2型炎症のマーカーに基づく慢性鼻炎患者の特徴:欧州CRSアウトカムレジスタ (CHRINOSOR) の調査結果
Carlo Cavaliere1, Sven F Seys2, Joost de Kinderen2
1Department of Sense Organs, Sapienza University, Rome, Italy.
Clinical and translational allergy
|September 1, 2025
まとめ
慢性鼻炎 (CRS) 患者におけるエオシノフィルの数は,症状の重症度と相関する2型炎症の有用なマーカーである. しかし,血清の総IgEは,この研究で同様の相関を示さなかった.
科学分野:
- 耳鼻喉科
- 免疫学
- アレルギー
背景:
- 主要な慢性鼻炎 (CRS) の分類は,鼻腔の関与と炎症のエンドタイプに依存しています.
- 炎症状態の評価は,特に2型標的生物学的薬の登場により,CRS患者にとって極めて重要です.
- 2型炎症マーカーが上昇したCRS患者の特徴は,治療の階層化にとって重要です.
研究 の 目的:
- 慢性鼻炎 (CRS) の患者を2型炎症マーカーの上昇に基づいて特徴づけること.
- 血中エオシノフィール数 (BEC),血清総IgE,およびCRSの重症度の間の相関を評価する.
- CRSにおける2型炎症のバイオマーカーとしてのエオシノフィルとIgEの有用性を評価する.
主な方法:
- 欧州の10の高等医療センターから281人のCRS患者が参加しました.
- 患者は病気のモニタリングのためにGalenus Healthのモバイルアプリを使用しました.
- 血中エオシノフィール数 (BEC) と血清総IgE値に基づく分層.
主要な成果:
- CRS患者の78. 4%がBEC≥150細胞/μLであり,40. 1%が血清総IgE≥100IU/mLであった.
- BECは症状の重症度 (NPS,SNOT-22,VAS),嗅覚の喪失,鼻の詰まり,鼻水などの増加と相関していました.
- 血清の総IgEは症状の重度パラメータと相関しなかった.
- 喘息は患者の58. 9%に存在し,高いSNOT-22と嗅覚の喪失に関連していました.
結論:
- 血中エオシノフィリア,IgE上昇,および/または喘息によって示されるCRS患者の有意な比率は2型エンドタイプを示しています.
- 血液のエオシノフィルは,CRSにおける2型炎症と疾患の重度の有用なマーカーです.
- 血清の総IgEは,臨床結果との相関関係が欠如しているため,CRSにおける重症度マーカーとしてあまり有用ではないようです.
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