dupilumab治疗慢性鼻窦炎伴鼻息肉患者嗅觉丧失和鼻窦一氧化氮的早期临床改善

IF 2.6 3区 医学 Q2 ALLERGY
Miguel J Lanz, Claudia P Eisenlohr, Lianet Herrera Cepeda
{"title":"dupilumab治疗慢性鼻窦炎伴鼻息肉患者嗅觉丧失和鼻窦一氧化氮的早期临床改善","authors":"Miguel J Lanz, Claudia P Eisenlohr, Lianet Herrera Cepeda","doi":"10.2500/aap.2025.46.250004","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background/Objective:</b> Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have a high morbidity of anosmia, yet there are few noninvasive biomarkers to measure treatment response. Nitric oxide (NO) is found in the paranasal sinuses at 100 times higher levels than in the lungs and is vital for antimicrobial and/or mucociliary activities and vasodilatory properties. Dupilumab has been shown to improve anosmia in 2 weeks as measured by the University of Pennsylvania Smell Identification Test (UPSIT), 22-item Sinonasal Outcome Test (SNOT-22), and Loss of Smell (LoS) scoring. We examined the use of NO in various collection methods to monitor anosmia improvement with dupilumab treatment. <b>Methods:</b> Adults with CRSwNP confirmed by computer tomography or endoscopy consented to receive dupilumab 300 mg every two weeks for 16 weeks. Subjects with polyposis despite treatment with steroids and/or a history of sinus surgery were recruited. Measurements of sinus NO (sNO) from the nostril while humming, nasal NO (nNO) while breath-holding, and fractional exhaled nitric oxide (FeNO) while exhaling were collected at baseline and at 1, 2, 4, 8, 12, 16 weeks. Olfactory impairment was measured by using the UPSIT, SNOT-22, and LoS scoring at every visit. <b>Results:</b> Sixteen adults, with a mean (range) age of 43 years (25-53 years) were predominantly women (12/16). Baseline mean (range) sNO values of 434 ppb (203-665 ppb) significantly increased at 2 weeks to a mean (range) of 1150 ppb (684-1616 ppb) (p < 0.05). Significant improvements in the UPSIT, SNOT-22, and LoS scores were found at 2 weeks; a weak correlation of the sNO level with the UPSIT and SNOT-22 scores was noted. No significant changes in the FeNO or nNO values were found. Significant improvement was found specifically with anosmia by the end of 2 weeks. <b>Conclusion:</b> Our small pilot study revealed increased sNO levels in the sinuses as early as 2 weeks after the initial dupilumab administration. Thus, in patients with CRSwNP without asthma, the sNO value has the potential to be used as a noninvasive, objective biomarker for early treatment improvement in anosmia.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 2","pages":"105-108"},"PeriodicalIF":2.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early clinical improvement of anosmia and sinus nitric oxide in chronic rhinosinusitis with nasal polyps subjects treated with dupilumab.\",\"authors\":\"Miguel J Lanz, Claudia P Eisenlohr, Lianet Herrera Cepeda\",\"doi\":\"10.2500/aap.2025.46.250004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background/Objective:</b> Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have a high morbidity of anosmia, yet there are few noninvasive biomarkers to measure treatment response. Nitric oxide (NO) is found in the paranasal sinuses at 100 times higher levels than in the lungs and is vital for antimicrobial and/or mucociliary activities and vasodilatory properties. Dupilumab has been shown to improve anosmia in 2 weeks as measured by the University of Pennsylvania Smell Identification Test (UPSIT), 22-item Sinonasal Outcome Test (SNOT-22), and Loss of Smell (LoS) scoring. We examined the use of NO in various collection methods to monitor anosmia improvement with dupilumab treatment. <b>Methods:</b> Adults with CRSwNP confirmed by computer tomography or endoscopy consented to receive dupilumab 300 mg every two weeks for 16 weeks. Subjects with polyposis despite treatment with steroids and/or a history of sinus surgery were recruited. Measurements of sinus NO (sNO) from the nostril while humming, nasal NO (nNO) while breath-holding, and fractional exhaled nitric oxide (FeNO) while exhaling were collected at baseline and at 1, 2, 4, 8, 12, 16 weeks. Olfactory impairment was measured by using the UPSIT, SNOT-22, and LoS scoring at every visit. <b>Results:</b> Sixteen adults, with a mean (range) age of 43 years (25-53 years) were predominantly women (12/16). Baseline mean (range) sNO values of 434 ppb (203-665 ppb) significantly increased at 2 weeks to a mean (range) of 1150 ppb (684-1616 ppb) (p < 0.05). Significant improvements in the UPSIT, SNOT-22, and LoS scores were found at 2 weeks; a weak correlation of the sNO level with the UPSIT and SNOT-22 scores was noted. No significant changes in the FeNO or nNO values were found. Significant improvement was found specifically with anosmia by the end of 2 weeks. <b>Conclusion:</b> Our small pilot study revealed increased sNO levels in the sinuses as early as 2 weeks after the initial dupilumab administration. Thus, in patients with CRSwNP without asthma, the sNO value has the potential to be used as a noninvasive, objective biomarker for early treatment improvement in anosmia.</p>\",\"PeriodicalId\":7646,\"journal\":{\"name\":\"Allergy and asthma proceedings\",\"volume\":\"46 2\",\"pages\":\"105-108\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Allergy and asthma proceedings\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2500/aap.2025.46.250004\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergy and asthma proceedings","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2500/aap.2025.46.250004","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0

摘要

背景/目的:慢性鼻窦炎合并鼻息肉(CRSwNP)患者嗅觉丧失的发病率很高,但很少有无创生物标志物来衡量治疗反应。一氧化氮(NO)在鼻窦中的含量是肺部的100倍,对抗菌和/或黏毛活性和血管舒张特性至关重要。通过宾夕法尼亚大学嗅觉识别测试(UPSIT)、22项鼻窦结果测试(SNOT-22)和嗅觉丧失(LoS)评分,Dupilumab已被证明在2周内改善嗅觉缺失。我们检查了不同收集方法中NO的使用,以监测dupilumab治疗后嗅觉改善情况。方法:通过计算机断层扫描或内窥镜检查确认CRSwNP的成人同意每两周接受dupilumab 300 mg,持续16周。尽管接受类固醇治疗和/或有鼻窦手术史,但仍有息肉病的受试者被招募。在基线和1、2、4、8、12、16周时收集哼唱时鼻孔的鼻窦一氧化氮(sNO)、憋气时鼻腔一氧化氮(nNO)和呼气时呼出的一氧化氮(FeNO)。嗅觉损伤在每次访问时使用UPSIT, SNOT-22和LoS评分进行测量。结果:16例成人,平均(范围)年龄为43岁(25-53岁),以女性为主(12/16)。基线平均(范围)sNO值为434 ppb (203-665 ppb),在2周后显著增加到平均(范围)1150 ppb (684-1616 ppb) (p < 0.05)。2周时UPSIT、SNOT-22和LoS评分显著改善;注意到sNO水平与UPSIT和SNOT-22分数之间存在弱相关性。FeNO或nNO值未见明显变化。两周后,嗅觉缺失得到了显著改善。结论:我们的小型试点研究显示,在最初的dupilumab治疗后2周,鼻窦中的sNO水平就增加了。因此,在没有哮喘的CRSwNP患者中,sNO值有可能被用作嗅觉缺失早期治疗改善的无创、客观的生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early clinical improvement of anosmia and sinus nitric oxide in chronic rhinosinusitis with nasal polyps subjects treated with dupilumab.

Background/Objective: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have a high morbidity of anosmia, yet there are few noninvasive biomarkers to measure treatment response. Nitric oxide (NO) is found in the paranasal sinuses at 100 times higher levels than in the lungs and is vital for antimicrobial and/or mucociliary activities and vasodilatory properties. Dupilumab has been shown to improve anosmia in 2 weeks as measured by the University of Pennsylvania Smell Identification Test (UPSIT), 22-item Sinonasal Outcome Test (SNOT-22), and Loss of Smell (LoS) scoring. We examined the use of NO in various collection methods to monitor anosmia improvement with dupilumab treatment. Methods: Adults with CRSwNP confirmed by computer tomography or endoscopy consented to receive dupilumab 300 mg every two weeks for 16 weeks. Subjects with polyposis despite treatment with steroids and/or a history of sinus surgery were recruited. Measurements of sinus NO (sNO) from the nostril while humming, nasal NO (nNO) while breath-holding, and fractional exhaled nitric oxide (FeNO) while exhaling were collected at baseline and at 1, 2, 4, 8, 12, 16 weeks. Olfactory impairment was measured by using the UPSIT, SNOT-22, and LoS scoring at every visit. Results: Sixteen adults, with a mean (range) age of 43 years (25-53 years) were predominantly women (12/16). Baseline mean (range) sNO values of 434 ppb (203-665 ppb) significantly increased at 2 weeks to a mean (range) of 1150 ppb (684-1616 ppb) (p < 0.05). Significant improvements in the UPSIT, SNOT-22, and LoS scores were found at 2 weeks; a weak correlation of the sNO level with the UPSIT and SNOT-22 scores was noted. No significant changes in the FeNO or nNO values were found. Significant improvement was found specifically with anosmia by the end of 2 weeks. Conclusion: Our small pilot study revealed increased sNO levels in the sinuses as early as 2 weeks after the initial dupilumab administration. Thus, in patients with CRSwNP without asthma, the sNO value has the potential to be used as a noninvasive, objective biomarker for early treatment improvement in anosmia.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
5.70
自引率
35.70%
发文量
106
审稿时长
6-12 weeks
期刊介绍: Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信