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Long-Term Particulate Matter Exposure May Increase Risk of Chronic Rhinosinusitis WIth Nasal Polyposis: Results From
Rory J Lubner1, Mason Krysinski1, Ping Li1
1Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL.
Background:
Particulate matter ⩽2.5 µm in diameter (PM2.5) and its role in chronic rhinosinusitis (CRS) pathogenesis have gained heightened attention. We previously demonstrated that PM2.5 exposure may bias the nasal mucosa in CRS toward a Type 2 inflammatory pathway. However, there are limited data comparing cytokine changes in CRS sinonasal tissue to non-CRS patients as it relates to PM2.5 exposure. We hypothesized that long-term exposure preferentially increases the risk of manifesting CRS with nasal polyposis (CRSwNP).
Methods:
We performed a retrospective analysis of 376 patients (308 CRS, 68 controls) who underwent endoscopic sinus or skull base surgery. A spatiotemporal machine-learning model estimated daily PM2.5 levels for 1 year prior to each patient's surgery date. Cytokines were quantified using a multiplex flow cytometric bead assay and compared to estimated PM2.5 exposure using Spearman correlation and multivariate regression. Patients with high and low 12-month PM2.5 exposures were matched across age, sex, income, and rurality using a nearest neighbor algorithm. Multivariate adjusted logistic regression was used to estimate the odds of CRS based on PM2.5 exposure.
Results:
Reduced IL-10 levels were associated with higher PM2.5 exposures in control patients (β = -0.735, p = 0.0196). In exposure-matched logistic regression analysis, high 12-month PM2.5 exposure was an independent predictor of CRSwNP (β = 1.97, OR: 7.22, p = 0.0001) after adjustment for age, income, rurality, and comorbid asthma/allergic rhinitis. A similar relationship was not identified for CRSsNP.
Conclusions:
PM2.5 exposure is associated with reduced IL-10 in control patients compared to CRS and may increase odds of CRSwNP development.
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