Prognostic and pharmacologic value of cystatin SN for chronic rhinosinusitis with nasal polyps - 04/08/21
, Luo Zhang, MD, PhD a, b, c, d, ⁎ Abstract |
Background |
Integrated care pathways improve the management of patients with chronic rhinosinusitis with nasal polyps (CRSwNP). The application of integrated care pathways requires development of endotype-based biomarkers to stratify patients. The value of cytokines and markers induced by cytokines for the management of CRSwNP is largely unknown.
Objectives |
Our aim was to determine the prognostic and pharmacologic value of type 2, non–type 2 cytokines, and markers associated with type 2 inflammation, including CCL26, periostin, and cystatin SN, in nasal secretions for CRSwNP.
Methods |
This retrospective study assigned 151 patients with CRSwNP to the discovery and validation phases. Concentrations of cytokines, CCL26, periostin, and cystatin SN in nasal secretions were determined by using Luminex and ELISA. Predictive significance was assessed with receiver-operating characteristic curves. Survival analysis was performed by using Kaplan-Meier curves and Cox regression models.
Results |
Cystatin SN was an independent predictor of the uncontrolled status of CRSwNP over a 2-year follow-up after adjustment for other risk factors (hazard ratio = 1.168 and 1.132 in the discovery and validation phases, respectively; both P < .001). Patients with high cystatin SN concentrations presented with a faster onset and higher rate of uncontrolled status than did those with low levels (P < .001). Enhanced medical treatment for patients with high cystatin SN levels postponed the uncontrolled status in the discovery (P = .016) and validation (P = .002) phases but did not completely abolish it by the end of the follow-up.
Conclusion |
Cystatin SN levels in nasal secretions hold strong prognostic value and can facilitate medical instructions for managing CRSwNP.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Key words : Chronic rhinosinusitis with nasal polyps, CRSwNP, cystatin SN, cytokines, endotype, management
Abbreviations used : AUC, CRSwNP, DCS, E/M ratio, EPOS 2012, ESS, HR, ICP, IQR, ROC, TNSS, TSLP
Plan
| Supported by the National Natural Science Foundation of China (grants 81900917, 81630023, 81870698, and 82025010); the Beijing Natural Science Foundation (grant 7194247); the Beijing Municipal Administration of Hospitals incubating Program (grant PX2019007); the CAMS Innovation Fund for Medical Sciences (grant 2019-I2M-5-022); the Program for Changjiang Scholars and Innovative Research Team (grant IRT13082); the National Key R&D Program of China (grants 2018YFC0116800 and 2016YFC20160905200); the Research of Capital Health Security and Cultivation (grant Z18110700160000); the Beijing Municipal Administration of Hospitals’ Mission Plan (grant SML20150203); the Beijing Municipal Administration of Hospitals’ Innovation Program of Clinical Techniques (grant XMLX201816); the Priming Scientific Research Foundation for the Senior Researcher in Beijing TongRen Hospital, Capital Medical University (grant 2017-YJJ-GGL-005); and the Beijing Municipal Administration of Hospitals’ Youth Programme (grant QML20150202). |
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| Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. |
Vol 148 - N° 2
P. 450-460 - août 2021 Retour au numéro
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