Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
European Archives of Oto-Rhino-Laryngology

03.05.2024 | Rhinology

Association of mucus eosinophil-derived neurotoxin levels with disease control status in patients with chronic rhinosinusitis

verfasst von: Xiaoxi Huang, Zheng Liu, Benjamin S. Bleier, Yu Song, Dawei Wu

Erschienen in: European Archives of Oto-Rhino-Laryngology

Einloggen, um Zugang zu erhalten

Abstract

Objective

Identifying the biomarkers for uncontrolled chronic rhinosinusitis (CRS) is important for directing treatment decisions. Eosinophilia has been reported to be involved in the poor disease control of CRS and mucus eosinophil-derived neurotoxin (EDN) is potentially a biomarker of intense eosinophil activation. This study aimed to assess the relationship between mucus EDN levels, disease severity, and degree of CRS control.

Methods

A total of 150 adult patients with CRS and 25 healthy controls were prospectively enrolled. The nasal mucus and tissue specimens were collected to analyze EDN levels. Disease severity was assessed by Lund-Mackay score and 22-item Sino-Nasal Outcome Test (SNOT-22) score. Five CRS symptom severities during the prior month (nasal blockage, rhinorrhoea/postnasal drip, facial pain/pressure, smell, sleep disturbance or fatigue), use of rescue medications in the last six months, and the presence of diseased mucosa on nasal endoscopy were obtained. Consistent with the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 CRS control criteria, uncontrolled CRS was defined as meeting at least three items.

Results

40% of patients with CRS presented with uncontrolled status. Patients with uncontrolled CRS had significantly higher nasal mucus EDN levels (P = 0.010), percentage of blood eosinophil (P = 0.015), SNOT-22 score (P < 0.001), Lund-Mackay score (P = 0.008), and a more eosinophilic dominant phenotype of CRS (P < 0.001) than patients with controlled CRS. Furthermore, mucus EDN levels were positively correlated with blood eosinophils (r = 0.541, P = 0.005), SNOT-22 score (r = 0.460, P = 0.021), and Lund-Mackay score (r = 0.387, P = 0.039). Mucus EDN levels were the significant parameter related to uncontrolled CRS in multivariable analysis after adjusting for patient demographics and comorbidities (odds ratio = 1.323; P = 0.004).

Conclusions

Mucus EDN levels may be a potential biomarker for identifying the CRS control status.
Literatur
1.
Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, et al. Chronic rhinosinusitis in Europe—an underestimated disease. A GA2 LEN study. Allergy. 2011;66(9):1216–23.
2.
Hirsch AG, Stewart WF, Sundaresan AS, Young AJ, Kennedy TL, Scott Greene J et al (2017) Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy 72(2):274–281CrossRefPubMed
3.
Shi JB, Fu QL, Zhang H, Cheng L, Wang YJ, Zhu DD et al (2015) Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy 70(5):533–539CrossRefPubMed
4.
Baguley C, Brownlow A, Yeung K, Pratt E, Sacks R, Harvey R (2014) The fate of chronic rhinosinusitis sufferers after maximal medical therapy. Int Forum Allergy Rhinol 4(7):525–532CrossRefPubMed
5.
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464.
6.
Alanin MC, Hopkins C (2020) Effect of functional endoscopic sinus surgery on outcomes in chronic rhinosinusitis. Curr Allergy Asthma Rep 20(7):27CrossRefPubMed
7.
van der Veen J, Seys SF, Timmermans M, Levie P, Jorissen M, Fokkens WJ et al (2017) Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre. Allergy 72(2):282–290CrossRefPubMed
8.
Sedaghat AR, Phillips KM. Chronic rhinosinusitis disease control: a review of the history and the evidence. Expert Rev Clin Immunol. 2023:1–8.
9.
Zhou J, Yuan F, Huang T, Zhu L, Wu D (2023) Current understanding of disease control and its application in patients with chronic rhinosinusitis. Front Cell Infect Microbiol 13:1104444CrossRefPubMedPubMedCentral
10.
Tao X, Chen F, Sun Y, Wu S, Hong H, Shi J et al (2018) Prediction models for postoperative uncontrolled chronic rhinosinusitis in daily practice. Laryngoscope 128(12):2673–2680CrossRefPubMed
11.
Wang K, Deng J, Yang M, Chen Y, Chen F, Gao WX et al (2019) Concordant systemic and local eosinophilia relates to poorer disease control in patients with nasal polyps. World Allergy Organ J 12(8):100052CrossRefPubMedPubMedCentral
12.
Penttilä E, Sillanpää S, Vento SI, Myller J, Koskinen A, Hammarén-Malmi S, et al. Eosinophilia, asthma, NERD and the use of oral corticosteroids predict uncontrolled chronic rhinosinusitis with nasal polyps after surgery. Asian Pac J Allergy Immunol. 2021. Epub 2021/09/21. doi: https://​doi.​org/​10.​12932/​ap-310321-1102.
13.
Jiang L, Wang K, Lin T, Jiang Y, Gao W, Li C et al (2022) A novel risk score for disease control prediction of chronic rhinosinusitis. Clin Otolaryngol 47(5):568–576CrossRefPubMedPubMedCentral
14.
Delemarre T, Bochner BS, Simon HU, Bachert C (2021) Rethinking neutrophils and eosinophils in chronic rhinosinusitis. J Allergy Clin Immunol 148(2):327–335CrossRefPubMedPubMedCentral
15.
Gevaert P, Han JK, Smith SG, Sousa AR, Howarth PH, Yancey SW et al (2022) The roles of eosinophils and interleukin-5 in the pathophysiology of chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 12(11):1413–1423CrossRefPubMedPubMedCentral
16.
Lou H, Zhang N, Bachert C, Zhang L (2018) Highlights of eosinophilic chronic rhinosinusitis with nasal polyps in definition, prognosis, and advancement. Int Forum Allergy Rhinol 8(11):1218–1225CrossRefPubMedPubMedCentral
17.
Kwah JH, Somani SN, Stevens WW, Kern RC, Smith SS, Welch KC et al (2020) Clinical factors associated with acute exacerbations of chronic rhinosinusitis. J Allergy Clin Immunol 145(6):1598–1605CrossRefPubMedPubMedCentral
18.
Gon Y, Ito R, Hattori T, Hiranuma H, Kumasawa F, Kozu Y et al (2015) Serum eosinophil-derived neurotoxin: correlation with persistent airflow limitation in adults with house-dust mite allergic asthma. Allergy Asthma Proc 36(6):e113–e120CrossRefPubMed
19.
Lee Y, Lee JH, Yang EM, Kwon E, Jung CG, Kim SC et al (2019) Serum Levels of Eosinophil-Derived Neurotoxin: A Biomarker for Asthma Severity in Adult Asthmatics. Allergy Asthma Immunol Res 11(3):394–405CrossRefPubMedPubMedCentral
20.
An J, Lee JH, Sim JH, Song WJ, Kwon HS, Cho YS et al (2020) Serum eosinophil-derived neurotoxin better reflect asthma control status than blood Eosinophil counts. J Allergy Clin Immunol Pract 8(8):2681–8.e1CrossRefPubMed
21.
Malinovschi A, Rydell N, Fujisawa T, Borres MP, Kim CK (2023) Clinical potential of eosinophil-derived neurotoxin in asthma management. J Allergy Clin Immunol Pract 11(3):750–761CrossRefPubMed
22.
Konikoff MR, Blanchard C, Kirby C, Buckmeier BK, Cohen MB, Heubi JE et al (2006) Potential of blood eosinophils, eosinophil-derived neurotoxin, and eotaxin-3 as biomarkers of eosinophilic esophagitis. Clin Gastroenterol Hepatol 4(11):1328–1336CrossRefPubMed
23.
Yang D, Chen Q, Su SB, Zhang P, Kurosaka K, Caspi RR et al (2008) Eosinophil-derived neurotoxin acts as an alarmin to activate the TLR2-MyD88 signal pathway in dendritic cells and enhances Th2 immune responses. J Exp Med 205(1):79–90CrossRefPubMedPubMedCentral
24.
Kim HS, Yang HJ, Song DJ, Lee YJ, Suh DI, Shim JY et al (2022) Eosinophil-derived neurotoxin: an asthma exacerbation biomarker in children. Allergy Asthma Proc 43(2):133–139CrossRefPubMed
25.
Tsuda T, Maeda Y, Nishide M, Koyama S, Hayama Y, Nojima S et al (2019) Eosinophil-derived neurotoxin enhances airway remodeling in eosinophilic chronic rhinosinusitis and correlates with disease severity. Int Immunol 31(1):33–40CrossRefPubMed
26.
Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU et al (2021) International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol 11(3):213–739CrossRefPubMed
27.
Wu D, Hong J, Chang F, Wei Y (2022) Development of a novel centrifugal extraction device to collect the olfactory cleft mucus. Acta Otolaryngol 142(3–4):323–328CrossRefPubMed
28.
Wu D, Liu Z, Bleier BS, Huang X, Hong J. Olfactory cleft mucus eosinophil-derived neurotoxin better reflects olfactory loss than blood eosinophil counts in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol. 2023. Epub 2023/06/02. https://​doi.​org/​10.​1002/​alr.​23202.
29.
Wu D, Li Y, Bleier BS, Wei Y (2020) Superior turbinate eosinophilia predicts olfactory decline in patients with chronic rhinosinusitis. Ann Allergy Asthma Immunol 125(3):304–10.e1CrossRefPubMed
30.
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44(3):837–845CrossRefPubMed
31.
32.
Sedaghat AR, Phillips KM (2023) Chronic rhinosinusitis disease control: a review of the history and the evidence. Expert Rev Clin Immunol 19(8):903–910CrossRefPubMed
33.
Ali A, Fakunle DR, Yu V, McDermott S, Previtera MJ, Meier JC et al (2023) Heterogeneity in the definition of chronic rhinosinusitis disease control: a systematic review of the scientific literature. Eur Arch Otorhinolaryngol 280(12):5345–5352CrossRefPubMed
34.
Sedaghat AR, Phillips KM (2023) Defining “control” of chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 31(1):17–23CrossRefPubMed
35.
Racette SD, Wijewickrama RC, Jayaprakash V, Sherris DA, Santos C, Kita H et al (2017) Correlation of symptoms, clinical signs, and biomarkers of inflammation in postsurgical chronic rhinosinusitis. Ann Otol Rhinol Laryngol 126(6):455–462CrossRefPubMed
36.
Yang D, Rosenberg HF, Chen Q, Dyer KD, Kurosaka K, Oppenheim JJ (2003) Eosinophil-derived neurotoxin (EDN), an antimicrobial protein with chemotactic activities for dendritic cells. Blood 102(9):3396–3403CrossRefPubMed
37.
Han Z, Junxu, Zhong N. Expression of matrix metalloproteinases MMP-9 within the airways in asthma. Respir Med. 2003;97(5):563–7.
38.
Yeo NK, Eom DW, Oh MY, Lim HW, Song YJ (2013) Expression of matrix metalloproteinase 2 and 9 and tissue inhibitor of metalloproteinase 1 in nonrecurrent vs recurrent nasal polyps. Ann Allergy Asthma Immunol 111(3):205–210CrossRefPubMed
39.
Visse R, Nagase H (2003) Matrix metalloproteinases and tissue inhibitors of metalloproteinases: structure, function, and biochemistry. Circ Res 92(8):827–839CrossRefPubMed
40.
Viskens AS, Wils T, Van Bulck P, Cools L, Vanderveken O, Hellings PW (2022) Multiple reasons underlaying uncontrolled disease in the majority of chronic rhinosinusitis patients. Front Allergy 3:1048385CrossRefPubMedPubMedCentral
41.
Wautlet A, Bachert C, Desrosiers M, Hellings PW, Peters AT (2023) The management of chronic rhinosinusitis with nasal polyps (CRSwNP) With biologics. J Allergy Clin Immunol Pract 11(9):2642–2651CrossRefPubMed
Metadaten
Titel
Association of mucus eosinophil-derived neurotoxin levels with disease control status in patients with chronic rhinosinusitis
verfasst von
Xiaoxi Huang
Zheng Liu
Benjamin S. Bleier
Yu Song
Dawei Wu
Publikationsdatum
03.05.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-024-08695-w

Neu im Fachgebiet HNO

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Eingreifen von Umstehenden rettet vor Erstickungstod

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Real-World-Daten sprechen eher für Dupilumab als für Op.

14.05.2024 Rhinosinusitis Nachrichten

Zur Behandlung schwerer Formen der chronischen Rhinosinusitis mit Nasenpolypen (CRSwNP) stehen seit Kurzem verschiedene Behandlungsmethoden zur Verfügung, darunter Biologika, wie Dupilumab, und die endoskopische Sinuschirurgie (ESS). Beim Vergleich der beiden Therapieoptionen war Dupilumab leicht im Vorteil.

Schwindelursache: Massagepistole lässt Otholiten tanzen

14.05.2024 Benigner Lagerungsschwindel Nachrichten

Wenn jüngere Menschen über ständig rezidivierenden Lagerungsschwindel klagen, könnte eine Massagepistole der Auslöser sein. In JAMA Otolaryngology warnt ein Team vor der Anwendung hochpotenter Geräte im Bereich des Nackens.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen
Bildnachweise