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Association of mucus eosinophil-derived neurotoxin levels with disease control status in patients with chronic rhinosinusitis

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

Identifying the biomarkers for uncontrolled chronic rhinosinusitis (CRS) is important for directing treatment decisions. Eosinophilia has been reported to be involved in the poor disease control of CRS and mucus eosinophil-derived neurotoxin (EDN) is potentially a biomarker of intense eosinophil activation. This study aimed to assess the relationship between mucus EDN levels, disease severity, and degree of CRS control.

Methods

A total of 150 adult patients with CRS and 25 healthy controls were prospectively enrolled. The nasal mucus and tissue specimens were collected to analyze EDN levels. Disease severity was assessed by Lund-Mackay score and 22-item Sino-Nasal Outcome Test (SNOT-22) score. Five CRS symptom severities during the prior month (nasal blockage, rhinorrhoea/postnasal drip, facial pain/pressure, smell, sleep disturbance or fatigue), use of rescue medications in the last six months, and the presence of diseased mucosa on nasal endoscopy were obtained. Consistent with the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 CRS control criteria, uncontrolled CRS was defined as meeting at least three items.

Results

40% of patients with CRS presented with uncontrolled status. Patients with uncontrolled CRS had significantly higher nasal mucus EDN levels (P = 0.010), percentage of blood eosinophil (P = 0.015), SNOT-22 score (P < 0.001), Lund-Mackay score (P = 0.008), and a more eosinophilic dominant phenotype of CRS (P < 0.001) than patients with controlled CRS. Furthermore, mucus EDN levels were positively correlated with blood eosinophils (r = 0.541, P = 0.005), SNOT-22 score (r = 0.460, P = 0.021), and Lund-Mackay score (r = 0.387, P = 0.039). Mucus EDN levels were the significant parameter related to uncontrolled CRS in multivariable analysis after adjusting for patient demographics and comorbidities (odds ratio = 1.323; P = 0.004).

Conclusions

Mucus EDN levels may be a potential biomarker for identifying the CRS control status.

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Funding

The Key clinical projects of Peking University Third Hospital (BYSYZD2023029), Natural Science Foundation of China (82000954), Beijing Science and Technology Nova Program (Z201100006820086), Beijing Hospitals Authority Youth Program (QML20190617), Beijing Hospitals Authority Clinical Medicine Development of Special Funding (XMLX202136), the Key clinical projects of Peking University Third Hospital (BYSYZD2023029), and Shan xi Natural Science Foundation (2021JQ-942).

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Authors and Affiliations

  1. Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China

    Xiaoxi Huang & Zheng Liu

  2. The Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, USA

    Benjamin S. Bleier

  3. Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, People’s Republic of China

    Yu Song & Dawei Wu

  4. Department of Otorhinolaryngology Head and Neck Surgery, Yanan City Hospital of Peking, University 3, Hospital, Yanan City, People’s Republic of China

    Yu Song

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All authors have made substantial contributions to the conception, analysis, and interpretation of data in this article, approved the submitted version, and agreed to be personally accountable for our contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which we are not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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Correspondence to Dawei Wu.

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Huang, X., Liu, Z., Bleier, B.S. et al. Association of mucus eosinophil-derived neurotoxin levels with disease control status in patients with chronic rhinosinusitis. Eur Arch Otorhinolaryngol (2024). https://doi.org/10.1007/s00405-024-08695-w

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