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. 2025 Feb;45(1):39-46.
doi: 10.14639/0392-100X-N2877.

Blood and local nasal eosinophilia in chronic rhinosinusitis with nasal polyps: prevalence and correlation with severity of disease

Eugenio De Corso  1 , Marco Corbò  2 , Claudio Montuori  2 , Daniela Furno  2 , Veronica Seccia  3 , Tiziana Di Cesare  2 , Carlotta Pipolo  4 , Silvia Baroni  5   6 , Rodolfo Mastrapasqua  7 , Alberta Rizzuti  2 , Giuseppe D'Agostino  2 , Leandro Maria D'Auria  2 , Maria Clara Pacilli  2 , Jacopo Galli  1   2
Affiliations

Blood and local nasal eosinophilia in chronic rhinosinusitis with nasal polyps: prevalence and correlation with severity of disease

Eugenio De Corso et al. Acta Otorhinolaryngol Ital. 2025 Feb.

Abstract

Objective: The aim of this study was to evaluate the clinical relevance of absolute eosinophil blood count and eosinophil count by nasal cytology in the context of real-life clinical practice and to determine if they correlate with the severity of symptoms in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods: We enrolled 425 patients with CRSwNP followed between January 2015 and April 2023 at the A. Gemelli Hospital Foundation-IRCCS, Rome, Italy. We gathered data on blood and local eosinophil count and correlated the results with clinical features. All patients underwent endoscopy, Visual Analogical Scale (VAS) for main symptoms, and SinoNasal Outcome Test 22 (SNOT-22).

Results: We observed significantly higher mean levels of eosinophils in serum and at nasal cytology in patients with CRSwNP and comorbidities (asthma, non-steroidal anti-inflammatory drugs - exacerbated respiratory disease and allergy) compared to those without. Blood eosinophilia was not associated with severity of symptoms, whereas patients with nasal eosinophil count > 5 eosinophils per high-power field at nasal cytology had a significantly higher median specific VAS for nasal symptoms and significantly higher SNOT 22 scores.

Conclusions: We demonstrated that blood eosinophil count and nasal cytology may represent useful tools in routine clinical practice to define Type 2 inflammation and that their levels are usually higher in patients with comorbidities. We also showed that blood eosinophilia was not correlated with severity of symptoms, whereas local eosinophil count was associated with high severity of symptoms and high burden on quality of life.

Keywords: SNOT-22; allergic rhinitis; asthma; chronic rhinosinusitis; nasal polyposis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Cover figure.
Cover figure.
Nasal eosinophil count >5 per high-power fields was associated with more severe symptoms and a greater burden on quality of life in patients with chronic rhinosinusitis with nasal polyps.
Figure 1.
Figure 1.
VAS nasal obstruction and smell impairment in patients with < 5 eosinophils/hpf or ≥ 5 eosinophils/hpf at nasal cytology.
Figure 2.
Figure 2.
VAS rhinorrhoea and cranio-facial pain in patients with < 5 eosinophils/hpf or ≥ 5 eosinophils/hpf at nasal cytology.
Figure 3.
Figure 3.
Mean SNOT-22 score subdividing patients based on nasal cytology eosinophil count assuming a cut-off of 5 eos/hpf or 10 eos/hpf.
See this image and copyright information in PMC

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