Zhang Hua, Xie Shaobing, Fan Ruohao, Wang Fengjun, Xie Zhihai, Jiang Weihong
Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, People's Republic of China.
Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Changsha, Hunan, 410008, People's Republic of China.
J Inflamm Res. 2022 Feb 15;15:1063-1077. doi: 10.2147/JIR.S350609. eCollection 2022.
Chronic rhinosinusitis with polyps (CRSwNP) is characterized by high heterogeneity and postoperative recurrence rate. This study aimed to explore the clinical significance of activated leukocyte cell adhesion molecule (ALCAM) in endotyping CRSwNP and predicting its recurrence.
We recruited 120 CRSwNP patients including 70 non-eosinophilic CRSwNP (neCRSwNP) and 50 eosinophilic CRSwNP (eCRSwNP) patients, and 40 healthy controls (HCs). Serum and tissue samples were collected. Serum ALCAM levels were detected by enzyme-linked immunosorbent assay (ELISA), and tissue ALCAM expression was assessed by reverse transcription-polymerase chain reaction (RT-PCR), Western blotting (WB) and immunohistochemistry (IHC). The predictive values of ALCAM expression for CRSwNP endotypes and postoperative recurrence were assessed.
The serum levels of ALCAM were significantly increased in CRSwNP patients in comparison with HCs and were correlated with the peripheral eosinophil count, tissue eosinophil counts, and percentage. Multivariate analysis and receiver operating characteristic (ROC) curve highlighted that serum ALCAM levels were associated with CRSwNP endotypes. Tissue ALCAM expression was significantly enhanced in CRSwNP patients, especially in eCRSwNP patients. At the end of the study, 110 patients completed the follow-up schedule, 78 patients were categorized into the non-recurrent group, and the other 32 patients were included in the recurrent group. The serum ALCAM levels were elevated in the recurrent group compared with the non-recurrent group, and ALCAM expression in the tissue was significantly elevated. The ROC curve exhibited a high predictive ability of serum ALCAM in predicting postoperative recurrence. Logistic regression and Kaplan-Meier curves demonstrated that serum ALCAM was an independent risk factor for postoperative recurrence.
This is the first report suggesting that ALCAM expression was upregulated and associated with mucosal eosinophil infiltration and CRSwNP recurrence. Serum ALCAM could be a promising biomarker for distinguishing endotypes and predicting postoperative recurrence in CRwNP patients.
伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）具有高度异质性和术后复发率。本研究旨在探讨活化白细胞细胞黏附分子（ALCAM）在CRSwNP内型分型及预测其复发中的临床意义。
我们招募了120例CRSwNP患者，包括70例非嗜酸性CRSwNP（neCRSwNP）患者和50例嗜酸性CRSwNP（eCRSwNP）患者，以及40例健康对照（HCs）。收集血清和组织样本。采用酶联免疫吸附测定（ELISA）检测血清ALCAM水平，通过逆转录-聚合酶链反应（RT-PCR）、蛋白质印迹法（WB）和免疫组织化学（IHC）评估组织ALCAM表达。评估ALCAM表达对CRSwNP内型及术后复发的预测价值。
与HCs相比，CRSwNP患者血清ALCAM水平显著升高，且与外周嗜酸性粒细胞计数、组织嗜酸性粒细胞计数及百分比相关。多因素分析和受试者工作特征（ROC）曲线表明，血清ALCAM水平与CRSwNP内型相关。CRSwNP患者组织ALCAM表达显著增强，尤其是eCRSwNP患者。研究结束时，110例患者完成随访，78例患者被归类为非复发组，另外32例患者被纳入复发组。复发组血清ALCAM水平高于非复发组，组织中ALCAM表达显著升高。ROC曲线显示血清ALCAM对术后复发具有较高的预测能力。逻辑回归和Kaplan-Meier曲线表明，血清ALCAM是术后复发的独立危险因素。
这是首份表明ALCAM表达上调并与黏膜嗜酸性粒细胞浸润及CRSwNP复发相关的报告。血清ALCAM可能是区分CRwNP患者内型及预测术后复发的有前景的生物标志物。
