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Diversity of TH cytokine profiles in patients with chronic rhinosinusitis : a multicenter study in Europe, Asia, and Oceania

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Abstract
Background: To date, no study has evaluated the diversity of T-H cell cytokine patterns of patients with chronic rhinosinusitis (CRS) among centers in different continents using identical methods. Objective: We sought to assess T-H cytokine profiles in patients with CRS from Europe, Asia, and Australia. Methods: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP; n 5 435) and control subjects (n 5 138) were recruited from centers in Adelaide, Benelux, Berlin, Beijing, Chengdu, and Tochigi. Nasal mucosal concentrations of T(H)2, T(H)17, and T(H)1 cytokines; eosinophilic cationic protein (ECP); myeloperoxidase (MPO); IL-8; and tissue total and Staphylococcus aureus enterotoxin (SE)-specific IgE were measured by using identical tools. Results: Combinations of T(H)1/T(H)2/T(H)17 cytokine profiles in patients with CRSwNP varied considerably between regions. CRSwNP tissues from patients from Benelux, Berlin, Adelaide, and Tochigi were T(H)2 biased, whereas those from Beijing mainly demonstrated T(H)2/T(H)1/T(H)17 mixed patterns, and patients from Chengdu showed an even lower T(H)2 expression. Concentrations of IL-8 and tissue total IgE in patients with CRSwNP were significantly higher than those in control subjects in all regions. More than 50% of patients with CRSwNP in Benelux, Berlin, Adelaide, and Tochigi showed a predominantly eosinophilic endotype compared with less than 30% of patients in Beijing and Chengdu. SE-specific IgE was found in significantly greater numbers in patients with CRSwNP from Benelux, Adelaide, and Tochigi and significantly lower numbers in patients from Beijing and Chengdu. Moreover, the T(H)1/T(H)2/T(H)17 cytokine profiles in patients with CRSsNP showed diversity among the 6 regions. Conclusion: T-H cytokine levels, eosinophilic/neutrophilic patterns, and SE-specific IgE expressions show extreme diversity among patients with CRS from Europe, Asia, and Oceania.
Keywords
T-H cytokines, IgE, ECP, chronic rhinosinusitis, pheno-type, endotype, Europe, Asia, Australia, CHINESE CHRONIC RHINOSINUSITIS, NASAL POLYPS, SINUS DISEASE, ASTHMA, INFLAMMATION, IGE, ENTEROTOXINS, PHENOTYPES, ENDOTYPES, RESPONSES

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Chicago
Wang, Xiangdong, Nan Zhang, Mingyu Bo, Gabriële Holtappels, Ming Zheng, Hongfei Lou, Hong Wang, Luo Zhang, and Claus Bachert. 2016. “Diversity of TH Cytokine Profiles in Patients with Chronic Rhinosinusitis : a Multicenter Study in Europe, Asia, and Oceania.” Journal of Allergy and Clinical Immunology 138 (5): 1344–1353.
APA
Wang, Xiangdong, Zhang, N., Bo, M., Holtappels, G., Zheng, M., Lou, H., Wang, H., et al. (2016). Diversity of TH cytokine profiles in patients with chronic rhinosinusitis : a multicenter study in Europe, Asia, and Oceania. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 138(5), 1344–1353.
Vancouver
1.
Wang X, Zhang N, Bo M, Holtappels G, Zheng M, Lou H, et al. Diversity of TH cytokine profiles in patients with chronic rhinosinusitis : a multicenter study in Europe, Asia, and Oceania. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. 2016;138(5):1344–53.
MLA
Wang, Xiangdong, Nan Zhang, Mingyu Bo, et al. “Diversity of TH Cytokine Profiles in Patients with Chronic Rhinosinusitis : a Multicenter Study in Europe, Asia, and Oceania.” JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 138.5 (2016): 1344–1353. Print.
@article{8506461,
  abstract     = {Background: To date, no study has evaluated the diversity of T-H cell cytokine patterns of patients with chronic rhinosinusitis (CRS) among centers in different continents using identical methods. 
Objective: We sought to assess T-H cytokine profiles in patients with CRS from Europe, Asia, and Australia. 
Methods: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP; n 5 435) and control subjects (n 5 138) were recruited from centers in Adelaide, Benelux, Berlin, Beijing, Chengdu, and Tochigi. Nasal mucosal concentrations of T(H)2, T(H)17, and T(H)1 cytokines; eosinophilic cationic protein (ECP); myeloperoxidase (MPO); IL-8; and tissue total and Staphylococcus aureus enterotoxin (SE)-specific IgE were measured by using identical tools. 
Results: Combinations of T(H)1/T(H)2/T(H)17 cytokine profiles in patients with CRSwNP varied considerably between regions. CRSwNP tissues from patients from Benelux, Berlin, Adelaide, and Tochigi were T(H)2 biased, whereas those from Beijing mainly demonstrated T(H)2/T(H)1/T(H)17 mixed patterns, and patients from Chengdu showed an even lower T(H)2 expression. Concentrations of IL-8 and tissue total IgE in patients with CRSwNP were significantly higher than those in control subjects in all regions. More than 50\% of patients with CRSwNP in Benelux, Berlin, Adelaide, and Tochigi showed a predominantly eosinophilic endotype compared with less than 30\% of patients in Beijing and Chengdu. SE-specific IgE was found in significantly greater numbers in patients with CRSwNP from Benelux, Adelaide, and Tochigi and significantly lower numbers in patients from Beijing and Chengdu. Moreover, the T(H)1/T(H)2/T(H)17 cytokine profiles in patients with CRSsNP showed diversity among the 6 regions. 
Conclusion: T-H cytokine levels, eosinophilic/neutrophilic patterns, and SE-specific IgE expressions show extreme diversity among patients with CRS from Europe, Asia, and Oceania.},
  author       = {Wang, Xiangdong and Zhang, Nan and Bo, Mingyu and Holtappels, Gabri{\"e}le and Zheng, Ming and Lou, Hongfei and Wang, Hong and Zhang, Luo and Bachert, Claus},
  issn         = {0091-6749},
  journal      = {JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY},
  keyword      = {T-H cytokines,IgE,ECP,chronic rhinosinusitis,pheno-type,endotype,Europe,Asia,Australia,CHINESE CHRONIC RHINOSINUSITIS,NASAL POLYPS,SINUS DISEASE,ASTHMA,INFLAMMATION,IGE,ENTEROTOXINS,PHENOTYPES,ENDOTYPES,RESPONSES},
  language     = {eng},
  number       = {5},
  pages        = {1344--1353},
  title        = {Diversity of TH cytokine profiles in patients with chronic rhinosinusitis : a~multicenter study in Europe, Asia, and Oceania},
  url          = {http://dx.doi.org/10.1016/j.jaci.2016.05.041},
  volume       = {138},
  year         = {2016},
}

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