Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Int Forum Allergy Rhinol. 2021 Jul;11(7):1064-1073. doi: 10.1002/alr.22759. Epub 2021 Feb 2.
The clinical characteristics of central-compartment-type chronic rhinosinusitis (CRS) in East Asian individuals are not clear. We sought to investigate the clinical features and the cytokine profiles of central-compartment-type CRS in our patient group.
Adult patients diagnosed with bilateral CRS were recruited, and patients who had previously undergone sinus surgery and pansinusitis (Lund-Mackay scores >23) were excluded. Central-compartment-type CRS was defined by both endoscopic and radiological features. The symptoms, inhalant allergen sensitization status, endoscopic findings, and radiological assessments were recorded and compared between patients with central-compartment-type CRS and other types of CRS. We also examined the extent of tissue eosinophilia and specific cytokine protein levels (eosinophil cationic protein [ECP], myeloperoxidase [MPO], immunoglobulin E [IgE], interleukin [IL]-4, IL-5, and IL-13) in the sinonasal tissues.
Central-compartment-type CRS was found in 16 (23.9%) patients, and non-central-compartment-type CRS was found in 51 (76.1%) patients. Hyposmia or anosmia as the major symptom was more common in the central-compartment-type CRS group. The numbers of eosinophils in tissue and serum were significantly higher in the central-compartment-type CRS patients. The presence of allergen sensitization was not significantly different between groups. The levels of IL-5 and IL-13 were increased in middle turbinate tissues of patients with central-compartment-type CRS.
Central-compartment-type CRS was associated with hyposmia or anosmia, eosinophilic subtypes, and elevated levels of IL-5 and IL-13 in middle turbinate tissues but not necessarily correlated with allergic disease in our patients.
东亚人群中中央型慢性鼻-鼻窦炎（CRS）的临床特征尚不清楚。我们旨在研究我们患者群体中中央型 CRS 的临床特征和细胞因子谱。
招募被诊断为双侧 CRS 的成年患者，并排除既往鼻窦手术和全鼻窦炎（Lund-Mackay 评分>23）的患者。中央型 CRS 通过内镜和影像学特征来定义。记录并比较中央型 CRS 患者和其他类型 CRS 患者的症状、吸入性过敏原致敏状态、内镜表现和影像学评估。我们还检查了鼻组织中嗜酸性粒细胞增多的程度和特定细胞因子蛋白水平（嗜酸性粒细胞阳离子蛋白[ECP]、髓过氧化物酶[MPO]、免疫球蛋白 E[IgE]、白细胞介素[IL]-4、IL-5 和 IL-13）。
16 例（23.9%）患者为中央型 CRS，51 例（76.1%）患者为非中央型 CRS。嗅觉减退或丧失为主要症状在中央型 CRS 组更为常见。中央型 CRS 患者的组织和血清中嗜酸性粒细胞数量明显更高。两组间过敏原致敏的存在无显著差异。中央型 CRS 患者中鼻甲组织中的 IL-5 和 IL-13 水平升高。
在我们的患者中，中央型 CRS 与嗅觉减退或丧失、嗜酸性细胞亚型和中鼻甲组织中 IL-5 和 IL-13 水平升高相关，但不一定与过敏性疾病相关。
