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. 2022 Sep 24:15:5557-5565.
doi: 10.2147/JIR.S377301. eCollection 2022.

An Integrated Analysis of Inflammatory Endotypes and Clinical Characteristics in Chronic Rhinosinusitis with Nasal Polyps

Dingqian Hao  1 , Yisha Wu  1 , Ping Li  1 , Chunhao Li  1 , Tianjiao Jiang  1 , Qian Zhang  1 , Shengyang Liu  1 , Li Shi  1
Affiliations

An Integrated Analysis of Inflammatory Endotypes and Clinical Characteristics in Chronic Rhinosinusitis with Nasal Polyps

Dingqian Hao et al. J Inflamm Res. .

Abstract

Objective: Chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly characterised by type 1 (T1), type 2 (T2) and type 3 (T3) inflammatory endotypes. However, correlations between inflammatory endotypes and clinical features in CRSwNP have not been demonstrated sufficiently. This study aimed to determine the endotype-phenotype associations in CRSwNP.

Methods: Clinical data of 31 control subjects and 106 CRSwNP patients were analysed. Interferon (IFN)-γ (T1), Charcot-Leyden crystal galectin (CLC) (T2) and Interleukin (IL)-17A (T3) were used as biomarkers to identify the inflammatory endotypes.

Results: The mRNA expression level of IFN-γ was positively correlated with IL-17A (r = 0.817; P < 0.0001). Headache/facial pain (P = 0.039) was associated with T1 endotype. Smell loss (P = 0.025) was associated with T2 endotype. Purulent rhinorrhea (P = 0.001) was associated with T3 endotype. Atopy (P = 0.030), asthma (P = 0.005) and recurrence (P = 0.022) were more frequent in T2 endotype. Total Symptom Scores (TSS) of T2 (P < 0.001) and T3 (P = 0.009) endotype were higher than non-T2 and non-T3, respectively. Sino Nasal Outcome Test-22 (SNOT-22) total scores of T3 (P = 0.054) endotype were higher than non-T3.

Conclusion: Identifications of endotype-phenotype associations are useful in clinical diagnoses and targeted therapies for patients with CRSwNP.

Keywords: chronic rhinosinusitis with nasal polyps; diagnosis; endotype; phenotype; therapy.

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Conflict of interest statement

The authors report no conflicts of interest in relation to this work and declare that the research was conducted without any commercial or financial relationships construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patterns of inflammatory endotypes in CRSwNP. (A-D) The proportions of specific (B-D), single (A), mixed (A) and untypeable (A) endotypes. (E-G) The mRNA expression levels of IFN-γ (E), CLC (F) and IL-17A (G). (H-J) The correlations of mRNA expression levels for IFN-γ (H, I), CLC (I, J) and IL-17A (H, J). ****P < 0.0001.
Figure 2
Figure 2
Clinical characteristics in specific inflammatory endotypes. (A-H) The scores of nasal congestion (A), purulent rhinorrhea (B), smell loss (C), headache/facial pain (D), sneezing (E), nasal itching (F), eye itching (G) and total symptom scores (H). (I-L) The scores for rhinology (I), ear/facial (J), sleep dysfunction (K) and SNOT-22 total scores (L). *P < 0.05, **P < 0.01 and ***P < 0.001.
Figure 3
Figure 3
Prevalence of comorbid atopy (A), asthma (B) and recurrence (C) in specific inflammatory endotypes. *P < 0.05 and **P < 0.01.
Figure 4
Figure 4
Odds ratio (OR) and 95% confidence interval (CI) of headache/facial pain (A), smell loss (B), purulent rhinorrhea (C) in specific inflammatory endotypes. *P < 0.05 and **P < 0.01.
Figure 5
Figure 5
Clinical characteristics in single, mixed and untypeable inflammatory endotypes. (A-F) The scores of nasal congestion (A), purulent rhinorrhea (B), smell loss (C), sneezing (D), eye itching (E) and total symptom scores (F). (G-I) The scores for rhinology (G), sleep dysfunction (H) and SNOT-22 total scores (I). *P < 0.05, **P < 0.01 and ***P < 0.001.
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