Clinical characteristics and surrogate markers of eosinophilic chronic rhinosinusitis in Southern China

Abstract

The surrogate markers for subclassifying eosinophilic chronic rhinosinusitis (ECRS) and non-ECRS remain elusive. We herein performed a cross-sectional study to assess the clinical implication of clinical symptoms, CT findings, blood eosinophil (EOS) examination based on histological examination of tissue eosinophilia in 105 adult CRS patients (including 72 with nasal polyps and 33 without nasal polyps) in southern China. We found the mean score of smell loss was significantly higher in ECRS subgroup than those in non-ECRS subgroup (p < 0.05), whereas the average ethmoid osteitis index in non-ECRS subgroup was significantly higher than that in ECRS subgroup (p < 0.05). Moreover, we found both the mean blood EOS number and ratio were significantly higher in ECRS subgroup than those in non-ECRS subgroup (p < 0.05). By applying receiver operating characteristic (ROC) curve analysis, we found blood EOS number had a sensitivity of 84.9 % and specificity of 84.4 % [area under the curve (AUC): 0.873] at the cutoff level of 0.16 × 10(9)/L, and blood EOS ratio had a sensitivity of 89.0 % and specificity of 84.4 % (AUC: 0.863) at the cutoff level of 2.05 % in this cohort. Our findings indicated that smell loss score, ethmoid osteitis index and blood EOS number and ratio may be used for the differential diagnosis of ECRS as the surrogate markers.

A prospective analysis evaluating tissue biopsy location and its clinical relevance in chronic rhinosinusitis with nasal polyps

“…According to prior studies, tissue eosinophilia is correlated with olfactory dysfunction in CRS. 8, 10, 31 Other studies concluded that there is a relationship between tissue eosinophilia and worse disease severity as defined by preoperative CT and endoscopy scores; however, these study cohorts included both CRSsNP and CRSwNP patients and the analyses were not always stratified by subtype. 10, 11 We note that in these studies Kountakis et al 11 did not specify the exact biopsy location and Soler et al 10 evaluated eosinophilia in ethmoid mucosa.…”

“…Multiple studies have investigated the relationship between eosinophilic inflammation and comorbid asthma, but the histopathologic definitions of eosinophilia used in these studies are quite variable. 11, 17, 20, 31 Zuo et al 31 and Kountakis et al 11 both reported an increased frequency of asthma in CRS patients with higher eosinophil densities ( > 5 eosinophils/high-power field [HPF]) in sinus mucosal or NP tissue. Similarly, Tokunaga et al 20 found that asthma was more prevalent in CRS patients with higher eosinophil densities ( > 70 eosinophils/HPF) in NP or polypoid tissue from the ethmoid cavity.…”

Natural killer cells regulate eosinophilic inflammation in chronic rhinosinusitis

“…In addition, these reduced functions of NK cells correlate inversely with blood eosinophil counts12. Peripheral blood eosinophilia is well known to be related to tissue eosinophilia and recurrence of CRS after surgery131415. These findings suggest that the immune regulatory function of NK cells may play a role in regulating the eosinophilic inflammation in CRS.…”

A pilot study of symptom profiles from a polyp vs an eosinophilic‐based classification of chronic rhinosinusitis

“…Ouyang et al 35 (n=86) found smell loss and cough to be associated with eCRS on a modified SNOT questionnaire. Both Zuo et al 36 (n=105) and Haruna et al 37 (n=84) also found eCRS to be significantly associated with smell loss utilizing a 7-point VAS scale and 10-point VAS scale, respectively. Together, these studies suggest that mucosal eosinophilia is strongly associated with smell loss.…”