Division of Allergy-Immunology Department of Medicine, Northwestern University Feinberg School of Medicine Chicago, Illinois, USA.
Department of Otolaryngology, Northwestern University Feinberg School of Medicine Chicago, Illinois, USA.
Immun Inflamm Dis. 2015 Mar;3(1):14-22. doi: 10.1002/iid3.46. Epub 2015 Feb 12.
Up to 50% of patients with chronic rhinosinusitis (CRS) have comorbid asthma, and we have reported that a subset of CRS patients who have nasal polyps (CRSwNP) have elevated autoantigen-specific antibodies within their nasal polyps (NP). While increases in the prevalence and/or severity of both asthma and autoimmunity in women are well characterized, it is not known whether CRSwNP is more severe or frequent in women than men. We sought to determine whether CRSwNP demonstrated sex-specific differences in frequency and/or severity. Using a retrospectively collected database of tertiary care patients (n = 1393), we evaluated the distribution of sex in patients with CRSwNP with or without comorbid asthma or aspirin hypersensitivity. We further compared the severity of sinus disease between men and women with CRSwNP. Although women comprised 55% of CRS patients without NP (CRSsNP), a significantly smaller proportion of CRSwNP patients were female (38%, P < 0.001). Interestingly, women with CRSwNP were significantly more likely than men to have comorbid asthma (P < 0.001), and 61% of patients with the most severe form of disease (aspirin-exacerbated respiratory disease (CRSwNP plus asthma plus aspirin sensitivity)) were women (P < 0.05). Women with CRSwNP were significantly more likely to have taken oral steroids, and were more likely to have a history of revision surgeries (P < 0.05) compared to men. These data suggest that women with CRSwNP have more severe disease than men in a tertiary care setting. Future studies are needed to elucidate the mechanisms that drive disease severity in men and women, paving the way for the development of personalized treatment strategies for CRSwNP based on sex.
高达 50%的慢性鼻-鼻窦炎（CRS）患者合并哮喘，我们曾报道过，一部分伴有鼻息肉（CRSwNP）的 CRS 患者，其鼻息肉中存在自身抗原特异性抗体升高。虽然女性哮喘和自身免疫的患病率和/或严重程度增加已得到充分证实，但尚不清楚 CRSwNP 在女性中是否比男性更严重或更常见。我们旨在确定 CRSwNP 在频率和/或严重程度上是否存在性别特异性差异。我们使用三级保健患者的回顾性数据库（n=1393），评估了伴有或不伴合并哮喘或阿司匹林过敏的 CRSwNP 患者中性别分布。我们进一步比较了 CRSwNP 男性和女性之间鼻窦疾病的严重程度。尽管女性占无息肉 CRS 患者（CRSsNP）的 55%，但 CRSwNP 患者中女性的比例明显较小（38%，P<0.001）。有趣的是，与男性相比，患有 CRSwNP 的女性更有可能合并哮喘（P<0.001），并且 61%的疾病最严重形式（阿司匹林加重的呼吸道疾病（CRSwNP 合并哮喘合并阿司匹林过敏））为女性（P<0.05）。与男性相比，患有 CRSwNP 的女性更有可能服用口服类固醇，且更有可能有手术史（P<0.05）。这些数据表明，在三级保健环境中，女性 CRSwNP 患者的疾病比男性更严重。需要进一步的研究来阐明导致男性和女性疾病严重程度的机制，为基于性别的 CRSwNP 个体化治疗策略的发展铺平道路。
