Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease characterized by different clinical features and treatment responsiveness. This study aimed to compare the serum metabolomics profiles between eosinophilic CRSwNP (eCRSwNP) and non-eosinophilic CRSwNP (neCRSwNP) and healthy controls (HC) and explore objective biomarkers for distinguishing eCRSwNP before surgery.

Methods: Serum samples were collected from 33 neCRSwNP patients, 37 eCRSwNP patients, and 29 HC. Serum metabolomics profiles were investigated by ultra-high-performance liquid chromatography–mass spectrometry.

Results: The analysis results revealed that neCRSwNP, eCRSwNP, and HC exhibited distinctive metabolite signatures. In addition, eCRSwNP could be distinguished from neCRSwNP referring to their serum metabolic profiles, and the top ten different metabolites were citrulline, choline, linoleic acid, adenosine, glycocholic acid, L-serine, triethanolamine, 4-guanidinobutyric acid, methylmalonic acid, and L-methionine, which were related to several most important pathways including arginine and proline metabolism; glycine, serine, and threonine metabolism; linoleic acid metabolism; and purine metabolism. Among these distinctive metabolites, citrulline, linoleic acid, adenosine, and 4-guanidinobutyric acid showed good predictabilities, and the serum levels of citrulline, linoleic acid, and adenosine were significantly correlated with tissue eosinophil (T-EOS) percentage and T-EOS count.

Conclusion: eCRSwNP patients exhibited discriminative serum metabolic signatures in comparison with neCRSwNP patients and HC. These results suggested that metabolomics profiles contributed to understanding the pathophysiological mechanisms of CRSwNP and distinguishing its phenotypes

背景：慢性鼻鼻息肉鼻窦炎（CRSwNP）是一种异质性疾病，其特征在于不同的临床特征和治疗反应。这项研究旨在比较嗜酸性CRSwNP（eCRSwNP）和非嗜酸性CRSwNP（neCRSwNP）与健康对照（HC）之间的血清代谢组学谱，并探讨客观的生物标志物，以在手术前区分eCRSwNP。

方法：从33名neCRSwNP患者，37名eCRSwNP患者和29名HC中收集血清样品。通过超高效液相色谱-质谱法研究了血清代谢组学概况。

结果：分析结果表明，neCRSwNP，eCRSwNP和HC表现出独特的代谢产物特征。此外，就其血清代谢谱而言，eCRSwNP可以与neCRSwNP区别开来，前十种不同的代谢产物是瓜氨酸，胆碱，亚油酸，腺苷，糖胆酸，L-丝氨酸，三乙醇胺，4-胍基丁酸，甲基丙二酸和L-蛋氨酸，与几个最重要的途径有关，包括精氨酸和脯氨酸代谢；甘氨酸，丝氨酸和苏氨酸代谢；亚油酸代谢 和嘌呤代谢。在这些独特的代谢产物中，瓜氨酸，亚油酸，腺苷和4-胍基丁酸显示出良好的可预测性，瓜氨酸，亚油酸的血清水平，

结论：与neCRSwNP患者和HC相比，eCRSwNP患者表现出有区别的血清代谢特征。这些结果表明，代谢组学概况有助于了解CRSwNP的病理生理机制并区分其表型。