - epidemiology
Asthma - pathology
Case-Control Studies
Chronic Disease
Comorbidity
Eosinophils - pathology
Female
Humans
Leukocyte Count
Male
Middle Aged
Nasal Mucosa - pathology
Phenotype
Prospective Studies
Rhinitis - diagnosis
Rhinitis - epidemiology
Rhinitis - pathology
Rhinitis, Allergic - diagnosis
Rhinitis, Allergic - epidemiology
Rhinitis, Allergic - pathology
Sinusitis - diagnosis
Sinusitis - epidemiology
Sinusitis - pathology
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Summary:Background An emerging trend in clinical research has centered on improving the characteristics of chronic rhinosinusitis (CRS) according to phenotypes and endotypes. The objective of this study is to utilize histopathological markers to better characterize CRS phenotypes that are defined by the presence or absence of comorbid bronchial asthma (BA) and allergic rhinitis (AR). Methods A prospective case-controlled study of CRS patients was conducted. For the CRS cohort, mucosal biopsies were obtained during endoscopic sinus surgery, while samples of ethmoid mucosa were collected in control patients undergoing endoscopic skull base surgery. Histopathological analysis of tissue samples determined the relative frequency of inflammatory cell types, including eosinophils, lymphocytes, neutrophils, mast cells, and plasma cells. The presence and absence of comorbid BA and AR were used to further divide CRS, allowing for further subgroup analysis. Results Of 82 recruited patients, there were 67 CRS patients and 15 controls. Significantly increased eosinophil ratios were found in CRS patients with AR, BA, or both, when compared with controls (P  .05). Lymphocyte ratios showed a significantly inverse correlation with trends demonstrated by eosinophil ratios in all patient subgroups (P 
ISSN:1945-8924
1945-8932
DOI:10.1177/1945892419846263