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Age-associated changes in chronic rhinosinusitis endotypes.

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Age-related immune changes in chronic rhinosinusitis (CRS) vary by subtype. Understanding these cytokine profiles aids in developing targeted therapies for different forms of CRS.

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Area of Science:

  • Immunology
  • Otorhinolaryngology
  • Precision Medicine

Background:

  • Immune function, including innate and adaptive immunity, undergoes age-related alterations.
  • Investigating age-related cytokine profiles in chronic rhinosinusitis (CRS) is crucial for advancing precision medicine.

Purpose of the Study:

  • To characterize age-related immunologic profile changes across different CRS subtypes.
  • To identify specific cytokine patterns associated with aging in various CRS classifications.

Main Methods:

  • Enrolled subjects included controls (n=29), CRS without nasal polyps (CRSsNP, n=86), eosinophilic nasal polyps (ENP, n=81), and non-eosinophilic nasal polyps (NENP, n=113).
  • Measured 20 markers of type 1/2/3 inflammation and other inflammatory processes in sinonasal tissue homogenates.
  • Performed statistical analysis, adjusting for atopy, smoking history, and disease duration.

Main Results:

  • Control tissues showed an inverse correlation between age and type 2/3/proinflammatory mediators.
  • CRSsNP and NENP exhibited age-related increases in type 2 cytokines and decreases in type 3 cytokines.
  • ENP displayed age-related increases in type 3 cytokines with persistently high type 2 mediators. Smokers with ENP showed increased inflammatory mediators and CT scores with age.

Conclusions:

  • Age-associated cytokine profiles differ significantly among CRS subtypes and control tissues.
  • CRSsNP and NENP show a shift towards type 2 inflammation with aging, while ENP demonstrates an increase in type 3 mediators.
  • These findings highlight the heterogeneity of immune responses in CRS and inform personalized treatment strategies.