Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Sci Rep. 2022 Jan 31;12(1):1671. doi: 10.1038/s41598-022-05614-z.
This study aimed to investigate the effect of age in patients with chronic rhinosinusitis with nasal polyp (CRSwNP). 269 patients were divided into eosinophilic and non-eosinophilic groups based on tissue eosinophilia, defined by eosinophils accounting for more than 20% of the total inflammatory cells. Patients were then further divided into younger and older groups based on the age of 35 years. Clinical characteristics including blood eosinophil, Lund Mackay score, and modified Lund-Kennedy (mLK) scores were compared. Levels of 14 cytokines from nasal tissues of an additional 78 patients were analyzed. Tissue eosinophilia was significantly associated with age and the proportion of non-eosinophilic CRSwNP was significantly higher in younger patients as compared to older patients (79.2% vs 56.6%). There was no difference in clinical characteristics and cytokine levels between the younger and older patients with eosinophilic CRSwNP. In contrast, in patients with non-eosinophilic CRSwNP, younger patients had significantly lower preoperative blood eosinophils and higher mLK scores at three and six months, postoperatively, compared to older patients. Alpha-1 antitrypsin and IL-5 levels were significantly lower in younger patients than in older patients in non-eosinophilic CRSwNP. This study suggests a potential association between age, non-type 2 inflammation and treatment outcome in CRSwNP.
本研究旨在探讨年龄对慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者的影响。根据组织嗜酸性粒细胞（定义为占总炎症细胞的 20%以上的嗜酸性粒细胞），将 269 例患者分为嗜酸性粒细胞和非嗜酸性粒细胞组。然后根据年龄（35 岁）将患者进一步分为年轻组和老年组。比较了包括血嗜酸性粒细胞、Lund-Mackay 评分和改良 Lund-Kennedy（mLK）评分在内的临床特征。对另外 78 例患者的鼻组织中 14 种细胞因子的水平进行了分析。组织嗜酸性粒细胞与年龄显著相关，与老年患者相比，年轻患者中非嗜酸性粒细胞 CRSwNP 的比例明显更高（79.2%比 56.6%）。嗜酸性粒细胞 CRSwNP 患者的年轻组和老年组之间的临床特征和细胞因子水平无差异。相比之下，在非嗜酸性粒细胞 CRSwNP 患者中，年轻患者的术前血嗜酸性粒细胞水平较低，术后三个月和六个月的 mLK 评分较高。与老年患者相比，非嗜酸性粒细胞 CRSwNP 患者的α-1 抗胰蛋白酶和 IL-5 水平明显较低。本研究提示年龄、非 2 型炎症与 CRSwNP 治疗结果之间可能存在关联。
