Multivariate analysis of inflammatory endotypes in recurrent nasal polyposis in a Chinese population

作者：Wei Bo; Liu Feng; Zhang Jie; Liu Yafeng; Du Jintao; Liu Shixi; Zhang Nan; Bachert Claus^*; Meng Juan^*

来源：Rhinology, 2018, 56(3): 216-226.

DOI：10.4193/Rhin17240

• Recurrent CRSwNP
• chronic rhinosinusitis
• nasal polyps
• cluster analysis
• type-2 inflammation

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical problem due to its propensity for recurrence. However, data on the frequency of CRSwNP recurrence after surgery in China are rare.
Methods: 78 CRSwNP patients undergoing functional endoscopic sinus surgery were followed-up for 8 years and classified into recurrent and non-recurrent groups. A cluster analysis of the CRSwNP based on inflammatory endotypes was performed, and the endotypes were secondarily matched with clinical phenotypes.
Result: The recurrence rate of CRSwNP in Southwest China was 21.8% over 8 years post-surgery. The CRSwNP was classified into 4 clusters: cluster 1 (higher expression of IL-5, IgE, and ECP and high positivity rate for SE-IgE); cluster 2 (higher concentrations of IL-6, IL-8 and MPO); cluster 3 (higher concentrations ofTNF-o and IFN-y); and cluster 4 (higher expression of IL-17). Cluster 1 (type-2 inflammation) exhibited the highest recurrence rate, co-morbid asthma and atopy. Notably, the ECP/MPO ratio increased significantly in patients with non-type-2 recurrent CRSwNP 8 years after the first surgery.
Conclusion: Different inflammatory endotypes of CRSwNP exhibited clearly different prognoses. The type-2 subgroup had high recurrence and co-morbid asthma rates comparable to the rates reported in Western countries.

• 出版日期2018
• 单位四川大学