Increased noneosinophilic nasal polyps in chronic rhinosinusitis in US second-generation Asians suggest genetic regulation of eosinophilia

Abstract

Capsule Summary In this study we found a significantly lower eosinophilia in nasal polyps surgically removed from second-generation Asian patients, similar to studies of native-born patients in Asian countries, suggesting the hypothesis that there may be genetic regulation of eosinophilia.

Functional role of kynurenine and aryl hydrocarbon receptor axis in chronic rhinosinusitis with nasal polyps

“…Most nasal polyps (NPs) in Caucasian patients with CRSwNP are eosinophilic, a state that is frequently associated with asthma. 1 In contrast, recent studies, including ours, have demonstrated that more than half of the patients with CRSwNP in East Asian countries presented with noneosinophilic inflammation. 2–4 Although genetic and/or environmental factors may contribute to the heterogeneity of CRSwNP, the mechanisms underlying the persistent and exaggerated inflammation in CRSwNP are not fully defined.…”

Differential short palate, lung, and nasal epithelial clone 1 suppression in eosinophilic and noneosinophilic chronic rhinosinusitis with nasal polyps

“…While many studies have tried to subclassify CRSwNP into eosinophilic and noneosinophilc subtypes, clear criteria for subclassifying eosinophilic and noneosinophilc remain elusive [48]. Most of the literature defines eosinophilic inflammation by examining the number or ratio of eosinophils in polyp tissues [49][50][51][52]. The current cutoffs proposed in the literature to define eosinophilic chronic rhinosinusitis include a tissue eosinophil amount to more than 5% of all leukocytes in five visual fields or a tissue eosinophil count of more than five cells/high power field (HPF).…”

Role of interleukin 33 in chronic rhinosinusitis

“…By comparison, type 2 inflammatory responses characterised by interleukin (IL) 4, IL-5, IL-13 cytokine expression and eosinophilic inflammation are features of CRSwNP 1. This categorisation may, however, be oversimplified as recent studies show that this may be subject to racial and regional differences 2 3. While the majority of Caucasian patients sampled in the USA and Europe have a pronounced infiltration of eosinophils and expression of IL-5 in the NPs, patients with CRSwNP in East Asian countries including Japan, Korea and China, exhibit a mixed inflammatory profile.…”