Abstract
Background: Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by mucosal inflammation in the nose and paranasal sinuses. Inflammation in CRS is also heterogeneous and is mainly characterized by type 2 (T2) inflammation, but subsets of patients show type 1 (T1) and type 3 (T3) inflammation. Whether inflammatory endotypes are associated with clinical phenotypes has yet to be explored in detail. Objective: To identify associations between inflammatory endotypes and clinical presentations in CRS. Methods: We compared 121 patients with nonpolypoid CRS (CRSsNP) and 134 patients with polypoid CRS (CRSwNP) and identified inflammatory endotypes using markers including IFN-γ (T1), eosinophil cationic protein (T2), Charcot-Leyden crystal galectin (T2), and IL-17A (T3). We collected clinical parameters from medical and surgical records and examined whether there were any associations between endotype and clinical features. Results: The presence of nasal polyps, asthma comorbidity, smell loss, and allergic mucin was significantly associated with the presence of T2 endotype in all patients with CRS. The T1 endotype was significantly more common in females, and the presence of pus was significantly associated with T3 endotype in all patients with CRS. We further analyzed these associations in CRSsNP and CRSwNP separately and found that smell loss was still associated with T2 endotype and pus with the T3 endotype in both CRSsNP and CRSwNP. Importantly, patients with CRS with T2 and T3 mixed endotype tended to have clinical presentations shared by both T2 and T3 endotypes. Conclusions: Clinical presentations are directly associated with inflammatory endotypes in CRS. Identification of inflammatory endotypes may allow for more precise and personalized medical treatments in CRS.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2812-2820.e3 |
| Journal | Journal of Allergy and Clinical Immunology: In Practice |
| Volume | 7 |
| Issue number | 8 |
| DOIs | |
| State | Published - Nov 1 2019 |
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Keywords
- Chronic rhinosinusitis
- Clinical presentation
- Endotype-phenotype association
- Inflammatory endotype
ASJC Scopus subject areas
- Immunology and Allergy
Cite this
}
Associations Between Inflammatory Endotypes and Clinical Presentations in Chronic Rhinosinusitis. / Stevens, Whitney; Peters, Anju Tripathi; Tan, Bruce Kuang-Huay; Klingler, Aiko I.; Poposki, Julie A.; Hulse, Kathryn E; Grammer III, Leslie C; Welch, Kevin Christian; Smith, Stephanie Shintani; Conley Jr, David B; Kern, Robert C; Schleimer, Robert P; Kato, Atsushi.
In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 7, No. 8, 01.11.2019, p. 2812-2820.e3.Research output: Contribution to journal › Article
TY - JOUR
T1 - Associations Between Inflammatory Endotypes and Clinical Presentations in Chronic Rhinosinusitis
AU - Stevens, Whitney
AU - Peters, Anju Tripathi
AU - Tan, Bruce Kuang-Huay
AU - Klingler, Aiko I.
AU - Poposki, Julie A.
AU - Hulse, Kathryn E
AU - Grammer III, Leslie C
AU - Welch, Kevin Christian
AU - Smith, Stephanie Shintani
AU - Conley Jr, David B
AU - Kern, Robert C
AU - Schleimer, Robert P
AU - Kato, Atsushi
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background: Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by mucosal inflammation in the nose and paranasal sinuses. Inflammation in CRS is also heterogeneous and is mainly characterized by type 2 (T2) inflammation, but subsets of patients show type 1 (T1) and type 3 (T3) inflammation. Whether inflammatory endotypes are associated with clinical phenotypes has yet to be explored in detail. Objective: To identify associations between inflammatory endotypes and clinical presentations in CRS. Methods: We compared 121 patients with nonpolypoid CRS (CRSsNP) and 134 patients with polypoid CRS (CRSwNP) and identified inflammatory endotypes using markers including IFN-γ (T1), eosinophil cationic protein (T2), Charcot-Leyden crystal galectin (T2), and IL-17A (T3). We collected clinical parameters from medical and surgical records and examined whether there were any associations between endotype and clinical features. Results: The presence of nasal polyps, asthma comorbidity, smell loss, and allergic mucin was significantly associated with the presence of T2 endotype in all patients with CRS. The T1 endotype was significantly more common in females, and the presence of pus was significantly associated with T3 endotype in all patients with CRS. We further analyzed these associations in CRSsNP and CRSwNP separately and found that smell loss was still associated with T2 endotype and pus with the T3 endotype in both CRSsNP and CRSwNP. Importantly, patients with CRS with T2 and T3 mixed endotype tended to have clinical presentations shared by both T2 and T3 endotypes. Conclusions: Clinical presentations are directly associated with inflammatory endotypes in CRS. Identification of inflammatory endotypes may allow for more precise and personalized medical treatments in CRS.
AB - Background: Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by mucosal inflammation in the nose and paranasal sinuses. Inflammation in CRS is also heterogeneous and is mainly characterized by type 2 (T2) inflammation, but subsets of patients show type 1 (T1) and type 3 (T3) inflammation. Whether inflammatory endotypes are associated with clinical phenotypes has yet to be explored in detail. Objective: To identify associations between inflammatory endotypes and clinical presentations in CRS. Methods: We compared 121 patients with nonpolypoid CRS (CRSsNP) and 134 patients with polypoid CRS (CRSwNP) and identified inflammatory endotypes using markers including IFN-γ (T1), eosinophil cationic protein (T2), Charcot-Leyden crystal galectin (T2), and IL-17A (T3). We collected clinical parameters from medical and surgical records and examined whether there were any associations between endotype and clinical features. Results: The presence of nasal polyps, asthma comorbidity, smell loss, and allergic mucin was significantly associated with the presence of T2 endotype in all patients with CRS. The T1 endotype was significantly more common in females, and the presence of pus was significantly associated with T3 endotype in all patients with CRS. We further analyzed these associations in CRSsNP and CRSwNP separately and found that smell loss was still associated with T2 endotype and pus with the T3 endotype in both CRSsNP and CRSwNP. Importantly, patients with CRS with T2 and T3 mixed endotype tended to have clinical presentations shared by both T2 and T3 endotypes. Conclusions: Clinical presentations are directly associated with inflammatory endotypes in CRS. Identification of inflammatory endotypes may allow for more precise and personalized medical treatments in CRS.
KW - Chronic rhinosinusitis
KW - Clinical presentation
KW - Endotype-phenotype association
KW - Inflammatory endotype
UR - http://www.scopus.com/inward/record.url?scp=85067178919&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067178919&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2019.05.009
DO - 10.1016/j.jaip.2019.05.009
M3 - Article
C2 - 31128376
AN - SCOPUS:85067178919
VL - 7
SP - 2812-2820.e3
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 8
ER -