Background: Eosinophilic nasal polyps (NPs) are associated with the presence of asthma in chronic rhinosinusitis (CRS) patients. Serum periostin has been considered a relevant biomarker for unified airway diseases. Objective: To determine the utility of biomarkers including serum periostin that reflects reduction of exacerbations of comorbid asthma in CRS patients. Methods: We prospectively recruited 56 CRS patients who were subjected to undergo endoscopic sinus surgery (ESS) (20 with asthma) between October 2015 and December 2017 and followed them for 1 year after ESS. Blood eosinophil count, serum periostin, and fractional nitric oxide (FeNO) were measured at enrollment. How these type 2-driven biomarkers reflect comorbid asthma was determined using receiver operating characteristic (ROC) analysis. The frequency of asthma exacerbations during 1 year was counted both before and after ESS. Associations between preoperative biomarkers including eosinophils in NPs and asthma exacerbations were evaluated. Results: Blood eosinophil count, FeNO, and serum periostin levels were significantly higher in CRS patients with asthma than in those without (p #x3c; 0.01 for all) and discriminated comorbid asthma among CRS patients (p #x3c; 0.05; AUC #x3e; 0.80 for all). The increased preoperative serum periostin correlated with lower absolute number of postoperative exacerbations (ρ = −0.49, p = 0.03) and its relative reduction after ESS (ρ = 0.53, p = 0.03) in asthmatic patients. Increased eosinophils in NPs were also associated with reduced asthma exacerbations. Conclusion: Preoperative increased serum periostin and eosinophils in NPs are associated with the preventive effect of ESS for asthma exacerbations in CRS patients comorbid with asthma.
Int Arch Allergy Immunol

中文翻译：

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鼻息肉中血清骨膜素水平的升高和嗜酸性粒细胞的升高与内镜鼻窦手术对慢性鼻-鼻窦炎患者哮喘加重的预防作用有关。

背景：嗜酸性鼻息肉（NPs）与慢性鼻-鼻窦炎（CRS）患者中哮喘的存在有关。血清骨膜素被认为是统一气道疾病的相关生物标志物。目的：确定包括血清骨膜素在内的生物标志物的实用性，该生物标志物可减轻CRS患者合并症的发作。方法：我们前瞻性地招募了2015年10月至2017年12月之间接受内镜鼻窦手术（ESS）（20例患有哮喘）的56例CRS患者，并在ESS后随访了1年。入组时测量血液嗜酸性粒细胞计数，血清骨膜蛋白和一氧化氮分数（FeNO）。这些2型驱动的生物标记物如何反映合并性哮喘的发生是通过接受者操作特征（ROC）分析确定的。在ESS之前和之后，对1年期间哮喘发作的频率进行计数。评估了术前生物标志物（包括NPs中的嗜酸性粒细胞）与哮喘加重之间的关联。结果： CRS哮喘患者的血液嗜酸性粒细胞计数，FeNO和血清骨膜素水平显着高于无哮喘的CRS患者（p＃x3c; CRS患者中所有患者均患有哮喘）（0.01）和可辨别的合并症（p＃x3c; 0.05; AUC＃x3e; 0.80）。哮喘患者术前血清骨膜素增加与术后加重的绝对值较低（ρ= -0.49，p = 0.03）及其在ESS后相对降低有关（ρ= 0.53，p = 0.03）。NP中的嗜酸性粒细胞增加也与哮喘急性发作减少有关。结论：术前NPs中血清骨膜蛋白和嗜酸性粒细胞增加与ESS对合并哮喘的CRS患者的哮喘加重有预防作用。
Int Arch过敏免疫