Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients

Jennifer 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; Rakesh K. Chandra; Stephanie Shintani-Smith; Robert C. Kern; Robert P. Schleimer; Bruce K. Tan

doi:10.1002/lary.26555

Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients

Jennifer 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, Rakesh K. Chandra, Stephanie Shintani-Smith, Robert C. Kern, Robert P. Schleimer, Bruce K. Tan^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

54 Scopus citations

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 language	English (US)
Pages (from-to)	2210-2218
Number of pages	9
Journal	Laryngoscope
Volume	127
Issue number	10
DOIs	https://doi.org/10.1002/lary.26555
State	Published - Oct 2017

Funding

This study was supported by NIH grant K23DC012067 and the Triological Society/American College of Surgeons (B.K.T.); the Chronic Rhinosinusitis Integrative Studies Program (CRISP) U19 AI106683 (B.K.T., R.C.K, A.K., K.E.H., R.P.S.); R01AI104733 (A.K.); and R01HL068546, R01HL078860, and R01 AI072570, as well as the Ernest S. Bazley Trust (R.P.S.). The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Keywords

Eosinophils
chronic rhinosinusitis
olfactory dysfunction

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/lary.26555

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Lavin, J., Min, J. Y., Lidder, A. K., Huang, J. H., Kato, A., Lam, K., Meen, E., Chmiel, J. S., Norton, J., Suh, L., Mahdavinia, M., Hulse, K. E., Conley, D. B., Chandra, R. K., Shintani-Smith, S., Kern, R. C., Schleimer, R. P., & Tan, B. K. (2017). Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients. Laryngoscope, 127(10), 2210-2218. https://doi.org/10.1002/lary.26555

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title = "Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients",

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.",

keywords = "Eosinophils, chronic rhinosinusitis, olfactory dysfunction",

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

note = "Publisher Copyright: {\textcopyright} 2017 The American Laryngological, Rhinological and Otological Society, Inc.",

year = "2017",

month = oct,

doi = "10.1002/lary.26555",

language = "English (US)",

volume = "127",

pages = "2210--2218",

journal = "Laryngoscope",

issn = "0023-852X",

publisher = "Wiley-Blackwell",

number = "10",

}

Lavin, J, Min, JY, Lidder, AK, Huang, JH, Kato, A, Lam, K, Meen, E, Chmiel, JS, Norton, J, Suh, L, Mahdavinia, M, Hulse, KE, Conley, DB, Chandra, RK, Shintani-Smith, S , Kern, RC , Schleimer, RP & Tan, BK 2017, 'Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients', Laryngoscope, vol. 127, no. 10, pp. 2210-2218. https://doi.org/10.1002/lary.26555

TY - JOUR

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

AU - Lavin, Jennifer

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, David B.

AU - Chandra, Rakesh K.

AU - Shintani-Smith, Stephanie

AU - Kern, Robert C.

AU - Schleimer, Robert P.

AU - Tan, Bruce K.

PY - 2017/10

Y1 - 2017/10

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.

KW - Eosinophils

KW - chronic rhinosinusitis

KW - olfactory dysfunction

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JO - Laryngoscope

JF - Laryngoscope

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ER -

Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients

Abstract

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