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Distinct eicosanoid patterns in severe recalcitrant nasal polyposis
Axel Nordström1, Mattias Jangard2, Marie Svedberg1
1Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden.
International Forum of Allergy & Rhinology
|May 14, 2023
Summary
Identifying patients prone to recurrent nasal polyps (NPs) is challenging. Postoperative leukotriene E4 (LTE4) levels may predict rapid NP regrowth, aiding targeted therapies for severe chronic rhinosinusitis with nasal polyps (CRSwNP).
Area of Science:
- Biomedical research
- Immunology
- Otorhinolaryngology
Background:
- Altered eicosanoid levels correlate with chronic rhinosinusitis with nasal polyps (CRSwNP) severity.
- Predicting recurrent nasal polyps (NPs) remains difficult despite known eicosanoid associations.
Purpose of the Study:
- To investigate nasal eicosanoid levels before and after surgery in patients with and without NP recurrence (NPR).
- To explore potential endotypes based on pre-surgical eicosanoid profiles for CRSwNP patients.
Main Methods:
- Measured leukotriene (LT) E4, LTB4, prostaglandin (PG) D2, PGE2, and 15(S)-HETE in nasal secretions.
- Collected samples pre-surgery and at 6 and 12 months post-surgery from 38 and 35 patients, respectively.
- Utilized cluster analysis to identify eicosanoid patterns and correlated them with clinical parameters and NPR.
Main Results:
- Patients with recurrent NPs showed higher pre-surgical levels of 15(S)-HETE, PGD2, and LTE4.
- NPR was linked to significant decreases in 15(S)-HETE and PGD2 post-surgery, while LTE4 levels fluctuated.
- Cluster analysis identified three endotypes, with one exhibiting higher LTE4/PGD2, lower PGE2/LTB4, and increased NPR.
Conclusions:
- Elevated postoperative LTE4 levels at 12 months may indicate rapid NP regrowth in recurrent cases.
- Distinct nasal eicosanoid profiles can identify severe, recalcitrant CRSwNP patients needing targeted therapies.
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