J Rhinol.  2021 Nov;28(3):147-152. 10.18787/jr.2021.00363.

Local Allergic Inflammation in Chronic Rhinosinusitis With Nasal Polyps Could Influence on Disease Severity and Olfaction

• Youn Bk
• Kim DK
• Kim BH
• Kim HG
• Jeong JH
• Cho SH

• KMID: 2522783
• DOI: http://doi.org/10.18787/jr.2021.00363

Abstract

Background and Objectives
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease resulting from inflammation of the nasal cavity and paranasal sinuses. Systemic allergic inflammation is an important cause of CRSwNP; however, the effect of local allergic inflammation is unclear. This study was designed to investigate the effect of local allergic inflammation in CRSwNP.
Materials and Methods
The study included 11 patients with CRSwNP and 18 control subjects. Olfactory function was measured with the Korean Version of Sniffin’s stick test. Nasal lavage fluids (NLFs) were collected from all subjects and analyzed for total IgE, eosinophilic cationic protein (ECP), and cytokines (tumor necrosis factor [TNF]-α, interleukin [IL]-4, IL-10, IL-17A, interferon-γ). Flow cytometry was used to measure various inflammatory cells in the NAL fluids.
Results
On analysis of flow cytometry and enzyme-linked immunosorbent assay, we found that CRSwNP patients had significantly increased eosinophil (%) and ECP levels in NLFs. In addition, there was significant local-systemic correlation between ECP level in NLFs and blood eosinophils (%) (r=0.391); however, there was no significant association between eosinophils (%) in NLFs and blood eosinophils. Moreover, in CRSwNP patients, the severity of disease was related with blood eosinophil (%), eosinophil (%), and ECP levels in NLFs, whereas olfactory function was associated with blood eosinophil (%) and ECP levels in NLFs.
Conclusion
CRSwNP is a disease with high allergic inflammation that has negative impacts on the severity of disease and olfactory function. Therefore, we suggest that control of local allergic inflammation will be helpful to treat CRSwNP patients.

Keyword

Chronic rhinosinusitis; Polyp; Local; Immune

Figure

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  Fig. 1. Evaluation of interaction local to systemic allergic inflammation (*p<0.05). A: Relationship between blood and nasal eosinophils (%). B: Realtionship between nasal ECP and eosinophils (%). ECP, eosinophil cationic protein.

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  Fig. 2. Effect of local allergic inflammation on clinical relevance. A: Relationship between blood eosinophils (%) and CT score/olfactory function (TDI). B: Relationship between nasal eosinophils (%) and CT score/olfactory function (TDI). C: Relationship between nasal ECP level and CT score/olfactory function (TDI). *p<0.05. TDI, Threshold-Discrimination-Identification. ECP, eosinophil cationic protein.

Reference

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