Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients

Jennifer M Lavin, Jin Young Min, Alcina K. Lidder, Julia He Huang, Atsushi Kato, Kent Lam, Eric Meen, Joan S Chmiel, James Norton, Lydia Suh, Mahboobeh Mahdavinia, Kathryn E Hulse, David B Conley Jr, Rakesh K. Chandra, Stephanie Shintani Smith, Robert C Kern, Robert P Schleimer, Bruce Kuang-Huay Tan*

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: To evaluate if molecular markers of eosinophilia in olfactory-enriched mucosa are associated with olfactory dysfunction. Study Design: Cross-sectional study of tissue biopsies from 99 patients, and an additional 30 patients who underwent prospective olfactory testing prior to sinonasal procedures. Methods: Tissue biopsies were processed for analysis of inflammatory markers using quantitative real time polymerase chain reaction (qRT-PCR). Ipsilateral olfactory performance was assessed using the Sniffin' Sticks (Burghart, Wedel, Germany) threshold component and the University of Pennsylvania Smell Identification Test (Sensonics, Haddon Heights, NJ). Age-adjusted data was correlated with inflammatory marker expression and clinical measures of obstruction from computed tomography and endoscopy. Results: Gene expression of the eosinophil marker CLC (Charcot Leyden crystal protein) was elevated in superior turbinate (ST) tissue in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) compared to ST and inferior turbinate tissue in CRS without nasal polyps (CRSsNP) and control patients (all P < 0.001, respectively). CLC in ST tissue was correlated with IL-5 and eotaxin-1 expression (all P < 0.001; P = 0.65, and 0.49, respectively). CLC expression was strongly correlated with eosinophilic cationic protein levels (P < 0.001; r = −0.76), and ST CLC expression was inversely related to olfactory threshold (P = 0.002, r = −0.57) and discrimination scores (P = 0.05, r = −0.42). In multiple linear regression of CLC gene expression, polyp status, and radiographic and endoscopic findings with olfactory threshold, CLC was the only significantly correlated variable (P < 0.05). Conclusion: Markers of eosinophils are elevated in the ST of patients with CRSwNP and correlate with olfactory loss. These findings support the hypothesis that olfactory dysfunction in CRS correlates local eosinophil influx into the olfactory cleft. Level of Evidence: NA. Laryngoscope, 127:2210–2218, 2017.

Original languageEnglish (US)
Pages (from-to)2210-2218
Number of pages9
JournalLaryngoscope
Volume127
Issue number10
DOIs
StatePublished - Oct 1 2017

Fingerprint

Turbinates
Eosinophilia
Nasal Polyps
Eosinophils
Chemokine CCL11
Biopsy
Laryngoscopes
Gene Expression
Olfactory Mucosa
Smell
Interleukin-5
Polyps
Endoscopy
Germany
lysolecithin acylhydrolase
Real-Time Polymerase Chain Reaction
Linear Models
Cross-Sectional Studies
Biomarkers
Tomography

Keywords

  • Eosinophils
  • chronic rhinosinusitis
  • olfactory dysfunction

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Lavin, Jennifer M ; Min, Jin Young ; Lidder, Alcina K. ; Huang, Julia He ; Kato, Atsushi ; Lam, Kent ; Meen, Eric ; Chmiel, Joan S ; Norton, James ; Suh, Lydia ; Mahdavinia, Mahboobeh ; Hulse, Kathryn E ; Conley Jr, David B ; Chandra, Rakesh K. ; Smith, Stephanie Shintani ; Kern, Robert C ; Schleimer, Robert P ; Tan, Bruce Kuang-Huay. / Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients. In: Laryngoscope. 2017 ; Vol. 127, No. 10. pp. 2210-2218.
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abstract = "Objective: To evaluate if molecular markers of eosinophilia in olfactory-enriched mucosa are associated with olfactory dysfunction. Study Design: Cross-sectional study of tissue biopsies from 99 patients, and an additional 30 patients who underwent prospective olfactory testing prior to sinonasal procedures. Methods: Tissue biopsies were processed for analysis of inflammatory markers using quantitative real time polymerase chain reaction (qRT-PCR). Ipsilateral olfactory performance was assessed using the Sniffin' Sticks (Burghart, Wedel, Germany) threshold component and the University of Pennsylvania Smell Identification Test (Sensonics, Haddon Heights, NJ). Age-adjusted data was correlated with inflammatory marker expression and clinical measures of obstruction from computed tomography and endoscopy. Results: Gene expression of the eosinophil marker CLC (Charcot Leyden crystal protein) was elevated in superior turbinate (ST) tissue in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) compared to ST and inferior turbinate tissue in CRS without nasal polyps (CRSsNP) and control patients (all P < 0.001, respectively). CLC in ST tissue was correlated with IL-5 and eotaxin-1 expression (all P < 0.001; P = 0.65, and 0.49, respectively). CLC expression was strongly correlated with eosinophilic cationic protein levels (P < 0.001; r = −0.76), and ST CLC expression was inversely related to olfactory threshold (P = 0.002, r = −0.57) and discrimination scores (P = 0.05, r = −0.42). In multiple linear regression of CLC gene expression, polyp status, and radiographic and endoscopic findings with olfactory threshold, CLC was the only significantly correlated variable (P < 0.05). Conclusion: Markers of eosinophils are elevated in the ST of patients with CRSwNP and correlate with olfactory loss. These findings support the hypothesis that olfactory dysfunction in CRS correlates local eosinophil influx into the olfactory cleft. Level of Evidence: NA. Laryngoscope, 127:2210–2218, 2017.",
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Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients. / Lavin, Jennifer M; Min, Jin Young; Lidder, Alcina K.; Huang, Julia He; Kato, Atsushi; Lam, Kent; Meen, Eric; Chmiel, Joan S; Norton, James; Suh, Lydia; Mahdavinia, Mahboobeh; Hulse, Kathryn E; Conley Jr, David B; Chandra, Rakesh K.; Smith, Stephanie Shintani; Kern, Robert C; Schleimer, Robert P; Tan, Bruce Kuang-Huay.

In: Laryngoscope, Vol. 127, No. 10, 01.10.2017, p. 2210-2218.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients

AU - Lavin, Jennifer M

AU - Min, Jin Young

AU - Lidder, Alcina K.

AU - Huang, Julia He

AU - Kato, Atsushi

AU - Lam, Kent

AU - Meen, Eric

AU - Chmiel, Joan S

AU - Norton, James

AU - Suh, Lydia

AU - Mahdavinia, Mahboobeh

AU - Hulse, Kathryn E

AU - Conley Jr, David B

AU - Chandra, Rakesh K.

AU - Smith, Stephanie Shintani

AU - Kern, Robert C

AU - Schleimer, Robert P

AU - Tan, Bruce Kuang-Huay

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objective: To evaluate if molecular markers of eosinophilia in olfactory-enriched mucosa are associated with olfactory dysfunction. Study Design: Cross-sectional study of tissue biopsies from 99 patients, and an additional 30 patients who underwent prospective olfactory testing prior to sinonasal procedures. Methods: Tissue biopsies were processed for analysis of inflammatory markers using quantitative real time polymerase chain reaction (qRT-PCR). Ipsilateral olfactory performance was assessed using the Sniffin' Sticks (Burghart, Wedel, Germany) threshold component and the University of Pennsylvania Smell Identification Test (Sensonics, Haddon Heights, NJ). Age-adjusted data was correlated with inflammatory marker expression and clinical measures of obstruction from computed tomography and endoscopy. Results: Gene expression of the eosinophil marker CLC (Charcot Leyden crystal protein) was elevated in superior turbinate (ST) tissue in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) compared to ST and inferior turbinate tissue in CRS without nasal polyps (CRSsNP) and control patients (all P < 0.001, respectively). CLC in ST tissue was correlated with IL-5 and eotaxin-1 expression (all P < 0.001; P = 0.65, and 0.49, respectively). CLC expression was strongly correlated with eosinophilic cationic protein levels (P < 0.001; r = −0.76), and ST CLC expression was inversely related to olfactory threshold (P = 0.002, r = −0.57) and discrimination scores (P = 0.05, r = −0.42). In multiple linear regression of CLC gene expression, polyp status, and radiographic and endoscopic findings with olfactory threshold, CLC was the only significantly correlated variable (P < 0.05). Conclusion: Markers of eosinophils are elevated in the ST of patients with CRSwNP and correlate with olfactory loss. These findings support the hypothesis that olfactory dysfunction in CRS correlates local eosinophil influx into the olfactory cleft. Level of Evidence: NA. Laryngoscope, 127:2210–2218, 2017.

AB - Objective: To evaluate if molecular markers of eosinophilia in olfactory-enriched mucosa are associated with olfactory dysfunction. Study Design: Cross-sectional study of tissue biopsies from 99 patients, and an additional 30 patients who underwent prospective olfactory testing prior to sinonasal procedures. Methods: Tissue biopsies were processed for analysis of inflammatory markers using quantitative real time polymerase chain reaction (qRT-PCR). Ipsilateral olfactory performance was assessed using the Sniffin' Sticks (Burghart, Wedel, Germany) threshold component and the University of Pennsylvania Smell Identification Test (Sensonics, Haddon Heights, NJ). Age-adjusted data was correlated with inflammatory marker expression and clinical measures of obstruction from computed tomography and endoscopy. Results: Gene expression of the eosinophil marker CLC (Charcot Leyden crystal protein) was elevated in superior turbinate (ST) tissue in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) compared to ST and inferior turbinate tissue in CRS without nasal polyps (CRSsNP) and control patients (all P < 0.001, respectively). CLC in ST tissue was correlated with IL-5 and eotaxin-1 expression (all P < 0.001; P = 0.65, and 0.49, respectively). CLC expression was strongly correlated with eosinophilic cationic protein levels (P < 0.001; r = −0.76), and ST CLC expression was inversely related to olfactory threshold (P = 0.002, r = −0.57) and discrimination scores (P = 0.05, r = −0.42). In multiple linear regression of CLC gene expression, polyp status, and radiographic and endoscopic findings with olfactory threshold, CLC was the only significantly correlated variable (P < 0.05). Conclusion: Markers of eosinophils are elevated in the ST of patients with CRSwNP and correlate with olfactory loss. These findings support the hypothesis that olfactory dysfunction in CRS correlates local eosinophil influx into the olfactory cleft. Level of Evidence: NA. Laryngoscope, 127:2210–2218, 2017.

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KW - chronic rhinosinusitis

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