花生四烯酸15-脂氧合酶对嗜酸性粒细胞性慢性鼻-鼻窦炎伴鼻息肉的预测意义

Predictive significance of arachidonate 15-lipoxygenase for eosinophilic chronic rhinosinusitis with nasal polyps.

作者信息

Liang Zhuoping, Yan Bing, Liu Chang, Tan Ruyu, Wang Chengshuo, Zhang Luo

机构信息

Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730 People's Republic of China.

Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005 People's Republic of China.

出版信息

Allergy Asthma Clin Immunol. 2020 Sep 16;16:82. doi: 10.1186/s13223-020-00480-8. eCollection 2020.

DOI:10.1186/s13223-020-00480-8

PMID:32973910

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7493848/

Abstract

BACKGROUND

Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) exhibits a poorer outcome compared with non-eosinophilic chronic rhinosinusitis with nasal polyps (nonECRSwNP), so it is significant to identify effective markers to differentiate ECRSwNP in guiding the treatment strategies of these patients. Although arachidonate 15-lipoxygenase (ALOX15) is positioned as a marker of eosinophilic inflammation, its study in differentiating ECRSwNP has not been reported. The aim of this study is to assess the potential of ALOX15 in distinguishing and predicting ECRSwNP.

METHODS

Forty-eight patients with chronic rhinosinusitis with nasal polyps (CRSwNP), including 30 ECRSwNP and 18 nonECRSwNP patients, were enrolled. ALOX15 mRNA level was determined in polyps by real-time polymerase chain reaction (RT-PCR). The patients' baseline characteristics were evaluated and analyzed for correlations with ALOX15. Receiver operating characteristic (ROC) curve was used to assess the predictive significance of the potential predictors for ECRSwNP.

RESULTS

ALOX15 mRNA level was significantly higher in ECRSwNP patients than in nonECRSwNP patients ( < 0.001). ALOX15 mRNA was significantly correlated with tissue and blood eosinophil percentages ( = 0.565, < 0.001 and = 0.395, = 0.006), olfaction scores ( = 0.400, = 0.005), total visual analogue scale (VAS) symptom scores ( = 0.383, = 0.007), ethmoid/maxillary sinus (E/M) ratio ( = 0.463, = 0.001), and endoscopy scores ( = 0.409, = 0.004). Logistic regression analysis showed ALOX15 mRNA level and percentage of blood eosinophils to be predictive factors for ECRSwNP ( = 0.004 and = 0.036, respectively). ROC curve indicated ALOX15 to have high predictive accuracy for ECRSwNP (area under the curve (AUC) = 0.909), which was further improved by combination of ALOX15 with percentage of blood eosinophils (AUC = 0.933).

CONCLUSIONS

The relative ALOX15 mRNA level alone or in combination with blood eosinophils might be a reliable biomarker for predicting a diagnosis of ECRSwNP.

摘要

背景

与非嗜酸性粒细胞性慢性鼻-鼻窦炎伴鼻息肉（nonECRSwNP）相比，嗜酸性粒细胞性慢性鼻-鼻窦炎伴鼻息肉（ECRSwNP）的预后较差，因此确定有效的标志物以鉴别ECRSwNP对于指导这些患者的治疗策略具有重要意义。尽管花生四烯酸15-脂氧合酶（ALOX15）被定位为嗜酸性粒细胞炎症的标志物，但其在鉴别ECRSwNP方面的研究尚未见报道。本研究旨在评估ALOX15在鉴别和预测ECRSwNP中的潜力。

方法

纳入48例慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者，其中包括30例ECRSwNP患者和18例nonECRSwNP患者。通过实时聚合酶链反应（RT-PCR）测定息肉中ALOX15 mRNA水平。评估患者的基线特征并分析其与ALOX15的相关性。采用受试者工作特征（ROC）曲线评估潜在预测指标对ECRSwNP的预测意义。

结果

ECRSwNP患者的ALOX15 mRNA水平显著高于nonECRSwNP患者（<0.001）。ALOX15 mRNA与组织和血液嗜酸性粒细胞百分比显著相关（=0.565，<0.001；=0.395，=0.006）、嗅觉评分（=0.400，=0.005）、视觉模拟量表（VAS）总症状评分（=0.383，=0.007）、筛窦/上颌窦（E/M）比值（=0.463，=0.001）和内镜评分（=0.409，=0.004）。逻辑回归分析显示ALOX15 mRNA水平和血液嗜酸性粒细胞百分比是ECRSwNP的预测因素（分别为=0.004和=0.036）。ROC曲线表明ALOX15对ECRSwNP具有较高的预测准确性（曲线下面积（AUC）=0.909），将ALOX15与血液嗜酸性粒细胞百分比联合使用可进一步提高预测准确性（AUC=0.933）。