The following is a summary of “Endotypes of chronic rhinosinusitis based on inflammatory and remodeling factors,” published in the FEBRUARY 2023 issue of Allergy & Immunology by Wang, et al.

The understanding of chronic rhinosinusitis (CRS) has been expanded by earlier research on the endotyping of the condition based on inflammatory markers. However, when paired with inflammatory and remodeling characteristics, it had yet to be distinctly determined what the endotype of CRS looks like. Therefore, according to inflammatory and remodeling variables, researchers aimed to categorize the endotypes of CRS patients.

The nasal mucosal tissues of 128 CRS patients and 24 control participants from northern China were examined using Luminex, ELISA, and ImmunoCAP to look for 48 inflammatory and remodeling markers. The cluster analysis was conducted using sixteen criteria. In addition, correlation analysis and immunofluorescence staining were used to examine and verify each cluster’s properties.

Five clusters of patients were identified. Except for IL-19 and IL-27, Clusters 1 and 2 exhibited non-type 2 signatures and low biomarker concentrations. With the highest expression of neutrophil factors, including granulocyte colony-stimulating factor, IL-8, and myeloperoxidase, and remodeling factors, including matrix metalloproteinases and fibronectin, Cluster 3 had a low type 2 endotype. Type 2 inflammation was moderate in Cluster 4. Cluster 5 displayed significant type 2 inflammation, correlated with comparatively greater neutrophil and remodeling factor levels. Asthma, allergies, anosmia, aspirin sensitivity, and the recurrence of CRS all increased in frequency from clusters 1 to 5.

Unique CRS endotypes and remodeling patterns were the results of various inflammatory processes. Therefore, decisions about the targeted treatment would be guided by the explicit differentiation and accurate description of these endotypes.

Reference: jacionline.org/article/S0091-6749(22)01377-X/fulltext