Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden.
Department of Otorhinolaryngology, Sophiahemmet Hospital, Stockholm, Sweden.
Prostaglandins Leukot Essent Fatty Acids. 2022 Sep;184:102474. doi: 10.1016/j.plefa.2022.102474. Epub 2022 Jul 23.
Severe nasal polyposis and mucosal inflammation, in patients with chronic rhinosinusitis (CRS) may include a dysregulated eicosanoid profile, but a clinical role for eicosanoids in CRS with nasal polyps (NP; CRSwNP) remains to be elucidated. This study focused on assessing levels and clinical implications of inflammatory mediators in nasal secretions and urine from patients with different NP severity or Aspirin Exacerbated Respiratory Disease (AERD). Levels of leukotrienes E and B, prostaglandins D and E as well as 15(S)-hydroxyeicosatetraenoic acid were measured with enzyme immunoassays and cytokines with magnetic bead immunoassays. Patients with CRSwNP were subdivided based on NP score; CRSwNP-low (NP score ≤ 4, n = 11) or CRSwNP-high (NP score ≥ 5, n = 32) and compared to CRS without polyps (CRSsNP, n = 12), CRSwNP-AERD (n = 11) and individuals without CRS (n = 25). Smell test score, fractional exhaled nitric oxide (FeNO), blood eosinophils and Sinonasal outcome test-22 were assessed as clinical markers. Leukotriene E, prostaglandin D and 15(S)-hydroxyeicosatetraenoic acid in nasal secretions correlated with NP score. Nasal leukotriene E also correlated with FeNO and smell test score, with highest levels found in CRSwNP-AERD. Levels of prostaglandin D in nasal secretion as well as urinary levels of the prostaglandin D metabolite 11β-prostaglandin F differed between CRSNP-high and CRSwNP-low. Urinary 11β-prostaglandin F was associated with asthma comorbidity whereas a similar association with prostaglandin D in nasal secretions was not observed. In conclusion, subdividing patients based on NP severity in combination with analysis of eicosanoids in non-invasively collected nasal secretions, may have clinical implications when assessing CRS disease severity.
严重的鼻息肉和黏膜炎症，在慢性鼻-鼻窦炎（CRS）患者中可能包括一个失调的类二十烷酸谱，但类二十烷酸在伴有鼻息肉（NP；CRSwNP）的 CRS 中的临床作用仍有待阐明。本研究集中评估了不同 NP 严重程度或阿司匹林加重的呼吸道疾病（AERD）患者鼻分泌物和尿液中炎症介质的水平及其临床意义。采用酶联免疫吸附法测定白三烯 E 和 B、前列腺素 D 和 E 以及 15(S)-羟二十碳四烯酸的水平，采用磁珠免疫分析法测定细胞因子的水平。CRSwNP 患者根据 NP 评分进一步细分；CRSwNP 低（NP 评分≤4，n=11）或 CRSwNP 高（NP 评分≥5，n=32），并与无息肉的 CRS（CRSsNP，n=12）、CRSwNP-AERD（n=11）和无 CRS 的个体（n=25）进行比较。嗅觉测试评分、呼出气一氧化氮分数（FeNO）、血嗜酸性粒细胞和鼻-鼻窦结局测试-22 被评估为临床标志物。鼻分泌物中的白三烯 E、前列腺素 D 和 15(S)-羟二十碳四烯酸与 NP 评分相关。鼻白三烯 E 还与 FeNO 和嗅觉测试评分相关，在 CRSwNP-AERD 中水平最高。鼻分泌物中前列腺素 D 的水平以及尿中前列腺素 D 代谢物 11β-前列腺素 F 的水平在 CRSNP 高和 CRSwNP 低之间存在差异。尿 11β-前列腺素 F 与哮喘合并症相关，而在鼻分泌物中观察到类似的前列腺素 D 与哮喘合并症相关。总之，根据 NP 严重程度对患者进行细分，并分析非侵入性收集的鼻分泌物中的类二十烷酸，在评估 CRS 疾病严重程度时可能具有临床意义。
