Inflammatory Profile of Chronic Rhinosinusitis With Nasal Polyp Patients in Brazil: Multicenter Study

Area of Science:

• Immunology
• Otolaryngology
• Pathology

Background:

• Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex inflammatory condition with varied clinical presentations.
• Understanding the inflammatory profiles of CRSwNP is crucial for targeted treatment strategies.
• Previous studies have suggested distinct inflammatory endotypes within CRSwNP populations.

Purpose of the Study:

• To determine the inflammatory profile of CRSwNP in Brazil.
• To characterize CRSwNP patient subgroups using cluster analysis based on inflammatory markers.
• To investigate the relationship between inflammatory markers and clinical characteristics in Brazilian CRSwNP patients.

Main Methods:

• A multicenter, cross-sectional study was conducted across 15 centers in Brazil.
• Clinical data, including demographics, comorbidities, and endoscopic/CT scores, were collected from 166 CRSwNP patients and 80 controls.
• Nasal polyp samples were analyzed for eosinophil and neutrophil counts, and cytokine concentrations.

Main Results:

• CRSwNP patients exhibited significantly altered cytokine levels compared to controls, including higher IFN-gamma and lower TNF-alpha.
• Cluster analysis revealed two distinct CRSwNP groups based on cytokine concentrations, with Cluster 1 showing higher overall cytokine levels.
• An eosinophil cut-off of ≥43 eosinophils/HPF in nasal polyps effectively differentiated the two clusters, correlating with higher Lund-Mackay scores and male prevalence.

Conclusions:

• Brazilian CRSwNP patients display mixed inflammatory patterns.
• Two distinct inflammatory subgroups, characterized by high and low inflammatory markers, were identified.
• Tissue eosinophilia (≥43 eosinophils/HPF) serves as a reliable biomarker to distinguish these CRSwNP subgroups.