IL-13 and IL-13-induced periostin levels are specifically decreased in patients following endoscopic sinus surgery for chronic rhinosinusitis.

Autor: Harmon R; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Schneider AL; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., Bai J; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Racette SD; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Reddy AT; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Huang JH; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Lehmann DS; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Price CPE; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Rodeghiero S; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Agarwal A; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Eide JG; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Dong S; Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., Conley DB; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Welch KC; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Kern RC; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Shintani-Smith S; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill., Peters AT; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., Kato A; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., Stevens WW; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., Muhammad LN; Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., Schleimer RP; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., Tan BK; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill. Electronic address: b-tan@northwestern.edu.
Jazyk: angličtina
Zdroj: The Journal of allergy and clinical immunology [J Allergy Clin Immunol] 2024 May; Vol. 153 (5), pp. 1292-1305. Date of Electronic Publication: 2023 Dec 28.
DOI: 10.1016/j.jaci.2023.11.922
Abstrakt: Background: Type 2 (T2) inflammation plays a pathogenic role in chronic rhinosinusitis (CRS). The effects of endoscopic sinus surgery (ESS) on T2 inflammation are unknown.
Objective: The aim of this study was to compare T2 inflammatory biomarkers from middle meatal (MM) mucus for distinguishing patients with CRS from CRS-free patients, identifying major phenotypes (CRS without nasal polyps [CRSsNP] and CRS with nasal polyps [CRSwNP]), assessing endotypic change, and establishing cross-sectional and longitudinal outcomes in patients undergoing ESS.
Methods: MM mucus samples were collected from patients with CRSsNP and patients with CRSwNP before and 6 to 12 months after ESS and compared with samples from CRS-free control patients. T2 biomarkers were evaluated both continuously and using threshold-based definitions of T2 endotype to identify relationships with patient-reported (based on the 22-Item Sinonasal Outcomes Test and Chronic Rhinosinusitis Patient-Reported Outcomes Measure) and clinician-reported (radiographic and endoscopic) severity. Linear mixed models were developed to analyze clinical variables associated with T2 biomarker levels.
Results: A total of 154 patients with CRS (89 with CRSsNP and 65 with CRSwNP) were enrolled, with a mean interval of 9 months between ESS and follow-up. An analysis of pre-ESS MM mucus samples revealed elevated levels of T2 mediators in patients with CRSwNP versus in patients with CRSsNP and CRS-free controls. Temporally stable correlations between levels of IL-13 and IL-5, levels of periostin and complement 5a, and levels of eosinophil cationic protein (ECP) and eotaxin-3 were observed. On this basis and on the basis of pathologic significance, levels of IL-13, periostin and ECP were further analyzed. After ESS, levels of IL-13 and periostin decreased significantly, whereas ECP levels remained unchanged. Across pre- and post-ESS evaluation, the T2 endotype was associated with radiographic severity but did not predict outcomes. CRSwNP status and African American race were associated with higher levels of IL-13 and periostin, whereas ECP level was higher in patients undergoing extensive surgery.
Conclusion: ESS decreased levels of IL-13 and periostin in the middle meatus. T2 inflammation after ESS was correlated with patient- and clinician-reported severity across phenotypes. Pre-ESS T2 inflammation did not predict post-ESS outcomes.
(Copyright © 2024 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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