Department of Otolaryngology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Department of Otorhinolaryngology, the University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Int Arch Allergy Immunol. 2023;184(6):576-586. doi: 10.1159/000528946. Epub 2023 Feb 6.
Chronic rhinosinusitis with nasal polyps (CRSwNPs) in China is characterized by a mixed eosinophilic-neutrophilic inflammation, linking to a more heterogeneous clinical phenotype. However, the relationship between eosinophilic and neutrophilic inflammation in Chinese patients with CRSwNP remains largely unknown. We aimed to further characterize the correlation between neutrophils with eosinophils in relation to clinical characters and disease control status after endoscopic sinus surgery (ESS).
A total of 242 patients were recruited and stratified based on tissue (≥10%) eosinophilia and (≥20/per high-power field) neutrophilia. Clinical characteristics and disease control status were compared between subgroups. Associations between tissue eosinophils and neutrophils were analyzed.
The uncontrolled patients accounted for 41.3%, 41.3%, 17.1%, and 22.2% in subjects with concomitant tissue eosinophilia and neutrophilia (EN-high), isolated eosinophilia (E-high), isolated neutrophilia (N-high), and no eosinophilia and neutrophilia (EN-low), respectively. Positive correlations between tissue eosinophils and neutrophils were observed in patients with CRSwNP as well as in EN-high and N-high subgroups but not in E-high and EN-low subgroups. The EN-high subgroup had higher tissue eosinophil numbers than the other three subgroups. Both EN-high and E-high subgroups had higher rates of uncontrolled subjects than the N-high and EN-low subgroups; however, there was no difference in the rate of uncontrolled subjects between EN-high and E-high subgroups and between N-high and EN-low subgroups.
Tissue neutrophils might have a potential interaction and mutual promotion effect with eosinophils in CRSwNP. However, tissue neutrophilia would not pose significant risk for poor disease control after ESS. Further larger, prospective studies are needed to confirm our findings.
中国的慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）的特征为混合性嗜酸性粒细胞-中性粒细胞炎症，与更异质的临床表型相关。然而，中国 CRSwNP 患者的嗜酸性粒细胞和中性粒细胞炎症之间的关系在很大程度上仍不清楚。我们旨在进一步描述嗜酸性粒细胞与中性粒细胞之间的相关性，以及内镜鼻窦手术（ESS）后与临床特征和疾病控制状况的关系。
共招募了 242 名患者，并根据组织（≥10%）嗜酸性粒细胞和（≥20/高倍视野）中性粒细胞进行分层。比较了亚组之间的临床特征和疾病控制状况。分析了组织嗜酸性粒细胞和中性粒细胞之间的相关性。
无控制的患者在伴有组织嗜酸性粒细胞和中性粒细胞（EN-高）、单纯嗜酸性粒细胞（E-高）、单纯中性粒细胞（N-高）和无嗜酸性粒细胞和中性粒细胞（EN-低）的患者中分别占 41.3%、41.3%、17.1%和 22.2%。CRSwNP 患者以及 EN-高和 N-高亚组中观察到组织嗜酸性粒细胞与中性粒细胞之间存在正相关，但 E-高和 EN-低亚组中没有。EN-高亚组的组织嗜酸性粒细胞数高于其他三个亚组。EN-高和 E-高亚组无控制患者的比例均高于 N-高和 EN-低亚组；然而，EN-高和 E-高亚组之间以及 N-高和 EN-低亚组之间无控制患者的比例无差异。
组织中性粒细胞可能与 CRSwNP 中的嗜酸性粒细胞具有潜在的相互作用和促进作用。然而，组织中性粒细胞增多并不会对 ESS 后疾病控制不佳产生显著风险。需要进一步进行更大规模的前瞻性研究来证实我们的发现。
