Elevated ALCAM Expression Associated with Endotypes and Postoperative Recurrence in Chronic Rhinosinusitis with Nasal Polyps

Abstract

Background: Chronic rhinosinusitis with polyps (CRSwNP) is characterized by high heterogeneity and postoperative recurrence rate. This study aimed to explore the clinical significance of activated leukocyte cell adhesion molecule (ALCAM) in endotyping CRSwNP and predicting its recurrence. Methods: We recruited 120 CRSwNP patients including 70 non-eosinophilic CRSwNP (neCRSwNP) and 50 eosinophilic CRSwNP (eCRSwNP) patients, and 40 healthy controls (HCs). Serum and tissue samples were collected. Serum ALCAM levels were detected by enzyme-linked immunosorbent assay (ELISA), and tissue ALCAM expression was assessed by reverse transcription-polymerase chain reaction (RT-PCR), Western blotting (WB) and immunohistochemistry (IHC). The predictive values of ALCAM expression for CRSwNP endotypes and postoperative recurrence were assessed. Results: The serum levels of ALCAM were significantly increased in CRSwNP patients in comparison with HCs and were correlated with the peripheral eosinophil count, tissue eosinophil counts, and percentage. Multivariate analysis and receiver operating characteristic (ROC) curve highlighted that serum ALCAM levels were associated with CRSwNP endotypes. Tissue ALCAM expression was significantly enhanced in CRSwNP patients, especially in eCRSwNP patients. At the end of the study, 110 patients completed the follow-up schedule, 78 patients were categorized into the non-recurrent group, and the other 32 patients were included in the recurrent group. The serum ALCAM levels were elevated in the recurrent group compared with the non-recurrent group, and ALCAM expression in the tissue was significantly elevated. The ROC curve exhibited a high predictive ability of serum ALCAM in predicting postoperative recurrence. Logistic regression and Kaplan-Meier curves demonstrated that serum ALCAM was an independent risk factor for postoperative recurrence. Conclusion: This is the first report suggesting that ALCAM expression was upregulated and associated with mucosal eosinophil infiltration and CRSwNP recurrence. Serum ALCAM could be a promising biomarker for distinguishing endotypes and predicting postoperative recurrence in CRwNP patients.

Serum Proteomic Analysis Revealed Biomarkers for Eosinophilic Chronic Rhinosinusitis with Nasal Polyps Pathophysiology

“…Its diagnosis primarily relies on pathological tissue section examination and eosinophil count, which is invasive and subject to certain subjectivity. 34 , 35 Although previous studies have identified several potential biomarkers for predicting eCRSwNP, such as serum metabolomics, 36 nasal microbiota, 37 and the peripheral blood lymphocyte-to-eosinophil ratio, 38 their sensitivity and specificity remain relatively constrained, hindering their adoption in clinical settings. Therefore, the exploration of objective biomarkers for eCRSwNP is still a current research focus, which will contribute to achieving personalized precision treatment.…”

Abnormal S100A8 expression associates with postoperative recurrence in chronic rhinosinusitis with nasal polyps

“…Currently, although surgical treatment is one of the effective treatment modalities to improve clinical symptoms in patients with CRSwNP, not all patients achieve good prognoses due to its uncertain etiology and high disease heterogeneity [ 31 ]. It was well established that the degree of eosinophil infiltration and type 2 inflammation in the mucosa profoundly influenced the risk of CRSwNP recurrence after surgery [ [32] , [33] , [34] ].In the present study, we found that serum and tissue S100A8 levels were significantly upregulated in patients with recurrent CRSwNP compared to patients with primary CRSwNP. Moreover, serum S100A8 levels were positively correlated with peripheral blood and tissue eosinophil percentages.…”

Increased B Cell-Activating Factor Expression Is Associated with Postoperative Recurrence of Chronic Rhinosinusitis with Nasal Polyps

“…Therefore, exploring risk factors associated with CRSwNP recurrence and predicting its recurrence are extremely challenging and urgently needed for rhinologists. Although several variables and indicators were reported to be correlated with postoperative recurrence, including accompanied asthma [10], Charcot-Leyden crystal [40] and peripheral parameters [41], and activated leukocyte cell adhesion molecule [42], there was no reliable biomarker available in clinical practice. Here, we firstly found that BAFF expressions were significantly enhanced in recurrent CRSwNP patients, and serum levels were closely linked with the rate of CRSwNP postoperative recurrence.…”