Veloso-Teles Rafaela, Cerejeira Rui, Roque-Farinha Rosa, Buchwald Christian von
Faculty of Health Sciences, 70987University of Beira Interior, Covilhã, Portugal.
Department of Otorhinolaryngology, Cova da Beira Hospital Centre (CHCB), Covilhã, Portugal.
Ear Nose Throat J. 2021 Sep;100(5_suppl):554S-561S. doi: 10.1177/0145561319893163. Epub 2019 Dec 4.
The immune pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains obscure. Our aim was to compare humoral immunity and white blood cell counts in patients with CRSwNP and controls. A prospective case-control study was carried out in 37 patients with CRSwNP and 34 controls without CRS. Clinical data were gathered through a systematic interview. Computed tomography scan, skin prick test, spirometry, and immunological parameters (leukocyte differential count, immunoglobulin classes, and immunoglobulin [Ig] G subclasses) in serum specimens were obtained. Statistical analysis was performed using SPSS v.23. The prevalence of chronic lower respiratory diseases was greater in the CRSwNP group ( < .001), but atopic disease had no significant difference. A significantly higher eosinophil ( < .001) and basophil relative count ( = .022) and a lower relative neutrophil count ( = .013) were found among CRSwNP group. Patients with CRSwNP had higher IgG1 ( = .022), but lower IgG2 ( = .014) and IgG3 ( = .018) serum levels compared to controls; IgG4, total IgG, IgA, IgM, and IgE serum levels did not differ between groups, as well as the prevalence of immunoglobulin classes or IgG subclasses deficiency. The variation observed in peripheral relative leukocyte count and the systemic IgG1 subclass shift are similar to what is known to happen in nasal polyp tissue. A unique systemic immune profile seems to be present in patients with CRSwNP.
伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）的免疫发病机制仍不清楚。我们的目的是比较CRSwNP患者和对照组的体液免疫及白细胞计数。对37例CRSwNP患者和34例无CRS的对照者进行了一项前瞻性病例对照研究。通过系统访谈收集临床资料。获取血清标本的计算机断层扫描、皮肤点刺试验、肺功能测定以及免疫参数（白细胞分类计数、免疫球蛋白类别和免疫球蛋白[Ig]G亚类）。使用SPSS v.23进行统计分析。CRSwNP组慢性下呼吸道疾病的患病率更高（<.001），但特应性疾病无显著差异。CRSwNP组中嗜酸性粒细胞相对计数显著更高（<.001）、嗜碱性粒细胞相对计数更高（=.022），中性粒细胞相对计数更低（=.013）。与对照组相比，CRSwNP患者的血清IgG1水平更高（=.022），但IgG2（=.014）和IgG3（=.018）水平更低；IgG4、总IgG、IgA、IgM和IgE血清水平在两组间无差异，免疫球蛋白类别或IgG亚类缺乏的患病率也无差异。外周相对白细胞计数和全身IgG1亚类变化与鼻息肉组织中已知情况相似。CRSwNP患者似乎存在独特的全身免疫特征。
