|
1
|
Zhang Q, Zhang C, Chen J, Shi L, Gao Y, Zhou Y, Cheng F, Wang D, Wang H, Sun X, Hu L. Correlation between Lund-Mackay computed tomography score and subjective symptoms in Chinese patients with nasal polyps. Acta Otolaryngol 2025; 145:59-65. [PMID: 39432114 DOI: 10.1080/00016489.2024.2412720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 09/29/2024] [Accepted: 10/01/2024] [Indexed: 10/22/2024]
Abstract
BACKGROUND The association between objective imaging findings and subjective symptoms remains undefined. AIMS To investigate the correlation between objective imaging findings and symptom severity in the overall chronic rhinosinusitis with nasal polyps (CRSwNP) population as well as its subendotypes according to the eosinophilic inflammation. METHODS Patients with CRSwNP undergoing endoscopic sinus surgery were included. All participants completed the Sino-Nasal Outcome Test (SNOT-22) questionnaire. The Lund-Mackay (LM) CT scores was also obtained. Spearman correlation analysis was performed to evaluate the correlation between CT scores and SNOT-22 scores. RESULTS Forty-four non-eosinophilic CRSwNP(neCRSwNP) and 93 eosinophilic CRSwNP (eCRSwNP) patients were recruited. There was significant association between LM total score and nasal subdomain of SNOT-22 in the overall CRSwNP patients. The nasal symptom of SNOT-22 was significantly associated with maxillary, frontal, sphenoid, anterior drainage, and posterior drainage in all CRSwNP patients. In eCRSwNP and neCRSwNP patients, the sense of smell/taste was associated with sphenoid and posterior drainage. Thick nasal discharge was positively correlated with maxillary, frontal, and anterior drainage only in eCRSwNP patients. CONCLUSIONS The high score of sphenoid and posterior drainage may suggest the occurrence of loss of sense of smell/taste, while high score of maxillary sinus may indicate suffering from thick nasal discharge in eCRSwNP patients.
Collapse
Affiliation(s)
- Qianqian Zhang
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
| | - Chen Zhang
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
| | - Jiani Chen
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
| | - Le Shi
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yingqi Gao
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
| | - Yumin Zhou
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
| | - Fuying Cheng
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
| | - Dehui Wang
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Huan Wang
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
| | - Xicai Sun
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
- Department of Otolaryngology, People's Hospital of Shigatse City, Shigatse, China
| | - Li Hu
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- High Altitude Rhinology Research Center of Eye &, ENT Hospital of Fudan University and People's Hospital of Shigatse City, China
- Refractory Chronic Sinusitis Clinical Center of Eye & ENT Hospital of Fudan University, Shanghai, China
| |
Collapse
|
|
2
|
Zhang C, Zhang Q, Chen J, Li H, Cheng F, Wang Y, Gao Y, Zhou Y, Shi L, Yang Y, Liu J, Xue K, Zhang Y, Yu H, Wang D, Hu L, Wang H, Sun X. Neutrophils in nasal polyps exhibit transcriptional adaptation and proinflammatory roles that depend on local polyp milieu. JCI Insight 2024; 9:e184739. [PMID: 39361432 PMCID: PMC11601912 DOI: 10.1172/jci.insight.184739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 10/02/2024] [Indexed: 10/05/2024] Open
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory upper airway disease, divided into eosinophilic CRSwNP (eCRSwNP) and noneosinophilic CRSwNP (neCRSwNP) according to eosinophilic levels. Neutrophils are major effector cells in CRSwNP, but their roles in different inflammatory environments remain largely unclear. We performed an integrated transcriptome analysis of polyp-infiltrating neutrophils from patients with CRSwNP, using healthy donor blood as a control. Additional experiments, including flow cytometry and in vitro epithelial cell and fibroblast culture, were performed to evaluate the phenotypic feature and functional role of neutrophils in CRSwNP. Single-cell RNA-sequencing analysis demonstrated that neutrophils could be classified into 5 functional subsets, with GBP5+ neutrophils occurring mainly in neCRSwNP and a high proportion of CXCL8+ neutrophils in both subendotypes. GBP5+ neutrophils exhibited significant IFN-I pathway activity in neCRSwNP. CXCL8+ neutrophils displayed increased neutrophil activation scores and mainly secreted oncostatin M (OSM), which facilitates communication with other cells. In vitro experiments showed that OSM enhanced IL-13- or IL-17-mediated immune responses in nasal epithelial cells and fibroblasts. Our findings indicate that neutrophils display transcriptional plasticity and activation when exposed to polyp tissue, contributing to CRSwNP pathogenesis by releasing OSM, which interacts with epithelial cells and fibroblasts depending on the inflammatory environment.
Collapse
Affiliation(s)
- Chen Zhang
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
- Department of Otolaryngology, Shigatse People’s Hospital, Shigatse City, China
| | - Qianqian Zhang
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Jiani Chen
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Han Li
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Fuying Cheng
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Yizhang Wang
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Yingqi Gao
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Yumin Zhou
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Le Shi
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Yufei Yang
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Juan Liu
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Kai Xue
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Yaguang Zhang
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Hongmeng Yu
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Dehui Wang
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Li Hu
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Huan Wang
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xicai Sun
- ENT Institute and Department of Otorhinolaryngology and
- High Altitude Rhinology Research Center, Eye and ENT Hospital, Fudan University, Shanghai, China
- Department of Otolaryngology, Shigatse People’s Hospital, Shigatse City, China
| |
Collapse
|
|
3
|
Chen Y, Wang T, Gao R, Wang F. Effects of Metabolic Syndrome and its components on the postoperative recurrence in Chronic Rhinosinusitis with Nasal Polyps' patients. Braz J Otorhinolaryngol 2024; 90:101371. [PMID: 38070374 PMCID: PMC10755715 DOI: 10.1016/j.bjorl.2023.101371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/25/2023] [Accepted: 11/22/2023] [Indexed: 01/01/2024] Open
Abstract
OBJECTIVES Metabolic Syndrome (MetS) has been established as a significant factor in the pathogenesis of numerous chronic inflammatory conditions. However, its role in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is unknown. This study aims to investigate the association between MetS, its components, and the risk of postoperative recurrence in Chinese patients with CRSwNP. METHODS A retrospective cohort study was conducted on CRSwNP patients who underwent endoscopic sinus surgery in our hospital. Patients were divided into MetS and non-MetS groups, and the clinical characteristics and recurrence rates were compared. All CRSwNP patients were followed up for more than 2-years and further categorized into non-recurrent and recurrent groups. Binary logistic regression analyses were performed to examine the effects of MetS and its components on the risk of postoperative recurrence. RESULTS A total of 555 CRSwNP patients were enrolled in the present study, 157 patients were included in the MetS group and 398 patients were categorized into the non-MetS group. The recurrence rate in the MetS group was significantly higher compared to the non-MetS group (p < 0.05). The rate of MetS, overweight or obesity, hyperglycemia and dyslipidemia were higher in the recurrent group in comparison with the non-recurrent group (p < 0.05). Multivariate logistic regression analysis suggested that MetS, overweight or obesity, hyperglycemia, dyslipidemia, and accompanying allergic rhinitis were associated with the risk of postoperative recurrence of CRSwNP (p < 0.05). Moreover, adjusted and unadjusted regression models showed that MetS was an independent risk factor for postoperative recurrence of CRSwNP, and the risk increased with more components of MetS included (p < 0.05). CONCLUSION Our findings revealed that MetS independently increased the risk of postoperative recurrence in patients with CRSwNP, with the risk escalating as the number of MetS components increased. Moreover, accompanying allergic rhinitis was also demonstrated to be a potential risk factor for CRSwNP recurrence. LEVEL OF EVIDENCE Level 4.
Collapse
Affiliation(s)
- Yu Chen
- Central South University, The Third Xiangya Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, China
| | - Tiansheng Wang
- Central South University, The Third Xiangya Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, China
| | - Ru Gao
- Central South University, The Third Xiangya Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, China
| | - Fengjun Wang
- Xiangya Hospital of Central South University, Department of Otolaryngology Head and Neck Surgery, Changsha, China; Xiangya Hospital of Central South University, Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Changsha, China; Xiangya Hospital of Central South University, National Clinical Research Center for Geriatric Disorders, Changsha, China.
| |
Collapse
|