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KMID : 1225720230150040437
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Allergy, Asthma & Immunology Research : AAIR
2023 Volume.15 No. 4 p.437 ~ p.450
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Inflammatory Endotypes of Chronic Rhinosinusitis in the Korean Population: Distinct Expression of Type 3 Inflammation
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Min Jin-Young
Kim Jin-Youp
Sung Chung-Man
Kim Seon-Tae
Cho Hyun-Jin
Mun Sue-Jean
Cho Sung-Woo
Hong Sang-Duk
Ryu Gwang-Hui
Cho Kyoung-Rai
Kim Young-Hyo
Park Soo-Kyoung
Kim Dong-Kyu
Seo Young-Eun
Heo Sung-Jae
Lee Ki-Il
Kim Su-Jin
Lee Sang-Jun
Mo Ji-Hun
Shin Seung-Heon
Kim Dae-Woo
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Abstract
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Purpose : Cluster analyses on inflammatory markers of chronic rhinosinusitis (CRS) in Asians from multicenter data are lacking. This multicenter study aimed to identify the endotypes of CRS in Koreans and to evaluate the relationship between the endotypes and clinical parameters.
Methods : Nasal tissues were obtained from patients with CRS and controls who underwent surgery. The endotypes of CRS were investigated by measuring interleukin (IL)-5, interferon (IFN)-γ, IL-17A, IL-22, IL-1β, IL-6, IL-8, matrix metalloproteinase-9, eotaxin-3, eosinophil cationic protein, myeloperoxidase (MPO), human neutrophil elastase (HNE), periostin, transforming growth factor-β1, total immunoglobulin E (IgE), and staphylococcal enterotoxin (SE)-specific IgE. We performed hierarchical cluster analysis and evaluated the phenotype, comorbidities, and Lund-Mackay computed tomography (LM CT) score in each cluster.
Results : Five clusters and 3 endotypes were extracted from 244 CRS patients: cluster 1 had no upregulated mediators compared to the other clusters (mild mixed inflammatory CRS); clusters 2, 3, and 4 had higher concentrations of neutrophil-associated mediators including HNE, IL-8, IL-17A, and MPO (T3 CRS); and cluster 5 had higher levels of eosinophil-associated mediators (T2 CRS). SE-specific IgE was undetectable in T3 CRS and had low detectable levels (6.2%) even in T2 CRS. The CRS with nasal polyps (CRSwNP) phenotype and LM CT scores showed no significant differences between T2 and T3 CRS, while the incidence of comorbid asthma was higher in T2 CRS than T3 CRS. In T3 clusters, higher levels of neutrophilic markers were associated with disease severity and CRSwNP phenotype.
Conclusions : In Koreans, there is a distinct T3 CRS endotype showing a high proportion of CRSwNP and severe disease extent, along with T2 CRS.
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KEYWORD
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Asians, biomarker, cluster analysis, nasal polyps, sinusitis, multicenter study, surgery
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