Component-Resolved Diagnosis for Endotyping Patients with Chronic Rhinosinusitis with Nasal Polyps

Int Arch Allergy Immunol. 2022;183(7):770-777. doi: 10.1159/000522255. Epub 2022 Mar 31.

Abstract

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammation-mediated disease of the nasal mucosa and paranasal sinuses that often coexists with asthma. The role of atopy in the development and severity of CRSwNP is still a controversial issue.

Objective: The aim of our study was to propose a systematic allergy workup to identify atopic patients in the context of CRSwNP and to characterize their allergen sensitization profile (sources/molecules).

Methods: Patients with a diagnosis of CRSwNP (n = 97) were studied in the otorhinolaryngologist and allergy settings. Demographic and clinical data were collected for each patient. Different allergen sensitization profiles (sources/molecules) were evaluated in atopic CRSwNP patients by using component-resolved diagnosis (CRD).

Results: In our cohort of patients, the CRSwNP was frequently diagnosed during adulthood with significant impact on health-related quality of life. Asthma and atopy were the most common comorbidities with a prevalence of asthma in the atopic group. In CRSwNP patients sensitized to grass pollens and/or to house dust mites, the CRD analysis revealed a prevalence of sensitization to species-specific allergens of Phleum pratense (Phl p1, Phl p2, and Phl p5) or Dermatophagoides pteronyssinus (Der p1 and Der p2) rather than to cross-reactive ones.

Conclusion: To define the allergen sensitization profile in atopic CRSwNP patients by CRD, it may be useful to better characterize type 2 inflammation, thus providing a personalized endotype-driven treatment.

Keywords: Allergy; Component-resolved diagnosis; Nasal polyps.

MeSH terms

  • Adult
  • Allergens
  • Asthma* / diagnosis
  • Asthma* / epidemiology
  • Chronic Disease
  • Humans
  • Hypersensitivity* / epidemiology
  • Hypersensitivity, Immediate*
  • Inflammation
  • Nasal Polyps* / complications
  • Nasal Polyps* / diagnosis
  • Nasal Polyps* / epidemiology
  • Quality of Life
  • Sinusitis* / diagnosis
  • Sinusitis* / epidemiology

Substances

  • Allergens