Allergogenic Profile in Patients with Different Subtypes of Chronic Rhinosinusitis with Nasal Polyps

Abstract

Aims: The aim of this study was to analyze the relationship between allergy and different subtypes of chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: A total of 83 patients with CRSwNP and 20 patients with nasal septum deviation (NSD) as controls were enrolled in our study. Nasal tissue was obtained from all subjects during surgery. Hematoxylin and eosin staining was performed and the CRSwNP cases were classified into eosinophilic nasal polyps (ENP) and noneosinophilic nasal polyps (nENP) cases according to the percent of eosinophils. The Allergy Screen test was used to detect total and specific immunoglobulin E (IgE) against 5 kinds of common inhalant allergens. Results: There were 28 (33.73%) patients with ENP and 55 with nENP. Total IgE levels were significantly increased in ENP compared with nENP patients. The IgE level was significantly correlated with the eosinophil count. According to the 5 kinds of common inhalant allergens, only ENP patients exhibited higher sensitivity to dust mites. Conclusion: Patients with ENP showed significantly higher IgE levels when compared with patients with nENP based on allergy.

International consensus statement on allergy and rhinology: rhinosinusitis 2021

“…Complicating this picture, rates of systemic atopy vary between eosinophilic and non‐eosinophilic CRSwNP populations 1392 . Additionally, local production of specific IgE is seen in the absence of systemic atopy 1393 .…”

The Role of Periostin in the Occurrence and Progression of Eosinophilic Chronic Sinusitis with Nasal Polyps

“…Additionally, an allergen challenge could increase periostin expression in the airway epithelium, subepithelium, smooth muscle, and inflammatory cells 31 , and periostin has been shown to act on eosinophils and enhance their recruitment to lesions 32 . In our recent study, we found that ENPs were associated with Th2-mediated allergic disease and allergen sensitization 18 . The periostin-rich microenvironment develops in areas that are associated with insult, and exposure to allergens in atopic diseases can be considered an insult 33 .…”

“…Evidence suggests that periostin could promote angiogenesis by upregulating VEGF through the focal adhesion kinase (FAK) or the signal-regulated kinase 1/2 (ERK 1/2) mediated signaling pathways 14 , 15 . To date, some investigators have proposed that periostin is produced locally in the sinonasal tissues and might contribute to polyp formation 16 , 17 ; meanwhile, we had found that patients with ENP were more likely to be atopic 18 , so we speculate that periostin might play an important role in tissue remodeling in NP via inducing VEGF, RANTES and eotaxin-2 production. However, current evidence for the relationships among VEGF, RANTES, eotaxin-2 and periostin and various nasal disorder subtypes is scarce, and their importance in different subtypes of NP pathogenesis is not well understood.…”

Aeroallergens, air pollutants, and chronic rhinitis and rhinosinusitis

“…Frequently tested aeroallergens ranging from molds, trees, weeds, grass, animal dander are usually secondary to the house dust mite (HDM) as the most frequent offender. 5 While some studies have purported direct associations between CRS volunteers and allergic sensitization, there is not a definitive correlation between the two. For instance, in a study by Gutman 2004 of 48 voluntary participants with CRS and recurrent acute rhinosinusitis, 57.4% had a positive allergy test with the majority being sensitive to more than one allergen (most commonly perennial allergens, mold and dust mites).…”