Inflammatory Endotypes of Chronic Rhinosinusitis in the Korean Population: Distinct Expression of Type 3 Inflammation

Min, Jin‐Young; Kim, Jin Youp; Sung, Chung Ki; Kim, Seon-Tae; Cho, Hyun Jin; Mun, Sue Jean; Cho, Sung-Woo; Hong, Sang Duk; Ryu, Gwanghui; Cho, Kyoung Rai; Kim, Young Hyo; Park, Soo Kyung; Kim, Chang Woo; Lee, Dong Hoon; Heo, Sung Jae; Lee, Ki-Il; Kim, Su Jin; Lee, Sangjun; Mo, Ji‐Hun; Shin, Seung‐Heon; Kim, Dae Woo

doi:10.4168/aair.2023.15.4.437

Cited by 9 publications

(3 citation statements)

References 30 publications

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“…The last 10 of the clusters demonstrate type 2 and type 3 patterns like our cluster 5; there are intermediate clusters with increased type 2, type 3, and type 1 characteristic biomarkers, and there are more clinically less aggressive clusters with type 1 factors such as type 1 marker INF-γ and increased IL-6, like our cluster 1 and cluster 2. Interestingly, in a recent study in Korea, five clusters of patients with chronic rhinosinusitis were found, and the most common finding was a type 3 endotype with a high presence of nasal polyps, severe disease extent, and type 2 CRS [34].…”

Section: Other Studies On Crs Endotypesmentioning

confidence: 98%

Endotypes of Chronic Rhinosinusitis with Primary and Recurring Nasal Polyps in the Latvian Population

Viksne,

Sumeraga,

Pilmane

2024

IJMS

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Chronic rhinosinusitis (CRS) is a complex syndrome with various inflammatory mechanisms resulting in different patterns of inflammation that correlate with the clinical phenotypes of CRS. Our aim was to use detected IL-1, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, Ki 67, HBD-2, HBD-3, and LL-37 to classify specific inflammatory endotypes in chronic rhinosinusitis with the tissue of nasal polyps (CRSwNP). Samples from 35 individuals with primary and recurrent CRSwNP were taken during surgery. The tissues were stained for the previously mentioned biomarkers immunohistochemically. A hierarchical cluster analysis was performed. The clinical parameters were compared between clusters. Five clusters had significantly different biomarkers between groups. There were no significant differences in the clinical parameters, except for the Lund–Mackay score, which was significantly higher in cluster 4 compared to that of cluster 1 (p = 0.024). Five endotypes of (CRSwNP) are characterized by different combinations of type 1, type 2, and type 3 tissue inflammation patterns. In the Latvian population, endotypes associated with neutrophilic inflammation or a combination of neutrophilic inflammation and type 2 inflammation are predominant. Increased proliferation marker Ki 67 values are not associated with more severe inflammation in the tissue samples of chronic rhinosinusitis with nasal polyps.

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Section: Other Studies On Crs Endotypesmentioning

confidence: 98%

Endotypes of Chronic Rhinosinusitis with Primary and Recurring Nasal Polyps in the Latvian Population

Viksne,

Sumeraga,

Pilmane

2024

IJMS

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“…It can be broadly classified into two phenotypes: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) 3 . Similar to asthma, CRS inflammation can be categorized into two primary types: type 2 (T2) and non‐T2 inflammation 4 . The type 2 inflammation is characterized by signature T2 cytokines such as interleukin (IL)‐4, IL‐5, and IL‐13, elevated immunoglobulin E (IgE), and tissue eosinophilia 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Similar to asthma, CRS inflammation can be categorized into two primary types: type 2 (T2) and non‐T2 inflammation 4 . The type 2 inflammation is characterized by signature T2 cytokines such as interleukin (IL)‐4, IL‐5, and IL‐13, elevated immunoglobulin E (IgE), and tissue eosinophilia 4 . This type of inflammation is more commonly observed in CRSwNP, with approximately 80% of patients with this clinical phenotype having a T2 inflammatory profile.…”

Section: Introductionmentioning

confidence: 99%

Assessing the clinico‐immunological profile of patients with obesity and chronic rhinosinusitis

Chaaban,

Asosingh,

Comhair

et al. 2023

Int Forum Allergy Rhinol

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BackgroundNo studies have investigated the systemic and local sinonasal profile of obesity‐related chronic rhinosinusitis (CRS), despite its observed association in recent retrospective studies. The objectives of our study were to assess the impact of obesity on the clinical and cytokine profile of patients with CRS and evaluate treatment response with functional endoscopic sinus surgery.MethodsThis was a prospective observational study at the Cleveland Clinic that included patients with CRS (n = 54) between December 2021 and September 2022. Data collection included demographics, body mass index (BMI), comorbidities, baseline sinonasal outcome test scores, baseline radiologic scores (Lund–Mackay), postoperative sinonasal outcome test scores (at 3–4 months), and local and systemic alarmins/T‐helper cytokines.ResultsOut of the 54 CRS patients, there were 20 CRS patients without nasal polyps (37%) and 34 with nasal polyps (63%). Patients were categorized based on obesity (BMI ≥ 30 kg/m2). Obese CRS patients had lower systemic alarmins (interleukin [IL]‐33 and Thymic stromal lymphopoietin (TSLP)) compared to non‐obese CRS patients (IL‐33: 744.2 ± 1164.6 pg/mL vs. 137.5 ± 320.0 pg/mL, p = 0.005; TSLP: 627.7 ± 1806.3 pg/mL vs. 28.1 ± 85.4 pg/mL, p = 0.017). CRS patients with nasal polyps with BMI ≥30 kg/m2 had higher postoperative sinonasal outcome test scores and lower levels of nasal eotaxin‐3 and IL‐33 compared to BMI <30 kg/m2 counterparts.ConclusionsIn conclusion, patients with obese CRS and nasal polyps displayed diminished levels of intranasal alarmins and reduced intranasal eotaxin‐3. These results potentially imply the presence of a unique, obese type 2‐low CRS phenotype that warrants further exploration.

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Blood Eosinophil Count is the Dominant Clinical Marker for type 2 Inflammatory Severity in CRSwNP

Wu,

Huang,

Chang

et al. 2024

The Laryngoscope

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ObjectiveSevere type 2 eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is challenging to treat and susceptible to recurrence post‐surgery. This study aimed to evaluate the relationship between clinical markers and tissue type 2 inflammatory severity in patients with CRSwNP.MethodsAdult patients who underwent endoscopic sinus surgery for bilateral CRSwNP were prospectively enrolled. Tissue eosinophil count (TEC) was evaluated. Expression levels of type 2 cytokines, including IL‐5 and IL‐13, in nasal polyps were determined using real‐time PCR. Correlations between clinical markers and tissue type 2 inflammation were also assessed.ResultsIn total, 150 participants were recruited. Ninety‐five (63.3%) exhibited type 2 eosinophilic CRSwNP defined by TEC ≥10/high power field. Weak to moderate correlations were observed between clinical and tissue markers of type 2 inflammation. Among the clinical markers, blood eosinophil count (BEC) exhibited the highest correlation with tissue type 2 inflammatory severity, as determined by TEC, IL‐5, and IL‐13 expression levels in nasal polyps. Comorbid asthma, nonsmoking status, ethmoid/maxillary sinuses (E/M) ratio, and BEC were significant predictors of eosinophilic CRSwNP in the regression analysis.ConclusionsBEC, a dominant clinical marker, exhibits the highest correlation with tissue type 2 inflammatory severity, as determined by TEC, IL‐5, and IL‐13 in nasal polyps. Comorbid asthma, nonsmoking status, E/M ratio, and BEC were significant predictors of eosinophilic CRSwNP. This could help clinicians better evaluate the severity of type 2 inflammation in patients with CRSwNP and provide optimal therapeutic strategies.Level of Evidence4 Laryngoscope, 2024

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Inflammatory Endotypes of Chronic Rhinosinusitis in the Korean Population: Distinct Expression of Type 3 Inflammation

Cited by 9 publications

References 30 publications

Endotypes of Chronic Rhinosinusitis with Primary and Recurring Nasal Polyps in the Latvian Population

Endotypes of Chronic Rhinosinusitis with Primary and Recurring Nasal Polyps in the Latvian Population

Assessing the clinico‐immunological profile of patients with obesity and chronic rhinosinusitis

Blood Eosinophil Count is the Dominant Clinical Marker for type 2 Inflammatory Severity in CRSwNP

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