PMID- 29862828 OWN - NLM STAT- MEDLINE DCOM- 20181120 LR - 20220410 IS - 1945-8932 (Electronic) IS - 1945-8932 (Linking) VI - 32 IP - 4 DP - 2018 Jul TI - Systemic Predictors of Eosinophilic Chronic Rhinosinusitis. PG - 252-257 LID - 10.1177/1945892418779451 [doi] AB - Background Eosinophilic chronic rhinosinusitis (eCRS) is linked with skewed T-helper 2 or immunoglobulin E (IgE)-mediated allergic responses, with differing diagnosis, prognosis, and management to non-eCRS. Objective The association between biomarkers and eCRS was investigated to assess the predictors of eCRS. Methods A cross-sectional study of adult patients with chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery was conducted. eCRS was defined by histopathological assessment showing >10 eosinophils/high-power field on sinus mucosal biopsy. Blood tests were performed preoperatively and assessed for a full blood count including eosinophils and a white cell count (WCC) as well as biochemical markers of inflammation and atopy including Immunoglobulin E (IgE), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and ImmunoCAP testing for serum-specific IgE. Comparisons between eCRS and non-eCRS patients were performed. Results 345 patients (48.1% female, age 48.72 +/- 15.06 years) were recruited, with 206 (59.7%) identified as eCRS, 41% with asthma and 47% CRS with nasal polyps. eCRS patients were more likely to have asthma ( P < .01) and nasal polyps ( P < .01). Blood eosinophils were significantly elevated in eCRS (0.42+/-0.34 vs 0.17+/-0.13 x 10(9)/L, P < .01) as were eosinophils as a ratio of WCC (6.21 +/- 4.48 vs 2.55 +/- 1.84, P < .01). ESR was decreased when compared with non-eCRS (8.1+/-7.87 vs 10.65+/-11.91, P = .03). Receiver operating characteristic curve analysis predicted high tissue eosinophilia at blood eosinophil levels above 0.24 x 10(9)/L (sensitivity 70.9%, specificity 78.4%, area under the curve [AUC]: 0.792, P < .01). eCRS was predicted at eosinophil above 4.27% of total WCC (sensitivity 64.1%, specificity 88.5%, AUC 0.797; P < .01; positive predictive value 89.2%, negative predictive value 62.4%, positive likelihood ratio 5.57, and diagnostic odds ratio 13.71). There was no significant association among WCC, CRP, IgE, or ImmunoCAP testing. Conclusion eCRS is associated with elevated blood eosinophils (>0.24 x 10(9)/L), eosinophil ratio (>4.27% of total WCC), and lower ESR when compared with non-eCRS. FAU - Ho, Jacqueline AU - Ho J AD - 1 Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia. AD - 2 St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia. FAU - Hamizan, Aneeza W AU - Hamizan AW AD - 1 Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia. AD - 3 Department of Otorhinolaryngology - Head & Neck Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. FAU - Alvarado, Raquel AU - Alvarado R AD - 1 Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia. FAU - Rimmer, Janet AU - Rimmer J AD - 1 Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia. AD - 4 Woolcock Institute, University of Sydney, Sydney, Australia. AD - 5 Faculty of Medicine, Notre Dame University, Sydney, Australia. FAU - Sewell, William A AU - Sewell WA AD - 2 St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia. AD - 6 Immunology Division, Garvan Institute of Medical Research, Sydney, Australia. FAU - Harvey, Richard J AU - Harvey RJ AD - 1 Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia. AD - 7 Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. LA - eng PT - Journal Article DEP - 20180604 PL - United States TA - Am J Rhinol Allergy JT - American journal of rhinology & allergy JID - 101490775 RN - 0 (Biomarkers) RN - 0 (Blood Proteins) RN - 37341-29-0 (Immunoglobulin E) RN - 9007-41-4 (C-Reactive Protein) SB - IM MH - Adult MH - Asthma/complications/*diagnosis MH - Biomarkers/blood MH - Blood Proteins/metabolism MH - C-Reactive Protein/metabolism MH - Cell Count MH - Chronic Disease MH - Cross-Sectional Studies MH - Eosinophils/*immunology MH - Female MH - Humans MH - Immunoglobulin E/metabolism MH - Male MH - Middle Aged MH - Nasal Polyps/complications/*diagnosis MH - Predictive Value of Tests MH - Prognosis MH - Rhinitis/complications/*diagnosis MH - Sinusitis/complications/*diagnosis MH - Th2 Cells/*immunology OTO - NOTNLM OT - adult OT - atopy OT - biomarkers OT - blood tests OT - chronic rhinosinusitis OT - cross-sectional studies OT - diagnosis OT - eosinophilic chronic rhinosinusitis OT - eosinophils OT - human EDAT- 2018/06/05 06:00 MHDA- 2018/11/21 06:00 CRDT- 2018/06/05 06:00 PHST- 2018/06/05 06:00 [pubmed] PHST- 2018/11/21 06:00 [medline] PHST- 2018/06/05 06:00 [entrez] AID - 10.1177/1945892418779451 [doi] PST - ppublish SO - Am J Rhinol Allergy. 2018 Jul;32(4):252-257. doi: 10.1177/1945892418779451. Epub 2018 Jun 4.