scholarly journals Reduction of blood eosinophil counts in eosinophilic chronic rhinosinusitis after surgery

2016 ◽  
Vol 130 (12) ◽  
pp. 1147-1152 ◽  
Author(s):  
A Honma ◽  
D Takagi ◽  
Y Nakamaru ◽  
A Homma ◽  
M Suzuki ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Sinus Surgery ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Interleukin 5 ◽  
Disease Biomarkers ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Before And After ◽  
Reflect Disease Severity ◽  
Eosinophil Counts

AbstractObjective:This study aimed to predict eosinophilic chronic rhinosinusitis prognosis by investigating changes in the blood eosinophil count and other disease biomarkers after surgery.Methods:Blood eosinophil numbers and serum interleukin-5 levels were measured in 22 eosinophilic chronic rhinosinusitis patients before and after functional endoscopic sinus surgery, and compared with equivalent measures in non-eosinophilic chronic rhinosinusitis patients and chronic rhinosinusitis without polyps patients. Differences between well-controlled eosinophilic chronic rhinosinusitis patients and those who experienced recurrence were also assessed.Results:Blood eosinophil numbers and serum interleukin-5 level decreased after surgery in eosinophilic chronic rhinosinusitis patients. In this patient group, blood eosinophil counts before surgery were significantly higher in patients who experienced recurrence (825.7 ± 26.1 vs 443.9 ± 76.6 cells/μl, p < 0.05), and decreased significantly after surgery (825.7 ± 26.1 vs 76.7 ± 25.8 cells/μl, p < 0.05).Conclusion:Blood eosinophil numbers may reflect disease severity in eosinophilic chronic rhinosinusitis patients and their prognosis after surgery.

Non-Eosinophilic Chronic Rhinosinusitis With Nasal Polyps: Eosinophil, Basophil, and Neutrophil Blood Counts Before and After Surgery

2018 ◽  
Vol 128 (3) ◽  
pp. 233-240
Author(s):  
Daniela Parrino ◽  
Giuseppe Brescia ◽  
Claudia Zanotti ◽  
Giulia Tealdo ◽  
Luciano Giacomelli ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Significant Negative Correlation ◽  
Sinus Surgery ◽  
Blood Eosinophil ◽  
Response Patterns ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Before And After ◽  
Consequent Reduction ◽  
Change In Mean

Objectives: Research selectively investigating non-eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is lacking. The inflammatory patterns seen in non-eosinophilic CRSwNP are still poorly understood. The present study is the first to compare blood eosinophil, basophil, and neutrophil counts before/after surgery in patients with non-eosinophilic CRSwNP stratified by their clinical features. Methods: The study concerned 107 consecutive patients with histologically confirmed non-eosinophilic CRSwNP who underwent endoscopic sinus surgery (ESS). Results: Statistical analysis ruled out any significant change in mean blood eosinophil, basophil, and neutrophil counts after ESS. A significant positive correlation emerged between blood eosinophil and basophil counts in both pre- and post-ESS laboratory tests. In the subcohort of allergic patients, a significant negative correlation was found after ESS between eosinophil and neutrophil levels and between basophil and neutrophil levels. Conclusions: In eosinophilic CRSwNP, ESS can clear polyps, remove inflammatory tissue, and reduce the inflammatory cytokines it generates, with a consequent reduction in blood eosinophil levels. The different results in non-eosinophilic CRSwNP support the conviction that the 2 types of CRSwNP are entities with distinct inflammatory response patterns.

Increased Serum Periostin Levels and Eosinophils in Nasal Polyps Are Associated with the Preventive Effect of Endoscopic Sinus Surgery for Asthma Exacerbations in Chronic Rhinosinusitis Patients

2020 ◽  
Vol 181 (11) ◽  
pp. 862-870
Author(s):  
Yoshihiro Kanemitsu ◽  
Ryota Kurokawa ◽  
Junya Ono ◽  
Kensuke Fukumitsu ◽  
Norihisa Takeda ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Eosinophil Count ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Blood Eosinophil ◽  
Preventive Effect ◽  
Blood Eosinophil Count ◽  
Asthma Exacerbations ◽  
Serum Periostin

<b><i>Background:</i></b> 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. <b><i>Objective:</i></b> To determine the utility of biomarkers including serum periostin that reflects reduction of exacerbations of comorbid asthma in CRS patients. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> Blood eosinophil count, FeNO, and serum periostin levels were significantly higher in CRS patients with asthma than in those without (<i>p</i> &#x3c; 0.01 for all) and discriminated comorbid asthma among CRS patients (<i>p</i> &#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, <i>p</i> = 0.03) and its relative reduction after ESS (ρ = 0.53, <i>p</i> = 0.03) in asthmatic patients. Increased eosinophils in NPs were also associated with reduced asthma exacerbations. <b><i>Conclusion:</i></b> 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.

scholarly journals Effects of Endoscopic Sinus Surgery for Eosinophilic Chronic Rhinosinusitis on Respiratory Functions and FeNO Production in the Lower Respiratory Tract

2021 ◽  
pp. 014556132110320
Author(s):  
Tetsuya Terada ◽  
Takaki Inui ◽  
Kou Moriyama ◽  
Keiki Noro ◽  
Yusuke Kikuoka ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Lower Airway ◽  
Act Scores ◽  
Asthma Control Test ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Before And After ◽  
The Mean ◽  
Asthma Group

Objective: To confirm the relevance of upper and lower airway inflammation in eosinophilic chronic rhinosinusitis (ECRS), the effects of endoscopic sinus surgery (ESS) on lower airway functions and inflammation need to be examined in ECRS patients. Methods: Chronic rhinosinusitis patients with nasal polyps (25 non-ECRS, 28 ECRS) were enrolled. The 12 patients in the ECRS group had comorbid asthma, in contrast to none in the non-ECRS group. We divided ECRS patients into 2 groups of ECRS with and without asthma. Clinical markers, including fraction of exhaled nitric oxide (FeNO), respiratory functions, and the Asthma Control Test (ACT) questionnaire, were investigated before and after ESS. Results: The FeNO levels in the ECRS with asthma group decreased after ESS. The mean FeNO levels in this group were 56.3 ppb before ESS and 24.9, 25.1, 25.0, and 15.5 ppb 1, 2, 3, and 4 months, respectively, after ESS. The mean forced expiratory rates in 1 second before and after ESS were 67.6% and 73.0%, respectively. The mean maximal expiratory flow rates at 50% of the vital capacity before and after ESS were 45.8% and 58.0%, respectively. Significant differences were observed in respiratory functions before and after ESS. The mean ACT scores in the ECRS with asthma group before and after ESS were 17.5 and 23.5, respectively. The ACT scores were significantly higher after than before ESS. Conclusions: The present results indicate that ECRS and bronchial asthma are common eosinophilic airway inflammatory diseases, and ESS for eosinophilic sinusitis may improve lower airway function.

Blood Eosinophil and Basophil Values Before and After Surgery for Eosinophilic-type Sinonasal Polyps

2018 ◽  
Vol 32 (3) ◽  
pp. 194-201 ◽  
Author(s):  
Giuseppe Brescia ◽  
Daniela Parrino ◽  
Claudia Zanotti ◽  
Giulia Tealdo ◽  
Umberto Barion ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Blood Eosinophil ◽  
Recurrence Rates ◽  
Significant Drop ◽  
Cytokine Levels ◽  
Before And After ◽  
Blood Basophil ◽  
Blood Eosinophils ◽  
Eosinophil Counts

Background Blood eosinophil and basophil levels have recently been considered for the purpose of endotyping chronic rhinosinusitis with nasal polyps (CRSwNP). Histologically, eosinophilic-type CRSwNPs have been associated with high recurrence rates after treatment. Objective The present study was the first to compare blood eosinophil and basophil counts in eosinophilic-type CRSwNP patients before and after endoscopic sinus surgery. Methods The study concerned 79 consecutive patients with histologically confirmed eosinophilic-type CRSwNP treated with endoscopic sinus surgery. Results A significant drop in mean blood eosinophil counts and percentages occurred from before to after endoscopic sinus surgery in the cohort as a whole. Mean blood eosinophil counts and percentages were also reduced after surgery in the subcohorts of CRSwNP patients with (i) asthma, (ii) aspirin-exacerbated respiratory disease (AERD), and (iii) no allergy. Although blood eosinophil and basophil counts correlated directly before and after surgery, a statistical reduction in blood basophil counts and percentages after surgery emerged only in the subcohort of nonallergic CRSwNP patients. Conclusion Endoscopic sinus surgery can clear polyps, remove inflammatory tissue, and reduce inflammatory cytokine levels. Consistently with the biological mechanism described, endoscopic sinus surgery could coincide with a reduction in blood eosinophils in eosinophilic-type CRSwNP.

scholarly journals Rapid Effect of Benralizumab for Hypereosinophilia in a Case of Severe Asthma with Eosinophilic Chronic Rhinosinusitis

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 336 ◽  
Author(s):  
Tsurumaki ◽  
Matsuyama ◽  
Ezawa ◽  
Koga ◽  
Yatomi ◽  
...  
Keyword(s):  
Lung Function ◽  
Chronic Rhinosinusitis ◽  
Severe Asthma ◽  
Nasal Polyps ◽  
Oral Corticosteroid ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Rapid Effect ◽  
Rapid Treatment

A 56-year-old man with severe asthma underwent bronchial thermoplasty (BT). However, his asthma exacerbated and hypereosinophilia developed 2 months later, thus necessitating oral corticosteroid (OCS) therapy. Six months after BT, a diagnosis of severe asthma with eosinophilic chronic rhinosinusitis (ECRS) was made and benralizumab treatment was initiated; the blood eosinophil count subsequently decreased and lung function improved, thereby permitting OCS dose tapering. Surprisingly, benralizumab both reduced nasal polyps and ameliorated ECRS. Thus, benralizumab may be a useful drug for the rapid treatment of severe asthma with ECRS, especially in patients with hypereosinophilia.

Systemic Predictors of Eosinophilic Chronic Rhinosinusitis

2018 ◽  
Vol 32 (4) ◽  
pp. 252-257 ◽  
Author(s):  
Jacqueline Ho ◽  
Aneeza W. Hamizan ◽  
Raquel Alvarado ◽  
Janet Rimmer ◽  
William A. Sewell ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Predictive Value ◽  
Nasal Polyps ◽  
Immunoglobulin E ◽  
Sinus Surgery ◽  
Full Blood Count ◽  
Blood Eosinophil ◽  
Markers Of Inflammation ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Blood Eosinophils

Background Eosinophilic chronic rhinosinusitis (eCRS) is linked with skewed T-helper 2 or immunoglobulin E (IgE)-mediated allergic responses, with differing diagnosis, prognosis, and management to non-eCRS. Objective The association between biomarkers and eCRS was investigated to assess the predictors of eCRS. Methods A cross-sectional study of adult patients with chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery was conducted. eCRS was defined by histopathological assessment showing >10 eosinophils/high-power field on sinus mucosal biopsy. Blood tests were performed preoperatively and assessed for a full blood count including eosinophils and a white cell count (WCC) as well as biochemical markers of inflammation and atopy including Immunoglobulin E (IgE), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and ImmunoCAP testing for serum-specific IgE. Comparisons between eCRS and non-eCRS patients were performed. Results 345 patients (48.1% female, age 48.72 ± 15.06 years) were recruited, with 206 (59.7%) identified as eCRS, 41% with asthma and 47% CRS with nasal polyps. eCRS patients were more likely to have asthma ( P < .01) and nasal polyps ( P < .01). Blood eosinophils were significantly elevated in eCRS (0.42±0.34 vs 0.17±0.13 × 109/L, P < .01) as were eosinophils as a ratio of WCC (6.21 ± 4.48 vs 2.55 ± 1.84, P < .01). ESR was decreased when compared with non-eCRS (8.1±7.87 vs 10.65±11.91, P = .03). Receiver operating characteristic curve analysis predicted high tissue eosinophilia at blood eosinophil levels above 0.24 × 109/L (sensitivity 70.9%, specificity 78.4%, area under the curve [AUC]: 0.792, P < .01). eCRS was predicted at eosinophil above 4.27% of total WCC (sensitivity 64.1%, specificity 88.5%, AUC 0.797; P < .01; positive predictive value 89.2%, negative predictive value 62.4%, positive likelihood ratio 5.57, and diagnostic odds ratio 13.71). There was no significant association among WCC, CRP, IgE, or ImmunoCAP testing. Conclusion eCRS is associated with elevated blood eosinophils (>0.24 × 109/L), eosinophil ratio (>4.27% of total WCC), and lower ESR when compared with non-eCRS.

scholarly journals Multiparametric Analysis of Factors Associated With Eosinophilic Chronic Rhinosinusitis With Nasal Polyps

2020 ◽  
pp. 014556132096035
Author(s):  
Gian Luca Fadda ◽  
Andrea Galizia ◽  
Giuseppe Galizia ◽  
Paolo Castelnuovo ◽  
Maurizio Bignami ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Predictive Biomarker ◽  
Blood Eosinophil ◽  
High Power Field ◽  
Diverse Range ◽  
Blood Eosinophilia ◽  
Tissue Eosinophilia ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Clinical Records

Introduction: Previous studies have reported a diverse range of threshold values for blood eosinophilia. In addition, a single predictive biomarker for eosinophilic chronic rhinosinusitis (CRS) with nasal polyps (ECRSwNP) has not yet been identified. Objectives: The aim of this study is to compare the clinical characteristics of ECRSwNP and non-ECRSwNP to evaluate the preoperative risk of tissue eosinophilia of chronic rhinosinusitis with nasal polyps (CRSwNP) through a multiparametric statistical analysis. Methods: One hundred ten patients with evidence of chronic polypoid rhinosinusitis were included in this study and clinical records were retrospectively reviewed. Eosinophilic CRSwNP was diagnosed based on the presence of at least 10 eosinophils per high-power field. The demographic and clinical features of ECRSwNP and non-ECRSwNP are described. The values of blood eosinophilia as predictors of tissue eosinophilia have been identified using receiver operating characteristic curves. As the predictive value of the identified cutoff through regression analysis was low, we evaluated whether other risk factors could be statistically associated with ECRSwNP, and from this, a new predictive model was proposed for the identification of eosinophilic nasal polyps before surgery. Results: We found that the best method for predicting ECRSwNP is based on a model having asthma, blood eosinophil percentage, posterior ethmoid value in Lund-Mackay score, and modified Lund-Kennedy score as explanatory variables. Conclusions: This study provides new data for a better understanding of the polypoid CRS endotypes, and the proposed model allows the endotype to be identified preoperatively.

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