Blood Eosinophil Count Key Indicator of Inflammatory Severity in chronic rhinosinusitis with nasal polyps: Study

Comorbid asthma, nonsmoking status, and the ethmoid/maxillary sinus ratio were significant predictors of eosinophilic CRSwNP. These findings highlight the role of BEC in evaluating disease severity and identifying patients at higher risk for more severe forms of the condition.

Severe type 2 eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is difficult to treat and prone to recurrence after surgery. To address this, Chien-Chia Huang, School of Medicine, Chang Gung University, Taoyuan, Taiwan, and colleagues aimed to assess the relationship between clinical markers and the severity of tissue type 2 inflammation in patients with CRSwNP.

For this purpose, the researchers prospectively enrolled adult patients who underwent endoscopic sinus surgery for bilateral CRSwNP. They evaluated the tissue eosinophil count (TEC) and measured the expression levels of type 2 cytokines, including IL-5 and IL-13, in nasal polyps using real-time PCR. The study also assessed the correlations between clinical markers and the severity of tissue type 2 inflammation.

The key findings of the study were as follows:

• A total of 150 participants were enrolled in the study.
• Ninety-five participants (63.3%) had type 2 eosinophilic CRSwNP (defined by TEC ≥10/high power field).
• Weak to moderate correlations were identified between clinical markers and tissue markers of type 2 inflammation.
• Blood eosinophil count (BEC) demonstrated the strongest correlation with tissue type 2 inflammatory severity, as indicated by TEC, IL-5, and IL-13 levels in nasal polyps.
• Comorbid asthma, nonsmoking status, ethmoid/maxillary sinus (E/M) ratio, and BEC were significant predictors of eosinophilic CRSwNP in the regression analysis.

The findings showed that BEC emerges as the leading clinical marker, showing the strongest correlation with tissue type 2 inflammatory severity, as reflected by TEC, IL-5, and IL-13 levels in nasal polyps. Significant predictors of eosinophilic CRSwNP included comorbid asthma, nonsmoking status, E/M ratio, and BEC. These findings could aid clinicians in assessing type 2 inflammation severity in CRSwNP patients and tailoring optimal therapeutic strategies.

Reference:

Wu, W., Huang, C., Chang, H., Lee, J., Fan, H., & Huang, C. Blood Eosinophil Count is the Dominant Clinical Marker for type 2 Inflammatory Severity in CRSwNP. The Laryngoscope. https://doi.org/10.1002/lary.31899