CRS 中嗅裂黏液炎症蛋白：一项病例对照研究。
Olfactory cleft mucus inflammatory proteins in CRS: a case-control study.
机构信息
Division of Rhinology and Sinus/Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
出版信息
Int Forum Allergy Rhinol. 2021 Sep;11(9):1321-1335. doi: 10.1002/alr.22770. Epub 2021 Feb 24.
BACKGROUND
Multiple hypotheses are evolving that suggest several, potentially overlapping etiologies for olfactory dysfunction (OD) in chronic rhinosinusitis (CRS). Understanding inflammatory cytokine profiles of the olfactory cleft (OC) and their association with olfactory function is foundational for future clinical care and research.
METHODS
This cross-sectional, case-control study evaluates associations among OC mucus inflammatory proteins, psychophysical olfactory testing, and computed tomography (CT) analysis of the OC and sinuses. Normative reference intervals were determined for each protein and odds ratios (ORs) were used to compare proportions of altered expression between CRS without nasal polyposis (CRSsNP) and CRS without nasal polyposis (CRSwNP).
RESULTS
Case subjects with CRS (n = 151) and controls (n = 74) were evaluated. A majority of OC proteins tested were found within detectable ranges for cases and controls. The CRS cohort had significantly higher concentrations for 23 of 26 proteins. CRS cases with abnormal levels of C-C motif chemokine ligand 2 (CCL2), CCL3, interleukin 5 (IL5), IL10, and IL13 associated with greater olfactory deficits. The prevalence of elevated IL5 and IL13 in anosmic patients was 64.6% and 62.5%, respectively (p < 0.004). CRS cases with the highest odds of elevated expression in CRSwNP were IL5 (OR = 10.83) and IL13 (OR = 8.36). However, both IL5 and IL13 were still elevated in approximately 14% of CRSsNP patients. The highest magnitude of correlation between the total percent of OC opacification was found to be with IL5 (r = 0.543; p < 0.001), whereas other moderate correlations were noted with immunoglobulin E (IgE), IL10, and IL13.
CONCLUSION
This study confirmed that OC inflammatory proteins vary both by disease phenotype and in their association with OD. Type 2 inflammatory mediators are increased in CRS, especially within the CRSwNP group. However, a substantial proportion of CRSsNP also express type 2 inflammatory mediators. Further research is necessary to understand the complex roles OC mucous inflammatory proteins might play in defining endotype and in impacting CRS-related OD. ©2021 ARSAAOA, LLC.
背景
有多种假说表明，慢性鼻-鼻窦炎（CRS）患者的嗅觉功能障碍（OD）可能存在多种潜在重叠的病因。了解嗅裂（OC）中的炎症细胞因子谱及其与嗅觉功能的关系，是未来临床治疗和研究的基础。
方法
本横断面病例对照研究评估了 OC 黏液中炎症蛋白与嗅觉心理物理学测试和 OC 及鼻窦计算机断层扫描（CT）分析之间的关系。为每种蛋白确定了参考区间，并使用比值比（OR）比较了无鼻息肉的 CRS（CRSsNP）和无鼻息肉的 CRS（CRSwNP）之间表达改变的比例。
结果
共评估了 151 例 CRS 病例和 74 例对照。OC 中测试的大多数蛋白在病例和对照中均处于可检测范围内。CRS 组 26 种蛋白中的 23 种蛋白浓度显著升高。OC 中 C-C 基序趋化因子配体 2（CCL2）、CCL3、白细胞介素 5（IL5）、IL10 和 IL13 水平异常的 CRS 病例与更严重的嗅觉障碍相关。嗅觉丧失患者中 IL5 和 IL13 升高的患病率分别为 64.6%和 62.5%（p < 0.004）。在 CRSwNP 中，IL5（OR = 10.83）和 IL13（OR = 8.36）表达升高的 CRS 病例的可能性最高。然而，大约 14%的 CRSsNP 患者仍存在 IL5 和 IL13 升高。OC 完全不透明百分比与 IL5 之间的相关性最高（r = 0.543；p < 0.001），而与免疫球蛋白 E（IgE）、IL10 和 IL13 之间存在中度相关性。
结论
本研究证实，OC 炎症蛋白不仅因疾病表型而异，而且与 OD 相关。CRS 中 2 型炎症介质增加，尤其是在 CRSwNP 组中。然而，相当一部分 CRSsNP 也表达 2 型炎症介质。需要进一步研究以了解 OC 黏液炎症蛋白在确定表型和影响 CRS 相关 OD 方面可能发挥的复杂作用。©2021 ARSAAOA，LLC。
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