Abstract
Background: Glucocorticoids (GC) therapeutic response in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) varies markedly.
Aims/Objectives: To compare the utility between subjective and objective assessment of GC sensitivity in reflecting the impact of GC on systemic and local eosinophilia in CRSwNP patients.
Material and methods: Twenty-six patients with CRSwNP were enrolled. All patients were given 30 mg of prednisone once daily for 7 days and subsequently classified into subjectively GC-sensitive and -insensitive subgroup or objectively GC-sensitive and -insensitive subgroup. The numbers of eosinophils and neutrophils in blood and polyp tissues were compared between GC-sensitive and GC-insensitive subgroup.
Results: 17/26 (65.4%) patients were subjectively and 8/26 (30.8%) patients objectively sensitive to GC treatment. The absolute number and percentage of eosinophils in blood were decreased both in GC-sensitive and -insensitive subjects after GC treatment. In addition, a significant reduction in tissue eosinophil percentage was only observed in objectively GC-sensitive subjects after GC treatment. Furthermore, the change of tissue eosinophil percentage in objectively GC-sensitive subjects was significantly higher than that in objectively GC-insensitive subjects.
Conclusions and significance: Objective assessment may better reflect oral GC response in tissue eosinophilic inflammation than subjective assessment in patients with CRSwNP.
Chinese abstract
背景:糖皮质激素(GC)治疗伴鼻息肉的慢性鼻窦炎(CRSwNP)的疗效之间有明显差异。
目的:比较主观和客观评估GC敏感性的效用, 该敏感性反映在GC对CRSwNP患者全身和局部嗜酸性粒细胞增多的影响。
材料与方法:26例CRSwNP患者入选。所有患者每天服用一次30毫克强的松, 持续7天, 随后分为主观GC敏感和不敏感亚组或客观GC敏感和不敏感亚组。比较GC敏感亚组和GC不敏感亚组的血液和息肉组织中嗜酸性粒细胞和中性粒细胞的数量。
结果:26名患者中有17例(65.4%)对GC治疗有主观敏感性, 8例(30.8%)对GC治疗有客观敏感性。GC治疗后, 血液中嗜酸性粒细胞的绝对数和百分比在GC敏感和不敏感受试者中均下降。另外, 只有在客观GC敏感受试者接受GC治疗后, 组织嗜酸性粒细胞百分比才会显著降低。此外, 客观GC敏感受试者的组织嗜酸性粒细胞百分比的变化明显高于客观GC不敏感受试者。
结论与意义:客观评价比主观评价更能反映CRSwNP患者的组织嗜酸性粒细胞性炎症对口服GC的反应。
Acknowledgements
We thank the nurses of Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University for collecting the study samples.
Disclosure statement
No potential conflict of interest was reported by the authors.