Comprehensive evaluation of type 2 endotype and clinical features in patients with chronic rhinosinusitis with nasal polyps in Taiwan: a cross-sectional study

Purpose Endotype-driven treatment has been introduced in the management of chronic rhinosinusitis with nasal polyps (CRSwNP), and an understanding of the associations between phenotypes and endotypes of CRSwNP will be beneficial in identifying responders. We aimed to determine the correlations betwe...

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Published in:European archives of oto-rhino-laryngology 2023-12, Vol.280 (12), p.5379-5389
Main Authors: Lin, Yi-Tsen, Lin, Chih-Feng, Liao, Chun-Kang, Yeh, Te-Huei
Format: Article
Language:English
Subjects:
Adult
Allergens
Chronic Disease
Cross-Sectional Studies
Eosinophilia - complications
Eosinophils
Head and Neck Surgery
Humans
Immunoglobulin E
Inflammation - complications
Interleukin-13
Interleukin-5
Medicine
Medicine & Public Health
Nasal Polyps - surgery
Neurosurgery
Otorhinolaryngology
Rhinitis - surgery
Rhinology
Sinusitis - surgery
Taiwan - epidemiology
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Summary:Purpose Endotype-driven treatment has been introduced in the management of chronic rhinosinusitis with nasal polyps (CRSwNP), and an understanding of the associations between phenotypes and endotypes of CRSwNP will be beneficial in identifying responders. We aimed to determine the correlations between clinical manifestations and type 2 inflammatory mediators of sinonasal tissues. Methods Adult patients undergoing endoscopic sinus surgery for bilateral CRSwNP were prospectively enrolled. Tissue eosinophilia and type 2 mediator expression in tissue homogenates were assessed and correlated with clinical features, including symptoms, comorbidities, blood eosinophil counts, specific allergen immunoglobulin (IgE) testing, computed tomography (CT) scan findings, and Sino-Nasal Outcome Test-22 scores. Results A total of 93 subjects were recruited in our study. Fifty-nine (63.4%) cases were identified as the eosinophilic endotype, demonstrating with higher rates of comorbidity of asthma, blood eosinophilia and a high ethmoid-maxillary ratio on CT images. To correlate of phenotypes with the inflammatory mediator profile, multivariate analyses revealed the associations of IgE expression in nasal polyp tissues with allergen sensitization (p = 0.042), CT ethmoid-maxillary ratio (p = 0.001) and tissue eosinophil counts (p = 0.022); the association of interleukin (IL-5) expression with the blood eosinophil percentage (p = 0.020); and the association of IL-13 expression with white blood cell count (p = 0.002) and central compartment-type inflammation (p 
ISSN:0937-4477
1434-4726
DOI:10.1007/s00405-023-08118-2