炎症内型对慢性鼻炎与鼻的疾病轨迹的影响
Christina Dorismond1, Yash Trivedi2, Mason R Krysinski1
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tenn.
The Journal of allergy and clinical immunology
|April 12, 2025
概括
具有鼻息肉的慢性鼻炎 (CRSwNP) 呈现出多种炎症内型. 患有1型和3型混合炎症的患者表现出更具侵略性的疾病,表明需要新的治疗策略.
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
- 遗传学 遗传学 是一个
背景情况:
- 慢性鼻炎与鼻息肉 (CRSwNP) 治疗传统上依赖于表型特征.
- 最近的研究强调将CRSwNP按炎症内型分类.
- 这些内型差异对CRSwNP结果的临床影响尚不清楚.
研究的目的:
- 为了比较不同CRSwNP内型的疾病轨迹,特别是多复发的时间.
- 在CRSwNP患者队列中识别不同的炎症概况.
主要方法:
- 从CRSwNP患者 (2015-2023) 收集的手术样本.
- 使用多重珠子测定量化细胞因子水平.
- 采用主要组件和层次集群分析来定义内型集群.
- 在已识别的集群中比较临床结果,包括多复发的时间.
主要成果:
- 在269名患者中确定了6个CRSwNP内型集群.
- 集群2 (混合型1/3炎症) 和集群4 (升高的IL-12/IL-21) 显示最短的时间到聚复发.
- 集群3 (先天性预炎症反应) 呈现了最长的多复发时间 (P < .001).
- 在口服类固醇或生物疗法启动的时间内没有观察到跨集群的显著差异.
结论:
- CRSwNP是一种异质的疾病,具有不同的内型.
- 1型和3型混合炎症与更反复的CRSwNP疾病有关.
- 目前的治疗策略可能需要扩展到超出2型炎症疗法之外,以有效地管理CRSwNP复发.
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