在接受生物治疗的2型扩散性/eosinophilic慢性鼻炎中,持续性疾病的预测者接受手术
Lu Hui Png1,2,3, Larry Kalish1,4,5, Raewyn G Campbell1,3,6
1Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
International forum of allergy & rhinology
|October 8, 2023
概括
慢性鼻炎与鼻息肉 (CRSwNP) 的生物治疗可能会在一些患者中失败. 治疗期间组织中小氨基和高血清中性的低水平预测了CRSwNP中对生物药物的反应不佳.
科学领域:
- 免疫学 免疫学 免疫学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 肺部病理学 肺部病理学
背景情况:
- 生物疗法改善了2型慢性鼻炎与鼻息肉 (CRSwNP) 管理.
- 然而,有一部分患者对这些治疗没有充分的反应.
- 确定治疗反应的预测因素对于优化患者护理至关重要.
研究的目的:
- 调查预测生物治疗中CRSwNP患者治疗控制的血清和组织学标记.
- 确定与CRSwNP中对生物制剂反应不佳相关的特定生物标志物.
主要方法:
- 一项横截面研究比较了CRSwNP患者在生物药物治疗中与手术后控制和控制不良的疾病.
- 分析了手术期间获得的血清和粘膜样本.
- 使用统计分析,包括后勤回归和ROC分析,以确定预测标记.
主要成果:
- 控制不良的CRSwNP与显著降低的组织乙氨基细胞相关 (8.3%与50.0%,p < 0.001).
- 在疾病控制不良的患者中观察到血清中性粒细胞的增加 (5.2比3.7×10^9细胞/L,p=0.02).
- 减少的组织乙氨基预测疾病控制不良 (OR = 0.21,p = 0.03). 血清中性粒细胞切断值为5.75 × 10^9细胞/L,预测了需要救援类皮质类固醇的需要 (AUC = 0.938,p = 0.002).
结论:
- 低组织乙氨基细胞数量和高血清中性细胞水平预示着CRSwNP患者对生物治疗的反应不佳.
- 血清中性粒细胞水平≥5.75 × 10^9细胞/L表明对CRSwNP目前的生物治疗反应不佳的可能性很高.
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