Predictive Significance of Charcot-Leyden Crystal Protein in Nasal Secretions in Recurrent Chronic Rhinosinusitis with Nasal Polyps

Abstract

<b><i>Introduction:</i></b> The recurrence occurs frequently among patients with chronic rhinosinusitis with nasal polyps (CRSwNP), and predictors that could be conveniently detected during practice in outpatient service are needed. <b><i>Objective:</i></b> We aimed to illustrate that the concentration of Charcot-Leyden crystal (CLC) in nasal secretions can effectively and noninvasively predict polyp recurrence. <b><i>Methods:</i></b> 108 patients with CRSwNP were divided into recurrence (<i>n</i> = 68) and recurrence-free (<i>n</i> = 40) groups. Preoperative CLC concentrations in nasal secretions were collected and detected by ELISA. Polyp tissues were harvested during biopsy or endoscopic sinus surgery and were evaluated for inflammatory cells by histopathological staining. Demographic information and the clinical characteristics of each patient were reviewed for associations with recurrence. Binary logistic regression analysis was performed to determine predictive factors for polyp recurrence. Receiver operating characteristic (ROC) curves and the Youden index were performed to determine their predictive values. Survival analysis was performed to compare recurrence risk of patients with different CLC concentrations. <b><i>Results:</i></b> Sixty-eight (62.96%) patients developed recurrence during a 12- to 33-month postoperative follow-up. CLC concentrations in nasal secretions were positively correlated with eosinophil percent in polyp tissue and peripheral blood and were significantly higher in patients of the recurrence group than in the patients of the recurrence-free group (<i>p <</i> 0.001). Binary logistic regression and ROC curve demonstrated that CLC protein in nasal secretions is predictive of polyp recurrence. According to the Youden index, a CLC concentration of 34.24 ng/mL can predict postoperative polyp recurrence with 92.6% sensitivity and 87.5% specificity. Patients with CLC concentrations higher than the cutoff value yielded a higher risk of recurrence (<i>p <</i> 0.001, HR = 11.31, 95% CI: 6.41–19.98). <b><i>Conclusions:</i></b> CLC protein in nasal secretions may serve as a promising noninvasive biomarker to predict CRSwNP recurrence.

Circulating MIF Associated With Disease Severity and Clinical Response of Sublingual Immunotherapy in House Dust Mite–Induced Allergic Rhinitis

“…The detailed parameters of ROC analysis are displayed in Table 5 . Based on the optimal cutoff values of the serum MIF level obtained by ROC analysis, patients were categorized into low MIF level group (serum MIF level <22.5 ng/ml, n = 51) and high MIF level group (serum MIF level >22.5 ng/ml, n = 29) as similarly described in previous publications ( Liang et al, 2020 ; Wu et al, 2021 ). In low MIF level group, the good-response rate was 78.4%, which was higher than that in high MIF level group (17.2%, p < 0.001).…”

Mepolizumab decreased the levels of serum galectin-10 and eosinophil cationic protein in asthma

“…As EETosis has been evident in various allergic diseases including ECRS [ 15 ], the released galectin-10 levels in serum might reflect the activity of eosinophil-related diseases. Although the levels of galectin-10 have been assessed in the tissues from patients with eosinophilic esophagitis [ 15 ], or nasal secretion during nonallergic rhinitis of patients with eosinophilia syndrome [ 16 ], aspirin-sensitive respiratory disease [ 17 ], and chronic rhinosinusitis (CRS) with nasal polyps [ 18 ], the clinical relevance of serum galectin-10 is totally unknown to date. In this study, the rapid decrease in serum galection-10 after mepolizumab treatment suggested the resolutions of CLC-mediated inflammation by mepolizumab, warranting further investigation.…”

“…Our finding indicates the usefulness of serum ECP over blood eosinophil count as potential predictive factor of mepolizumab efficacy for ECRS in severe asthma. Galectin-10 in nasal secretion has been shown to be significantly higher in patients with recurrent nasal polyp [ 18 ], suggesting an important role of galectin-10 in formation of nasal polyp. However, the clinical relevance of serum galectin-10 in nasal polyp or ECRS has not been reported yet.…”

Association of Air Pollutant Exposure and Sinonasal Histopathology Findings in Chronic Rhinosinusitis

“…Recent studies have shown that individuals with higher levels of Charcot-Leyden proteins and mRNA in sinonasal tissues are associated with having eosinophilic CRS and disease recurrence. [23][24][25] The negative effects of airborne pollutants on respiratory health have been widely reported in epidemiological and experimental studies. There is only limited literature on the effects of pollution in patients with CRS.…”

“…Recent studies have shown that individuals with higher levels of Charcot-Leyden proteins and mRNA in sinonasal tissues are associated with having eosinophilic CRS and disease recurrence. 23–25…”