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European Archives of Oto-Rhino-Laryngology

Erschienen in:

18.11.2022 | Rhinology

Diagnostic value of serum and tissue eosinophil in diagnosis of asthma among patients with chronic rhinosinusitis

verfasst von: Che Mohd Hilmi Che Mat, Norasnieda Md Shukri, Sakinah Mohamad, Sharifah Emilia Tuan Sharif, Rosdi Ramli, Murni Hartini Jais, Mat Zuki Mat Jaeb, Najib Majdi Yaacob, Mohd Yusran Yusoff, Siti Muhamad Nur Husna, Baharudin Abdullah

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 5/2023

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Abstract

Background

Chronic rhinosinusitis (CRS) is one of the most common chronic inflammatory diseases of sinonasal mucosa. Asthma among CRS patients is often underdiagnosed which makes the management of CRS more challenging. Therefore, using serum and tissue eosinophil as an indicator and predictor of asthma in CRS patients is vital for further preventing recurrent and increasing the effectiveness of treatment for CRS.

Objective

To determine the association and diagnostic ability of serum and tissue eosinophils in the diagnosis of asthma among CRS patients.

Methods

A cross-sectional study was conducted involving 24 CRS patients with asthma and without asthma, respectively, from the Otorhinolaryngology clinic of two tertiary hospitals located on the East Coast of Peninsular Malaysia. Serum and tissue eosinophils (obtained from nasal polyp) levels between both groups were compared. Association between serum and tissue eosinophils with asthma was evaluated using logistic regression analysis, adjusting for important sociodemographic characteristics. The diagnostic ability of serum and tissue eosinophil was then evaluated by assessing the receiver operating characteristic curve.

Results

A total of 48 CRS patients with a mean [SD] age of 47.50 [14.99] years were included. Patients with asthma had significantly higher serum [0.48 vs 0.35 × 10⁹/L] and tissue eosinophil [100 vs 8.5 per HPF] levels. Tissue eosinophils were found to be an independent predictor of asthma with adjusted OR 1.05, p < 0.001, after adjusting for age and serum eosinophils. The area under the receiver operating characteristic curve for serum eosinophil was 69.0%. At optimal cut-off value (0.375 × 10⁹/L), the sensitivity and specificity for serum eosinophil was 75.0% and 70.8%. The area under the receiver operating characteristic curve for tissue eosinophil was 93.4%. At the optimal cut-off value (58.0 per HPF), the sensitivity and specificity for tissue eosinophils were 79.2% and 91.7%, respectively.

Conclusion

This study indicates a significantly higher level of serum and tissue eosinophils in CRS with asthma. However, there was no correlation between serum and tissue eosinophils in both group. Based on this study, the CRS patient needs to be screened for asthma if the level of serum eosinophil is > 0.375 × 10⁹/L and tissue eosinophil > 58 per HPF.

Hastan D et al (2011) Chronic rhinosinusitis in Europe–an underestimated disease. A GA2LEN study. Allergy 66(9):1216–1223CrossRefPubMed

Murphy MP et al (2002) Health care utilization and cost among adults with chronic rhinosinusitis enrolled in a health maintenance organization. Otolaryngol Head Neck Surg 127(5):367–376CrossRefPubMed

Hedman J et al (1999) Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 28(4):717–722CrossRefPubMed

Settipane GA, Chafee FH (1977) Nasal polyps in asthma and rhinitis: a review of 6,037 patients. J Allergy Clin Immunol 59(1):17–21CrossRefPubMed

Ahn J-C et al (2016) Prevalence and risk factors of chronic rhinosinusitus, allergic rhinitis, and nasal septal deviation: results of the Korean National Health and Nutrition Survey 2008–2012. JAMA otolaryngol Head Neck Surg 142(2):162–167CrossRefPubMed

Shi JB et al (2015) Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven. Chin Cities 70(5):533–539

Fokkens WJ et al (2020) European position paper on rhinosinusitis and nasal polyps 2020. Rhinology 58(Suppl S29):1-464. https://doi.org/10.4193/Rhin20.600

Reddel HK et al (2015) A summary of the new GINA strategy: a roadmap to asthma control. Eur Respir J 46(3):622–639CrossRefPubMedPubMedCentral

Cheong AT et al (2021) Implementing asthma management guidelines in public primary care clinics in Malaysia. NPJ Primary Care Respir Med 31(1):1–8CrossRef

10.

Gold LS et al (2014) Level of asthma control and health care utilization in Asia-Pacific countries. Respir Med 108(2):271–277CrossRefPubMed

11.

Ministry of Health, M. National Health and Morbidity Survey: Healthcare demand and out-of-pocket health expenditure. 2011; http://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2011-VolumeIII.pdf.

12.

Wenig BM (2016) Non-neoplastic lesions of the sinonasal tract. Atlas Head Neck Pathol 2016:9–80

13.

Cauna N et al (1972) Fine structure of nasal polyps. Ann Otol Rhinol Laryngol 81(1):41–58CrossRefPubMed

14.

Kovalszki A, Weller PF (2016) Eosinophilia. Prim Care 43(4):607–617CrossRefPubMedPubMedCentral

15.

Tran TN et al (2014) High blood eosinophil count is associated with more frequent asthma attacks in asthma patients. Ann Allergy Asthma Immunol 113(1):19–24CrossRefPubMed

16.

Lou H et al (2018) Highlights of eosinophilic chronic rhinosinusitis with nasal polyps in definition, prognosis, and advancement. Int Forum Allergy Rhinol 8(11):1218–1225. https://doi.org/10.1002/alr.22214

17.

Liu C et al (2019) Predictive significance of Charcot-Leyden crystals for eosinophilic chronic rhinosinusitis with nasal polyps. Am J Rhinol Allergy 33(6):671–680CrossRefPubMed

18.

Yu L et al (2022) Predictive value of clinical characteristics in eosinophilic chronic rhinosinusitis with nasal polyps: A cross‐sectional study in the Chinese population. Int Forum Allergy Rhinol 12:726–734. https://doi.org/10.1002/alr.22901

19.

Weller PF, Spencer LA (2017) Functions of tissue-resident eosinophils. Nat Rev Immunol 17(12):746–760CrossRefPubMedPubMedCentral

20.

Aslan F et al (2017) Could Eosinophilia predict clinical severity in nasal polyps? Multidiscip Respir Med 12(1):1–5CrossRef

21.

Goh B-S et al (2005) Prevalence of allergic fungal sinusitis in refractory chronic rhinosinusitis in adult Malaysians. Otolaryngol Head Neck Surg 133(1):27–31CrossRefPubMed

22.

Ek A et al (2013) Chronic rhinosinusitis in asthma is a negative predictor of quality of life: results from the S wedish GA 2 LEN survey. Allergy 68(10):1314–1321CrossRefPubMed

23.

Slavin RG (1992) Asthma and sinusitis. J Allergy Clin Immunol 90(3):534–537CrossRefPubMed

24.

Borrish L (2002) Sinusitis and asthma: entering the realm of evidence-based medicine. J Allergy Clin Immunol 109(4):606–608CrossRefPubMed

25.

Moloney JR (1977) Nasal polyps, nasal polypectomy, asthma, and aspirin sensitivity: their association in 445 cases of nasal polyps. J Laryngol Otol 91(10):837–846CrossRefPubMed

26.

Bresciani M et al (2001) Rhinosinusitis in severe asthma. J Allergy Clin Immunol 107(1):73–80CrossRefPubMed

27.

Lamblin C et al (1999) Eosinophilic airway inflammation in nasal polyposis. J Allergy Clin Immunol 104(1):85–92CrossRefPubMed

28.

Ikeda K et al (2013) Subclassification of chronic rhinosinusitis with nasal polyp based on eosinophil and neutrophil. Laryngoscope 123(11):E1–E9CrossRefPubMed

29.

Sakuma Y et al (2011) New clinical diagnostic criteria for eosinophilic chronic rhinosinusitis. Auris Nasus Larynx 38(5):583–588CrossRefPubMed

30.

Takeno S, Hirakawa K, Ishino T (2010) Pathological mechanisms and clinical features of eosinophilic chronic rhinosinusitis in the Japanese population. Allergol Int 59(3):247–256CrossRefPubMed

31.

Kimura N et al (1997) Clinical effect of low-dose, long-term roxithromycin chemotherapy in patients with chronic sinusitis. Acta Med Okayama 51(1):33–37PubMed

32.

Bachert C, Patou J, Van Cauwenberge P (2006) The role of sinus disease in asthma. Curr Opin Allergy Clin Immunol 6(1):29–36CrossRefPubMed

33.

Han DH et al (2009) Predictors of bronchial hyperresponsiveness in chronic rhinosinusitis with nasal polyp. Allergy 64(1):118–122CrossRefPubMed

34.

Turato G et al (2018) Blood eosinophilia neither reflects tissue eosinophils nor worsens clinical outcomes in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 197(9):1216–1219CrossRefPubMed

35.

McHugh T et al (2018) High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta‐analysis. Int Forum Allergy Rhinol 8(12):1421–1429. https://doi.org/10.1002/alr.22194

36.

Ho J et al (2018) Systemic predictors of eosinophilic chronic rhinosinusitis. Am J Rhinol Allergy 32(4):252–257CrossRefPubMed

Titel: Diagnostic value of serum and tissue eosinophil in diagnosis of asthma among patients with chronic rhinosinusitis
verfasst von: Che Mohd Hilmi Che Mat
Norasnieda Md Shukri
Sakinah Mohamad
Sharifah Emilia Tuan Sharif
Rosdi Ramli
Murni Hartini Jais
Mat Zuki Mat Jaeb
Najib Majdi Yaacob
Mohd Yusran Yusoff
Siti Muhamad Nur Husna
Baharudin Abdullah
Publikationsdatum: 18.11.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 5/2023
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-022-07746-4

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Diagnostic value of serum and tissue eosinophil in diagnosis of asthma among patients with chronic rhinosinusitis