Factor Analysis-Based Quantitative Endotyping Improves Associations With CRS Cross-Sectional and Longitudinal...

Area of Science:

• Immunology
• Otolaryngology
• Data Science

Background:

• Chronic rhinosinusitis (CRS) is a complex inflammatory condition of the sinonasal passages.
• Endotype-based classification is gaining traction for understanding CRS heterogeneity.
• Identifying distinct inflammatory pathways is crucial for targeted treatment.

Purpose of the Study:

• To apply factor analysis for continuous endotype assignment in CRS patients.
• To assess the association of identified factors with cross-sectional and longitudinal CRS outcomes.
• To compare the predictive power of factor scores versus individual biomarkers.

Main Methods:

• Prospective enrollment of 203 patients (controls, CRSsNP, CRSwNP) undergoing endoscopic sinus surgery.
• Analysis of middle meatal mucus biomarkers pre- and post-surgery.
• Factor analysis to identify inflammatory patterns, generating factor scores for outcome correlation.

Main Results:

• Four distinct inflammatory factors (T1, T2, T3, Macrophage-associated) were identified.
• CRSwNP patients exhibited higher T2 and Macrophage-associated factor scores.
• Factor scores showed stronger associations with radiographic and patient-reported outcomes than individual biomarkers, particularly post-surgery.

Conclusions:

• Factor analysis provides a robust method for quantifying CRS inflammatory endotypes.
• Identified factors offer improved prediction of both short-term and long-term CRS outcomes.
• This approach enhances understanding of CRS heterogeneity and aids in outcome assessment.