Quality of Life and Potential Biomarkers in Different Phenotypes of Chronic Rhinosinusitis With Nasal Polyps (CRSwNP).

Abstract

Background and objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impairs quality of life (QOL), especially in individuals with comorbid asthma and nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD). The 22-item Sino-Nasal Outcome Test (SNOT-22) is a validated questionnaire for assessing QOL in these patients. Objectives: To evaluate the subjective burden of CRSwNP, CRSwNP with asthma, and N-ERD using SNOT-22 and investigate associations with serum chemokines and cytokines as biomarkers in a representative sample of individuals from the 3 phenotypes.

Material and methods: This cross-sectional study analyzed data from 117 participants in the rhinology unit between 2015 and 2021. Symptoms and disease severity were evaluated (mean [SD]) using the visual analog scales (VAS), SNOT-22, Lund-Mackay score (LMS), nasal polyp score (NPS), and aeroallergen sensitization test (atopy). Serum levels of 17 cytokines and chemokines were measured using Luminex/ELISA.

Results: The SNOT-22 (56.3 [22.5]), LMS (19.2 [4.9]), and NPS (5.3 [1.4]) scores were worse for the N-ERD phenotype than for CRSwNP with and without asthma. This group was the most affected in sinonasal severity VAS scores (P<.0500). Nasal obstruction and loss of smell were the most affected SNOT-22 domains and VAS symptoms, respectively (P<.0500). In N-ERD, NPS correlated positively with the total SNOT-22 score (coefficient values 6.51 and 10.9, P<.0500). Sex did not correlate with SNOT-22 scores (P=.1500). Higher serum levels of VEGF-A (P=.0460), TARC (P=.0378), and TSLP (P=.0491) were detected in the N-ERD group.

Conclusion: SNOT-22 can be used to effectively assess QOL and differentiate between CRSwNP phenotypes, highlighting a greater burden in N-ERD patients. Biomarker analysis supports the distinct inflammatory profile of N-ERD.