Association of mucus eosinophil-derived neurotoxin levels with disease control status in patients with chronic rhinosinusitis.
Biomarkers
Chronic rhinosinusitis
Disease control
Eosinophil-derived neurotoxin
Nasal mucus
Predictor
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
03 May 2024
03 May 2024
Historique:
received:
24
02
2024
accepted:
17
04
2024
medline:
3
5
2024
pubmed:
3
5
2024
entrez:
3
5
2024
Statut:
aheadofprint
Résumé
Identifying the biomarkers for uncontrolled chronic rhinosinusitis (CRS) is important for directing treatment decisions. Eosinophilia has been reported to be involved in the poor disease control of CRS and mucus eosinophil-derived neurotoxin (EDN) is potentially a biomarker of intense eosinophil activation. This study aimed to assess the relationship between mucus EDN levels, disease severity, and degree of CRS control. A total of 150 adult patients with CRS and 25 healthy controls were prospectively enrolled. The nasal mucus and tissue specimens were collected to analyze EDN levels. Disease severity was assessed by Lund-Mackay score and 22-item Sino-Nasal Outcome Test (SNOT-22) score. Five CRS symptom severities during the prior month (nasal blockage, rhinorrhoea/postnasal drip, facial pain/pressure, smell, sleep disturbance or fatigue), use of rescue medications in the last six months, and the presence of diseased mucosa on nasal endoscopy were obtained. Consistent with the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 CRS control criteria, uncontrolled CRS was defined as meeting at least three items. 40% of patients with CRS presented with uncontrolled status. Patients with uncontrolled CRS had significantly higher nasal mucus EDN levels (P = 0.010), percentage of blood eosinophil (P = 0.015), SNOT-22 score (P < 0.001), Lund-Mackay score (P = 0.008), and a more eosinophilic dominant phenotype of CRS (P < 0.001) than patients with controlled CRS. Furthermore, mucus EDN levels were positively correlated with blood eosinophils (r = 0.541, P = 0.005), SNOT-22 score (r = 0.460, P = 0.021), and Lund-Mackay score (r = 0.387, P = 0.039). Mucus EDN levels were the significant parameter related to uncontrolled CRS in multivariable analysis after adjusting for patient demographics and comorbidities (odds ratio = 1.323; P = 0.004). Mucus EDN levels may be a potential biomarker for identifying the CRS control status.
Identifiants
pubmed: 38700538
doi: 10.1007/s00405-024-08695-w
pii: 10.1007/s00405-024-08695-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Key clinical projects of Peking University Third Hospital
ID : BYSYZD2023029
Organisme : Natural Science Foundation of China
ID : 82000954
Organisme : Beijing Science and Technology Nova Program
ID : Z201100006820086
Organisme : Beijing Hospitals Authority Youth Program
ID : QML20190617
Organisme : Beijing Hospitals Authority Clinical Medicine Development of Special Funding
ID : XMLX202136
Organisme : Shan xi Natural Science Foundation
ID : 2021JQ-942
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, et al. Chronic rhinosinusitis in Europe—an underestimated disease. A GA
Hirsch AG, Stewart WF, Sundaresan AS, Young AJ, Kennedy TL, Scott Greene J et al (2017) Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy 72(2):274–281
doi: 10.1111/all.13042
pubmed: 27590749
Shi JB, Fu QL, Zhang H, Cheng L, Wang YJ, Zhu DD et al (2015) Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy 70(5):533–539
doi: 10.1111/all.12577
pubmed: 25631304
Baguley C, Brownlow A, Yeung K, Pratt E, Sacks R, Harvey R (2014) The fate of chronic rhinosinusitis sufferers after maximal medical therapy. Int Forum Allergy Rhinol 4(7):525–532
doi: 10.1002/alr.21315
pubmed: 24610673
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464.
Alanin MC, Hopkins C (2020) Effect of functional endoscopic sinus surgery on outcomes in chronic rhinosinusitis. Curr Allergy Asthma Rep 20(7):27
doi: 10.1007/s11882-020-00932-6
pubmed: 32462321
van der Veen J, Seys SF, Timmermans M, Levie P, Jorissen M, Fokkens WJ et al (2017) Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre. Allergy 72(2):282–290
doi: 10.1111/all.12983
pubmed: 27392210
Sedaghat AR, Phillips KM. Chronic rhinosinusitis disease control: a review of the history and the evidence. Expert Rev Clin Immunol. 2023:1–8.
Zhou J, Yuan F, Huang T, Zhu L, Wu D (2023) Current understanding of disease control and its application in patients with chronic rhinosinusitis. Front Cell Infect Microbiol 13:1104444
doi: 10.3389/fcimb.2023.1104444
pubmed: 37342244
pmcid: 10277650
Tao X, Chen F, Sun Y, Wu S, Hong H, Shi J et al (2018) Prediction models for postoperative uncontrolled chronic rhinosinusitis in daily practice. Laryngoscope 128(12):2673–2680
doi: 10.1002/lary.27267
pubmed: 30295929
Wang K, Deng J, Yang M, Chen Y, Chen F, Gao WX et al (2019) Concordant systemic and local eosinophilia relates to poorer disease control in patients with nasal polyps. World Allergy Organ J 12(8):100052
doi: 10.1016/j.waojou.2019.100052
pubmed: 31452832
pmcid: 6704051
Penttilä E, Sillanpää S, Vento SI, Myller J, Koskinen A, Hammarén-Malmi S, et al. Eosinophilia, asthma, NERD and the use of oral corticosteroids predict uncontrolled chronic rhinosinusitis with nasal polyps after surgery. Asian Pac J Allergy Immunol. 2021. Epub 2021/09/21. doi: https://doi.org/10.12932/ap-310321-1102 .
Jiang L, Wang K, Lin T, Jiang Y, Gao W, Li C et al (2022) A novel risk score for disease control prediction of chronic rhinosinusitis. Clin Otolaryngol 47(5):568–576
doi: 10.1111/coa.13949
pubmed: 35622459
pmcid: 9542583
Delemarre T, Bochner BS, Simon HU, Bachert C (2021) Rethinking neutrophils and eosinophils in chronic rhinosinusitis. J Allergy Clin Immunol 148(2):327–335
doi: 10.1016/j.jaci.2021.03.024
pubmed: 33895002
pmcid: 8355033
Gevaert P, Han JK, Smith SG, Sousa AR, Howarth PH, Yancey SW et al (2022) The roles of eosinophils and interleukin-5 in the pathophysiology of chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 12(11):1413–1423
doi: 10.1002/alr.22994
pubmed: 35243803
pmcid: 9790271
Lou H, Zhang N, Bachert C, Zhang L (2018) Highlights of eosinophilic chronic rhinosinusitis with nasal polyps in definition, prognosis, and advancement. Int Forum Allergy Rhinol 8(11):1218–1225
doi: 10.1002/alr.22214
pubmed: 30296011
pmcid: 6282610
Kwah JH, Somani SN, Stevens WW, Kern RC, Smith SS, Welch KC et al (2020) Clinical factors associated with acute exacerbations of chronic rhinosinusitis. J Allergy Clin Immunol 145(6):1598–1605
doi: 10.1016/j.jaci.2020.01.023
pubmed: 32004523
pmcid: 8177481
Gon Y, Ito R, Hattori T, Hiranuma H, Kumasawa F, Kozu Y et al (2015) Serum eosinophil-derived neurotoxin: correlation with persistent airflow limitation in adults with house-dust mite allergic asthma. Allergy Asthma Proc 36(6):e113–e120
doi: 10.2500/aap.2015.36.3884
pubmed: 26534742
Lee Y, Lee JH, Yang EM, Kwon E, Jung CG, Kim SC et al (2019) Serum Levels of Eosinophil-Derived Neurotoxin: A Biomarker for Asthma Severity in Adult Asthmatics. Allergy Asthma Immunol Res 11(3):394–405
doi: 10.4168/aair.2019.11.3.394
pubmed: 30912328
pmcid: 6439192
An J, Lee JH, Sim JH, Song WJ, Kwon HS, Cho YS et al (2020) Serum eosinophil-derived neurotoxin better reflect asthma control status than blood Eosinophil counts. J Allergy Clin Immunol Pract 8(8):2681–8.e1
doi: 10.1016/j.jaip.2020.03.035
pubmed: 32304842
Malinovschi A, Rydell N, Fujisawa T, Borres MP, Kim CK (2023) Clinical potential of eosinophil-derived neurotoxin in asthma management. J Allergy Clin Immunol Pract 11(3):750–761
doi: 10.1016/j.jaip.2022.11.046
pubmed: 36581068
Konikoff MR, Blanchard C, Kirby C, Buckmeier BK, Cohen MB, Heubi JE et al (2006) Potential of blood eosinophils, eosinophil-derived neurotoxin, and eotaxin-3 as biomarkers of eosinophilic esophagitis. Clin Gastroenterol Hepatol 4(11):1328–1336
doi: 10.1016/j.cgh.2006.08.013
pubmed: 17059896
Yang D, Chen Q, Su SB, Zhang P, Kurosaka K, Caspi RR et al (2008) Eosinophil-derived neurotoxin acts as an alarmin to activate the TLR2-MyD88 signal pathway in dendritic cells and enhances Th2 immune responses. J Exp Med 205(1):79–90
doi: 10.1084/jem.20062027
pubmed: 18195069
pmcid: 2234357
Kim HS, Yang HJ, Song DJ, Lee YJ, Suh DI, Shim JY et al (2022) Eosinophil-derived neurotoxin: an asthma exacerbation biomarker in children. Allergy Asthma Proc 43(2):133–139
doi: 10.2500/aap.2022.43.210001
pubmed: 35317890
Tsuda T, Maeda Y, Nishide M, Koyama S, Hayama Y, Nojima S et al (2019) Eosinophil-derived neurotoxin enhances airway remodeling in eosinophilic chronic rhinosinusitis and correlates with disease severity. Int Immunol 31(1):33–40
doi: 10.1093/intimm/dxy061
pubmed: 30239772
Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU et al (2021) International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol 11(3):213–739
doi: 10.1002/alr.22741
pubmed: 33236525
Wu D, Hong J, Chang F, Wei Y (2022) Development of a novel centrifugal extraction device to collect the olfactory cleft mucus. Acta Otolaryngol 142(3–4):323–328
doi: 10.1080/00016489.2022.2047223
pubmed: 35289706
Wu D, Liu Z, Bleier BS, Huang X, Hong J. Olfactory cleft mucus eosinophil-derived neurotoxin better reflects olfactory loss than blood eosinophil counts in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol. 2023. Epub 2023/06/02. https://doi.org/10.1002/alr.23202 .
Wu D, Li Y, Bleier BS, Wei Y (2020) Superior turbinate eosinophilia predicts olfactory decline in patients with chronic rhinosinusitis. Ann Allergy Asthma Immunol 125(3):304–10.e1
doi: 10.1016/j.anai.2020.04.027
pubmed: 32387168
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44(3):837–845
doi: 10.2307/2531595
pubmed: 3203132
Sedaghat AR, Fokkens WJ, Lund VJ, Hellings PW, Kern RC, Reitsma S, et al. Consensus criteria for chronic rhinosinusitis disease control: an international Delphi Study. Rhinology. 2023. Epub 2023/10/07. https://doi.org/10.4193/Rhin23.335 .
Sedaghat AR, Phillips KM (2023) Chronic rhinosinusitis disease control: a review of the history and the evidence. Expert Rev Clin Immunol 19(8):903–910
doi: 10.1080/1744666X.2023.2229027
pubmed: 37343511
Ali A, Fakunle DR, Yu V, McDermott S, Previtera MJ, Meier JC et al (2023) Heterogeneity in the definition of chronic rhinosinusitis disease control: a systematic review of the scientific literature. Eur Arch Otorhinolaryngol 280(12):5345–5352
doi: 10.1007/s00405-023-08090-x
pubmed: 37378726
Sedaghat AR, Phillips KM (2023) Defining “control” of chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 31(1):17–23
doi: 10.1097/MOO.0000000000000858
pubmed: 36730615
Racette SD, Wijewickrama RC, Jayaprakash V, Sherris DA, Santos C, Kita H et al (2017) Correlation of symptoms, clinical signs, and biomarkers of inflammation in postsurgical chronic rhinosinusitis. Ann Otol Rhinol Laryngol 126(6):455–462
doi: 10.1177/0003489417701939
pubmed: 28376637
Yang D, Rosenberg HF, Chen Q, Dyer KD, Kurosaka K, Oppenheim JJ (2003) Eosinophil-derived neurotoxin (EDN), an antimicrobial protein with chemotactic activities for dendritic cells. Blood 102(9):3396–3403
doi: 10.1182/blood-2003-01-0151
pubmed: 12855582
Han Z, Junxu, Zhong N. Expression of matrix metalloproteinases MMP-9 within the airways in asthma. Respir Med. 2003;97(5):563–7.
Yeo NK, Eom DW, Oh MY, Lim HW, Song YJ (2013) Expression of matrix metalloproteinase 2 and 9 and tissue inhibitor of metalloproteinase 1 in nonrecurrent vs recurrent nasal polyps. Ann Allergy Asthma Immunol 111(3):205–210
doi: 10.1016/j.anai.2013.06.023
pubmed: 23987197
Visse R, Nagase H (2003) Matrix metalloproteinases and tissue inhibitors of metalloproteinases: structure, function, and biochemistry. Circ Res 92(8):827–839
doi: 10.1161/01.RES.0000070112.80711.3D
pubmed: 12730128
Viskens AS, Wils T, Van Bulck P, Cools L, Vanderveken O, Hellings PW (2022) Multiple reasons underlaying uncontrolled disease in the majority of chronic rhinosinusitis patients. Front Allergy 3:1048385
doi: 10.3389/falgy.2022.1048385
pubmed: 36583193
pmcid: 9792505
Wautlet A, Bachert C, Desrosiers M, Hellings PW, Peters AT (2023) The management of chronic rhinosinusitis with nasal polyps (CRSwNP) With biologics. J Allergy Clin Immunol Pract 11(9):2642–2651
doi: 10.1016/j.jaip.2023.04.054
pubmed: 37182568