Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China 710004.
Mediators Inflamm. 2022 May 19;2022:9155080. doi: 10.1155/2022/9155080. eCollection 2022.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disease with high heterogeneity and postoperative recidivation. The IL-33/ST2 axis is known to be involved in Th2 immune responses. This study is aimed at exploring levels of serum IL-33 and soluble ST2 (sST2) in CRSwNP patients and their potential for predicting CRSwNP endotypes and postoperative recurrence.
The present study recruited 149 CRSwNP patients, 80 of whom were noneosinophilic (neCRSwNP) and 69 eosinophilic (eCRSwNP), as well as 60 healthy controls (HCs). Serum samples were collected from all participants, and sST2 and IL-33 concentrations were measured using ELISA. Multivariate analysis, receiver operating characteristic (ROC) curves, and Kaplan-Meier curves were used to evaluate the value of serum sST2 and IL-33 levels in distinguishing CRSwNP endotypes and predicting postoperative recurrence.
The levels of serum sST2 and IL-33 in CRSwNP patients were significantly higher than those in HCs, especially in the eCRSwNP group. Increased sST2 and IL-33 levels were associated with eosinophil counts and percentages in both tissue and blood. Multivariate regression and ROC curve analysis showed that serum sST2 and IL-33 exhibited potential for distinguishing CRSwNP endotypes, and the combination of serum IL-33 and sST2 showed even more predictive power. Finally, 124 CRSwNP patients completed the entire 3-year follow-up. Multivariate analysis and Kaplan-Meier curves showed that serum sST2 and IL-33 levels were associated with recurrence; serum sST2 and IL-33 each exhibited potential for predicting postoperative recurrence, and combining serum sST2 and IL-33 exhibited better accuracy and practicability.
Our results suggested that serum sST2 and IL-33 levels were upregulated in CRSwNP patients and related to the degree of mucosal eosinophil infiltration and postoperative recurrence. Serum sST2 and IL-33 might serve as objective biomarkers for distinguishing phenotypes and predicting recurrence in CRSwNP, and their combined use outperformed either marker alone.
慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）是一种常见的具有高度异质性和术后复发的炎症性疾病。IL-33/ST2 轴被认为参与了 Th2 免疫反应。本研究旨在探讨 CRSwNP 患者血清 IL-33 和可溶性 ST2（sST2）的水平及其预测 CRSwNP 表型和术后复发的潜力。
本研究纳入了 149 例 CRSwNP 患者，其中 80 例为非嗜酸性（neCRSwNP），69 例为嗜酸性（eCRSwNP），以及 60 例健康对照者（HCs）。所有参与者均采集血清样本，采用 ELISA 法检测 sST2 和 IL-33 浓度。采用多变量分析、受试者工作特征（ROC）曲线和 Kaplan-Meier 曲线评估血清 sST2 和 IL-33 水平在区分 CRSwNP 表型和预测术后复发中的价值。
CRSwNP 患者血清 sST2 和 IL-33 水平明显高于 HCs，尤其是 eCRSwNP 组。sST2 和 IL-33 水平升高与组织和血液中的嗜酸性粒细胞计数和百分比有关。多变量回归和 ROC 曲线分析显示，血清 sST2 和 IL-33 具有区分 CRSwNP 表型的潜力，联合血清 IL-33 和 sST2 具有更强的预测能力。最后，124 例 CRSwNP 患者完成了整个 3 年的随访。多变量分析和 Kaplan-Meier 曲线显示，血清 sST2 和 IL-33 水平与复发相关；血清 sST2 和 IL-33 各自具有预测术后复发的潜力，联合检测血清 sST2 和 IL-33 具有更高的准确性和实用性。
我们的结果表明，CRSwNP 患者血清 sST2 和 IL-33 水平上调，与鼻黏膜嗜酸性粒细胞浸润程度和术后复发相关。血清 sST2 和 IL-33 可能作为区分 CRSwNP 表型和预测复发的客观生物标志物，联合使用优于单独使用。
