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Endotypes of chronic rhinosinusitis based on inflammatory and remodeling factors

Xiangdong Wang, Yutong Sima, Yan Zhao, Nan Zhang (UGent) , Ming Zheng, Kun Du, Min Wang, Yue Wang, Yun Hao, Ying Li, et al.
(2023) JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. 151(2). p.458-468
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Abstract
Background: Previous studies on the endotyping of chronic rhinosinusitis (CRS) that were based on inflammatory factors have broadened our understanding of the disease. However, the endotype of CRS combined with inflammatory and remodeling features has not yet been clearly elucidated. Objective: We sought to identify the endotypes of patients with CRS according to inflammatory and remodeling factors. Methods: Forty-eight inflammatory and remodeling factors in the nasal mucosal tissues of 128 CRS patients and 24 control subjects from northern China were analyzed by Luminex, ELISA, and ImmunoCAP. Sixteen factors were used to perform the cluster analysis. The characteristics of each cluster were analyzed using correlation analysis and validated by immunofluorescence staining. Results: Patients were classified into 5 clusters. Clusters 1 and 2 showed non-type 2 signatures with low biomarker concentrations, except for IL-19 and IL-27. Cluster 3 involved a low type 2 endotype with the highest expression of neutrophil factors, such as granulocyte colony-stimulating factor, IL-8, and myeloperoxidase, and remodeling factors, such as matrix metalloproteinases and fibronectin. Cluster 4 exhibited moderate type 2 inflammation. Cluster 5 exhibited high type 2 inflammation, which was associated with relatively higher levels of neutrophil and remodeling factors. The proportion of CRS with nasal polyps, asthma, allergies, anosmia, aspirin sensitivity, and the recurrence of CRS increased from clusters 1 to 5. Conclusion: Diverse inflammatory mechanisms result in distinct CRS endotypes and remodeling profiles. The explicit differentiation and accurate description of these endotypes will guide targeted treatment decisions. (J Allergy Clin Immunol 2023;151:458-68.)
Keywords
Chronic rhinosinusitis, endotypes, remodeling factors, cluster analysis, NASAL POLYPOSIS, RESPIRATORY-TRACT, TISSUE INHIBITOR, CELLS, EXPRESSION, FEATURES, MMP-9, EOSINOPHILS, NEUTROPHILS, PROMOTE

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MLA
Wang, Xiangdong, et al. “Endotypes of Chronic Rhinosinusitis Based on Inflammatory and Remodeling Factors.” JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, vol. 151, no. 2, 2023, pp. 458–68, doi:10.1016/j.jaci.2022.10.010.
APA
Wang, X., Sima, Y., Zhao, Y., Zhang, N., Zheng, M., Du, K., … Bachert, C. (2023). Endotypes of chronic rhinosinusitis based on inflammatory and remodeling factors. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 151(2), 458–468. https://doi.org/10.1016/j.jaci.2022.10.010
Chicago author-date
Wang, Xiangdong, Yutong Sima, Yan Zhao, Nan Zhang, Ming Zheng, Kun Du, Min Wang, et al. 2023. “Endotypes of Chronic Rhinosinusitis Based on Inflammatory and Remodeling Factors.” JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 151 (2): 458–68. https://doi.org/10.1016/j.jaci.2022.10.010.
Chicago author-date (all authors)
Wang, Xiangdong, Yutong Sima, Yan Zhao, Nan Zhang, Ming Zheng, Kun Du, Min Wang, Yue Wang, Yun Hao, Ying Li, Manjiao Liu, Yingshi Piao, Chengyao Liu, Peter Tomassen, Luo Zhang, and Claus Bachert. 2023. “Endotypes of Chronic Rhinosinusitis Based on Inflammatory and Remodeling Factors.” JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 151 (2): 458–468. doi:10.1016/j.jaci.2022.10.010.
Vancouver
1.
Wang X, Sima Y, Zhao Y, Zhang N, Zheng M, Du K, et al. Endotypes of chronic rhinosinusitis based on inflammatory and remodeling factors. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. 2023;151(2):458–68.
IEEE
[1]
X. Wang et al., “Endotypes of chronic rhinosinusitis based on inflammatory and remodeling factors,” JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, vol. 151, no. 2, pp. 458–468, 2023.
@article{01GQJCFJQHNQWAQK27Q1XS35DF,
  abstract     = {{Background: Previous studies on the endotyping of chronic rhinosinusitis (CRS) that were based on inflammatory factors have broadened our understanding of the disease. However, the endotype of CRS combined with inflammatory and remodeling features has not yet been clearly elucidated. Objective: We sought to identify the endotypes of patients with CRS according to inflammatory and remodeling factors. Methods: Forty-eight inflammatory and remodeling factors in the nasal mucosal tissues of 128 CRS patients and 24 control subjects from northern China were analyzed by Luminex, ELISA, and ImmunoCAP. Sixteen factors were used to perform the cluster analysis. The characteristics of each cluster were analyzed using correlation analysis and validated by immunofluorescence staining. Results: Patients were classified into 5 clusters. Clusters 1 and 2 showed non-type 2 signatures with low biomarker concentrations, except for IL-19 and IL-27. Cluster 3 involved a low type 2 endotype with the highest expression of neutrophil factors, such as granulocyte colony-stimulating factor, IL-8, and myeloperoxidase, and remodeling factors, such as matrix metalloproteinases and fibronectin. Cluster 4 exhibited moderate type 2 inflammation. Cluster 5 exhibited high type 2 inflammation, which was associated with relatively higher levels of neutrophil and remodeling factors. The proportion of CRS with nasal polyps, asthma, allergies, anosmia, aspirin sensitivity, and the recurrence of CRS increased from clusters 1 to 5. Conclusion: Diverse inflammatory mechanisms result in distinct CRS endotypes and remodeling profiles. The explicit differentiation and accurate description of these endotypes will guide targeted treatment decisions. (J Allergy Clin Immunol 2023;151:458-68.)}},
  author       = {{Wang, Xiangdong and Sima, Yutong and Zhao, Yan and Zhang, Nan and Zheng, Ming and Du, Kun and Wang, Min and Wang, Yue and Hao, Yun and Li, Ying and Liu, Manjiao and Piao, Yingshi and Liu, Chengyao and Tomassen, Peter and Zhang, Luo and Bachert, Claus}},
  issn         = {{0091-6749}},
  journal      = {{JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY}},
  keywords     = {{Chronic rhinosinusitis,endotypes,remodeling factors,cluster analysis,NASAL POLYPOSIS,RESPIRATORY-TRACT,TISSUE INHIBITOR,CELLS,EXPRESSION,FEATURES,MMP-9,EOSINOPHILS,NEUTROPHILS,PROMOTE}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{458--468}},
  title        = {{Endotypes of chronic rhinosinusitis based on inflammatory and remodeling factors}},
  url          = {{http://doi.org/10.1016/j.jaci.2022.10.010}},
  volume       = {{151}},
  year         = {{2023}},
}
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