CRS‐PRO and SNOT‐22 correlations with type 2 inflammatory mediators in chronic rhinosinusitis

Racette, Samuel D.; Schneider, Alexander L.; Ganesh, Meera; Huang, Julia; Lehmann, David S.; Price, Caroline P.E.; Rodegherio, Samuel G.; Reddy, Abhita T.; Eide, Jacob G.; Conley, David B.; Welch, Kevin C.; Kern, Robert C.; Shintani‐Smith, Stephanie; Kato, Atsushi; Schleimer, Robert P.; Tan, Bruce K.

doi:10.1002/alr.23002

Cited by 13 publications

(2 citation statements)

References 35 publications

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“…In terms of symptoms evaluation and the burden on QOL, almost all respondents (98%) use the sino-nasal outcome test 22 (SNOT-22) (Q34 s.f.) confirming its validity as demonstrated in the literature 6 , 24 , 25 . Notably, over 70% of respondents use the visual analogue scale (VAS) (including nasal obstruction, rhinorrhoea, smell, and craniofacial pain).…”

Section: Results and Practical Recommendationssupporting

confidence: 87%

Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics

Corso

Pipolo

Cantone³

et al. 2023

Acta Otorhinolaryngol Ital

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SUMMARY Objective We conducted a national survey to understand how rhinology practice has changed with the advent of biologics and how this affected patients with uncontrolled, severe chronic rhinosinusitis with nasal polyps (CRSwNP). We aimed to analyse the results of the survey and infer practical recommendations for clinical practice. Methods A group of ear, nose, and throat specialists (ENTs) experienced in the management of CRSwNP developed a 74-question survey. ENTs from rhinology centres authorised to prescribe biologics in the context of the national health system were invited to answer it between 01/05/2022 and 31/07/2022. The responses underwent descriptive analyses, and the authors discussed the results and derived practical recommendations for clinical practice. Results ENTs working in rhinology centres changed their practices coinciding with the advent of biologics. CRSwNP evaluations have become more complex because they involve diagnostic confirmation, determining the patients’ immunologic profile, and other factors. We observed heterogenous behaviours in practice that may be conditioned by the novelty of the topic. The results of the survey were used to develop practical recommendations for ENTs and are summarised herein. Conclusions Clinical practice in rhinology outpatient clinics has changed profoundly in the era of biologics. Our practical recommendations for clinicians working in rhinology centres are expected to help standardise practice and improve care.

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Section: Results and Practical Recommendationssupporting

confidence: 87%

Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics

Corso

Pipolo

Cantone³

et al. 2023

Acta Otorhinolaryngol Ital

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“…Before surgery, the complete medical history of each patient was collected, paying particular attention to atopy, asthma, aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) sensitivity and previous polypectomy procedures. Moreover, each patient completed the Sino-Nasal Outcomes (SNOT)-22 survey to subjectively assess disease-related symptoms 7 .…”

Section: Methodsmentioning

confidence: 99%

Eosinophil-mast cell pattern of intraepithelial infiltration as a marker of severity in CRSwNP

Gelardi,

Giancaspro,

Duda

et al. 2023

Sci Rep

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Chronic rhinosinusitis with nasal polyps (CRSwNP) is defined as a Type 2 eosinophilic disease, while CRSsNP is considered a Type 1 neutrophilic disease. Since neutrophils are also activated in eosinophilic CRSwNP, the eosinophil–neutrophil dualism has been revaluated. Among the inflammatory cells infiltrating sinus-nasal tissues, the role of mast cells (MCs) is not already recognized, although Clinical-Cytological Grading, which defines the severity of CRSwNP, attributes to mixed eosinophil-MC forms of CRSwNP a greater risk of recurrence. We aimed to examine nasal polyps from both a cytological and histopathological point of view, to evaluate the presence and localization of MCs. Cytological and histological examination of 39 samples of nasal polyps were performed. Immunohistochemistry was used to evaluate the presence of Tryptase + CD117 + MCs, which were counted both in the epithelial layer and in the lamina propria. A statistically significant correlation was found between intraepithelial MCs and CRSwNP severity (p < 0.001) and between the total eosinophil count and the total mast cell count (p < 0.001). Cytological examination and immunohistochemistry were comparable in detecting the presence of intraepithelial MCs (p = 0.002). The histological cut-off of 6 intraepithelial MCs was identified to detect severe CRSwNP (p < 0.001). MCs have been shown to be located in the lamina propria of almost all eosinophilic nasal polyps without significantly affecting their severity. Intraepithelial MCs are associated with greater severity of CRSwNP. Histopathological criteria of the eosinophil-MC form of CRSwNP in addition to the eosinophilic one, should be defined to guarantee patients effective and tailored treatments.

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CRS‐PRO and SNOT‐22 correlations with type 2 inflammatory mediators in chronic rhinosinusitis

Racette

Schneider

Ganesh

et al. 2022

Int Forum Allergy Rhinol

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The 22-item Sino-Nasal Outcome Test (SNOT-22) and 12-item Patient Reported Outcomes in Chronic Rhinosinusitis (CRS-PRO) instrument are validated patient-reported outcomes measures in CRS. In this study we assess the correlation of these with type 2 (T2) biomarkers before and after endoscopic sinus surgery (ESS). Methods: Middle meatal mucus data were collected and the SNOT-22 and CRS-PRO were administered to 123 patients (71 CRS without nasal polyps [CRSsNP], 52 CRS with nasal polyps [CRSwNP]) with CRS before and 6 to 12 months after undergoing ESS. Interleukin (IL)-4, IL-5, IL-13, and eosinophilic cationic protein (ECP) were measured using a multiplexed bead assay and enzyme-linked immunoassay. Pre-and post-ESS SNOT-22 and CRS-PRO were compared with T2 biomarkers. Results: Before ESS neither PROM correlated with any biomarker. After ESS, CRS-PRO showed a correlation with 2 mediators (IL-5 and IL-13: p = 0.012 and 0.003, respectively) compared with none for the SNOT-22. For CRSwNP patients, pre-ESS CRS-PRO and SNOT-22 correlated with IL-4 (p = 0.04 for both). However, after ESS, CRS-PRO correlated with 3 biomarkers (IL-5, IL-13, and ECP: p = 0.02, 0.024, and 0.04, respectively) and SNOT-22 with 2 biomarkers (IL-5 and IL-13: p = 0.038 and 0.02, respectively). There were no significant relationships between any of the T2 biomarkers pre-or post-ESS among patients with CRSsNP. Exploratory analyses of the subdomains showed the SNOT-22

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CRS‐PRO and SNOT‐22 correlations with type 2 inflammatory mediators in chronic rhinosinusitis

Cited by 13 publications

References 35 publications

Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics

Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics

Eosinophil-mast cell pattern of intraepithelial infiltration as a marker of severity in CRSwNP

CRS‐PRO and SNOT‐22 correlations with type 2 inflammatory mediators in chronic rhinosinusitis

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