Distinct Profiles of Patient-Reported Outcomes Across Allergen Signatures in Chronic Rhinosinusitis

Area of Science:

• Immunology
• Otolaryngology
• Allergy

Background:

• Chronic rhinosinusitis (CRS) presents diverse symptoms not fully explained by anatomy or endotypes.
• Limited research exists on linking allergen sensitization profiles to patient outcomes in CRS.

Purpose of the Study:

• To systematically analyze the association between allergen sensitization profiles and patient-reported outcomes in CRS.
• To identify how different allergen signatures relate to specific symptom domains and seasonality in CRS patients.

Main Methods:

• A multicenter, retrospective study of 1880 CRS patients undergoing preoperative IgE testing for 35 allergens.
• Utilized nonnegative matrix factorization to deconvolve IgE profiles into four allergen signatures (Mite, Grass/Weed, Pet, Tree).
• Assessed associations between signatures and Sino-Nasal Outcome Test (SNOT-22) scores, controlling for covariates and seasonality.

Main Results:

• Dominant allergen signatures included nonallergic (50%), mite (26%), grass/weed (9%), pet (9%), and tree (5%).
• Pet signature linked to nasal and emotion domains; mite/grass-weed to function domain; tree signature showed no significant associations.
• Seasonal patterns varied, with grass/weed and tree groups showing high variation, pet group consistently high, and mite group showing winter-spring predominance.

Conclusions:

• Allergen signatures derived from IgE testing explain significant variations in CRS patient-reported outcomes.
• These signatures map to distinct symptom domains and seasonal patterns, offering insights into CRS heterogeneity.
• Integrating allergen signature information may enable personalized counseling and targeted interventions for CRS management.