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Inflammatory endotypes help to identify chronic rhinosinusitis
Researchers in this study identified correlations between phenotypes and inflammatory endotypes in patients with chronic rhinosinusitis which may aid in a more accurate description of distinct clusters of chronic rhinosinusitis, according to recent research.
“In summary, we have identified distinct inflammatory endotypes within patients with chronic rhinosinusitis, which largely correlated with phenotypes and further differentiated them,” Peter Tomassen, MD, from the Upper Airways Research Laboratory at Ghent University in Ghent, Belgium, and colleagues wrote in their study. “Endotypes clearly provide a more accurate description of the inflammatory mechanisms involved than phenotype only, and inflammation in patients with CRS might be more diverse than previously assumed.”
Tomassen and colleagues analyzed immune markers in 173 surgery cases of patients with chronic rhinosinusitis (CRS) who underwent surgery, according to the abstract. The researchers evaluated tissue from the cases for interleukin-5 (IL-5), IFN-γ, IL-17A, TNF-α, IL-22, IL-1β, IL-6 and IL-8, as well as for myeloperoxidase, eosinophilic cationic protein, immunoglobulin E (IgE), Staphylococcus aureus enterotoxin-specific IgE, transforming growth factor beta 1 (TGF-β1) and albumin.
When clustering the 173 cases, they found a total of 10 clusters, which consisted of 4 clusters with low or undetectable IL-5, IgE, albumin concentrations and eosinophilic cationic protein while another 6 clusters had high concentrations of each of those markers, according to the abstract. Within the IL-5 negative clusters, there were 3 clusters that contained a phenotype of CRS without nasal polyps (CRSsNP), a phenotype without increased asthma prevalence and a phenotype containing a TH17 profile and mixed CRS with nasal polyps (CRSwNP) and CRSsNP.
Within the IL-5 positive clusters, the researchers found “a group with moderate IL-5 concentrations, a mixed CRSsNP/CRSwNP and increased asthma phenotype, and a group with high IL-5 levels, an almost exclusive nasal polyp phenotype with strongly increased asthma prevalence,” Tomassen and colleagues wrote.
The researchers noted that clusters 9 and 10 contained the highest total IgE levels of around 1,000 kU/L, the highest rate of comorbid asthma between 64% and 71% as well as Staphylococcus aureus enterotoxin-specific IgE, according to the abstract. – by Jeff Craven
Disclosure: Tomassen received research support from the Sixth European Union Framework Program for Research and Fonds Wetenschappelijk Onderzoek Vlaanderen. The other researchers report various financial disclosures. Please see the full study for a complete list of disclosures.