Role of blood inflammatory cells in chronic rhinosinusitis with nasal polyps

Abstract

Background/Objective: The pathophysiological and prognostic role of blood inflammatory cells in chronic rhinosinusitis with nasal polyps (CRSwNP) emerging from recent studies was investigated.

Material and Methods: The main available evidence and largely-recent publications were critically analyzed.

Results: Several authors reported a direct association between blood eosinophilia and CRSwNP recurrence rates. In some large series, a direct association between recurrent CRSwNP and blood basophil values emerged too. CRSwNP patients’ blood eosinophil and basophil values were strongly related. It was also found that preoperative neutrophil-to-lymphocyte, eosinophil-to-lymphocyte, and basophil-to-lymphocyte ratios were significantly higher in patients who experienced a disease relapse than in those who did not. In histologically-confirmed eosinophilic-type CRSwNP treated with endoscopic sinus surgery, mean blood eosinophil values dropped significantly from before to after the surgical procedure.

Conclusions/Significance: CRSwNP endotypes have different inflammatory profiles reflected in the relative proportions of different types of blood cells. The available data support the theory that blood eosinophil and basophil levels should be included in the routine preoperative work-up of CRSwNP patients in order to give patients accurate prognostic information, adopt rational follow-up protocols after surgery, and provide dedicated postoperative medical treatments.

Chinese abstract

背景/目的：近期研究中发现的慢性鼻窦炎伴鼻息肉（CRSWNP）中的血液炎症细胞在病理生理和预后作用, 在此得以探讨。

材料和方法：对现有的主要证据和近期发表的文章进行了批判性分析。

结果：几位作者报道了血嗜酸性粒细胞增多与CRSwNP复发率之间的直接联系。在一些大的序列中, 也出现复发性CRSwNP和血嗜碱性粒细胞值之间的直接联系。CRSwNP患者的血嗜酸性粒细胞和嗜碱性粒细胞值有很强的相关性。研究还发现, 复发患者术前中性粒细胞与淋巴细胞、嗜酸性粒细胞与淋巴细胞、嗜碱性粒细胞与淋巴细胞之比明显高于未复发患者。在经鼻内镜手术治疗的由组织学证实的嗜酸性粒细胞型CRSwNP中, 平均血嗜酸性粒细胞值从手术前到手术后显著下降。

结论/意义：CRSwNP内型具有不同的炎症特征, 反映于不同类型血细胞的相对比例。现有资料支持这种看法：将血嗜酸性粒细胞和嗜碱性粒细胞水平纳入CRSwNP患者常规术前检查, 以便为患者提供准确的预后信息, 术后采取合适的随访方案, 并提供专门的术后治疗。

Keywords:

• Chronic rhinosinusitis nasal polyps
• blood inflammatory cells
• eosinophils
• basophils
• prognosis
• endotypes

Disclosure statement

No potential conflict of interest was reported by the authors.