Quality of life in type 2 and non-type 2 endotypes in chronic rhinosinusitis with nasal polyps: A prospective trial

IF 4.6 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2025-05-31 DOI:10.1002/clt2.70070

Stijn Bogaert, Elisabeth Rheindorf, Stefan Dazert, Stefan Volkenstein, Lisa Knipps, Jonas Jae-Hyun Park, Oliver Pfaar

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引用次数: 0

Abstract

Background

In current clinical practice, primary diffuse chronic rhinosinusitis with nasal polyps (CRSwNP) is classified into two endotypes: type 2 and non-type 2. Previous studies on sinonasal health-related quality of life (HRQoL) in CRS have primarily focused on differences between phenotypes. This study aimed to compare HRQoL between the two endotypes in patients with CRSwNP.

The type 2 endotype had a higher median nasal polyp score (NPS) than non-types (4 and 2, respectively), but this difference did not reach significance. Loss of smell was associated with NPS, and facial pain/pressure was inversely correlated with age. Age was significantly associated with loss of smell, but only in non-type 2 CRSwNP.

Methods

This was a prospective, monocentric study conducted between 2018 and 2023 on CRSwNP patients referred for surgery. Health-related quality of life was assessed using the German standardized SNOT-20 questionnaire. Type 2 was defined according to the updated EPOS/EUFOREA 2023 criteria.

Results

A total of 122 patients with CRSwNP were included, 113 (92.6%) of whom were classified as type 2. Type 2 was associated with a significantly worse SNOT-20 German Adapted Version score. Two of the four cardinal symptoms of CRS—loss of smell and rhinorrhea—were significantly more severe and prevalent in the type 2 endotype, with loss of smell being very specific. The most prevalent symptom in both endotypes was nasal obstruction, with no difference between both endotypes.

Conclusion

Type 2 CRSwNP has a more severe impact on HRQoL compared with non-type 2 CRSwNP. Hyposmia, rhinorrhea, and potentially NPS may offer endotypic and pathophysiological insights.

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慢性鼻窦炎伴鼻息肉患者2型和非2型内型患者的生活质量：一项前瞻性试验

在目前的临床实践中，原发性弥漫性慢性鼻窦炎伴鼻息肉（CRSwNP）分为2型和非2型两种内型。先前关于CRS患者鼻腔健康相关生活质量（HRQoL）的研究主要集中在表型之间的差异。本研究旨在比较两种内皮型CRSwNP患者的HRQoL。2型鼻息肉中位评分（NPS）高于非2型（分别为4分和2分），但差异无统计学意义。嗅觉丧失与NPS相关，面部疼痛/压力与年龄呈负相关。年龄与嗅觉丧失显著相关，但仅在非2型CRSwNP中。方法：这是一项2018年至2023年间对转介手术的CRSwNP患者进行的前瞻性单中心研究。健康相关生活质量采用德国标准化SNOT-20问卷进行评估。2型是根据更新的EPOS/EUFOREA 2023标准定义的。结果共纳入122例CRSwNP患者，其中2型113例（92.6%）。2型与SNOT-20德语改编版评分显著较差相关。crs的四种主要症状中的两种——嗅觉丧失和鼻出血——在2型内型患者中更为严重和普遍，嗅觉丧失是非常特殊的。两种内镜类型中最常见的症状是鼻塞，两种内镜类型之间没有差异。2型鼻息肉中位评分（NPS）高于非2型（分别为4分和2分），但差异无统计学意义。嗅觉丧失与NPS相关，面部疼痛/压力与年龄呈负相关。年龄与嗅觉丧失显著相关，但仅在非2型CRSwNP中。结论与非2型CRSwNP相比，2型CRSwNP对HRQoL的影响更为严重。低体温，鼻漏和潜在的NPS可能提供内源性和病理生理学的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.