Predictive markers of long-term recurrence in chronic rhinosinusitis with nasal polyps.


Journal

American journal of otolaryngology
ISSN: 1532-818X
Titre abrégé: Am J Otolaryngol
Pays: United States
ID NLM: 8000029

Informations de publication

Date de publication:
Historique:
received: 26 05 2019
revised: 29 08 2019
accepted: 04 09 2019
pubmed: 16 11 2019
medline: 14 4 2020
entrez: 16 11 2019
Statut: ppublish

Résumé

In last years, many attempts were made to recognize chronic rhinosinusitis with nasal polyps (CRSwNP) phenotypes focusing on identifying relevant key pathogenic molecules. Polyps recurrence rate ranges from 4% to 60%, so it's clear that not all clinical and immunologic factors associated with recurrence are known. We investigate the inflammatory profile in patients with long term recurrent and non-recurrent CRSwNPs and if a specific profile is associated with recurrence, comparing eosinophilic, neutrophilic and lymphocytic infiltration, as well as IL-5 and IL-8 expression to long term recurrence rate. This prospective study included 44 adult patients with CRSwNP treated with endoscopic sinus surgery between 2008 and 2010. Long term follow-up data (8-10 years) indicated that among 44 patients, 18 (40.1%) experienced long term recurrence of nasal polyposis needing maximal medical treatment or revision surgery. We realized two groups: one with patients who didn't present long term recurrence (26 patients) and another with patients who presented long term recurrence (18 patients) and in both groups eosinophilic, neutrophilic and lymphocytic infiltration and IL-5 and IL-8 expression were measured. The parameters that reached statistical significance (p < 0.05) comparing the two groups were eosinophilic infiltration and IL-5 expression, whereas neutrophilic and lymphocytic infiltration, as IL-8 expression didn't show any significant difference. Asthma and aspirin intolerance seemed significantly more frequent in patients with recurrence, while allergy presented not statistically significant difference between two groups. We can conclude that high eosinophilic infiltration and high IL-5 expression in CRSwNP correlate with higher rate of long term recurrence, while neutrophilic and lymphocytic infiltration, and IL-8 expression don't correlate with it. These findings provide the opportunity to improve our ability to predict the prognosis of surgical intervention, although it is still needed to explore the optimal predictor of outcome in CRSwNP.

Sections du résumé

BACKGROUND BACKGROUND
In last years, many attempts were made to recognize chronic rhinosinusitis with nasal polyps (CRSwNP) phenotypes focusing on identifying relevant key pathogenic molecules. Polyps recurrence rate ranges from 4% to 60%, so it's clear that not all clinical and immunologic factors associated with recurrence are known.
OBJECTIVE OBJECTIVE
We investigate the inflammatory profile in patients with long term recurrent and non-recurrent CRSwNPs and if a specific profile is associated with recurrence, comparing eosinophilic, neutrophilic and lymphocytic infiltration, as well as IL-5 and IL-8 expression to long term recurrence rate.
METHODS METHODS
This prospective study included 44 adult patients with CRSwNP treated with endoscopic sinus surgery between 2008 and 2010. Long term follow-up data (8-10 years) indicated that among 44 patients, 18 (40.1%) experienced long term recurrence of nasal polyposis needing maximal medical treatment or revision surgery. We realized two groups: one with patients who didn't present long term recurrence (26 patients) and another with patients who presented long term recurrence (18 patients) and in both groups eosinophilic, neutrophilic and lymphocytic infiltration and IL-5 and IL-8 expression were measured.
RESULTS RESULTS
The parameters that reached statistical significance (p < 0.05) comparing the two groups were eosinophilic infiltration and IL-5 expression, whereas neutrophilic and lymphocytic infiltration, as IL-8 expression didn't show any significant difference. Asthma and aspirin intolerance seemed significantly more frequent in patients with recurrence, while allergy presented not statistically significant difference between two groups.
CONCLUSIONS CONCLUSIONS
We can conclude that high eosinophilic infiltration and high IL-5 expression in CRSwNP correlate with higher rate of long term recurrence, while neutrophilic and lymphocytic infiltration, and IL-8 expression don't correlate with it. These findings provide the opportunity to improve our ability to predict the prognosis of surgical intervention, although it is still needed to explore the optimal predictor of outcome in CRSwNP.

Identifiants

pubmed: 31727332
pii: S0196-0709(19)30493-4
doi: 10.1016/j.amjoto.2019.102286
pii:
doi:

Substances chimiques

Biomarkers 0
Interleukin-5 0
Interleukin-8 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102286

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Davide Rosati (D)

Department of Sensory Organs, "Sapienza University" of Rome, Azienda Policlinico Umberto I, Rome, Italy. Electronic address: rosatidavideorl@gmail.com.

Chiara Rosato (C)

Ospedale S. Maria Goretti, Latina, Italy.

Giulio Pagliuca (G)

Ospedale S. Maria Goretti, Latina, Italy.

Bruna Cerbelli (B)

UOC of Pathology, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Latina, Italy.

Carlo Della Rocca (C)

UOC of Pathology, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Latina, Italy.

Claudio Di Cristofano (C)

UOC of Pathology, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Latina, Italy.

Salvatore Martellucci (S)

Department of Sensory Organs, "Sapienza University" of Rome, Azienda Policlinico Umberto I, Rome, Italy.

Andrea Gallo (A)

Department of Sensory Organs, "Sapienza University" of Rome, Azienda Policlinico Umberto I, Rome, Italy.

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Classifications MeSH