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Multidimensional endotypes of chronic rhinosinusitis and their association with treatment outcomes

机译：慢性鼻窦炎的多维子项及其与治疗结果的关系

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摘要

Abstract Background The expression of chronic rhinosinusitis ( CRS ) is multidimensional. Disease heterogeneity in patients with CRS remains poorly understood. This study aimed to identify endotypes of CRS using cluster analysis by integrating multidimensional characteristics and to explore their association with treatment outcomes. Methods A total of 28 clinical variables and 39 mucosal cellular and molecular variables were analyzed using principal component analysis. Cluster analysis was performed on 246 prospectively recruited Chinese CRS patients with at least 1‐year postoperative follow‐up. Difficult‐to‐treat CRS was characterized in each generated cluster. Results Seven subject clusters were identified. Cluster 1 (13.01%) was comparable to the classic well‐defined eosinophilic CRS with polyps, having severe disease and the highest proportion of difficult‐to‐treat CRS . Patients in cluster 2 (16.26%) and cluster 4 (13.82%) had relatively lower proportions of presence of polyps and presented mild inflammation with moderate proportions of difficult‐to‐treat cases. Subjects in cluster 2 were highly atopic. Cluster 3 (7.31%) and cluster 6 (21.14%) were characterized by severe or moderate neutrophilic inflammation, respectively, and with elevated levels of IL ‐8 and high proportions of difficult‐to‐treat CRS . Cluster 5 (4.07%) was a unique group characterized by the highest levels of IL ‐10 and lacked difficult‐to‐treat cases. Cluster 7 (24.39%) demonstrated the lowest symptom severity, a low proportion of difficult‐to‐treat CRS , and low inflammation load. Finally, we found that difficult‐to‐treat CRS was associated with distinct clinical features and biomarkers in the different clusters. Conclusions Distinct clinicopathobiologic clusters of CRS display differences in clinical response to treatments and characteristics of difficult‐to‐treat CRS .
机译：摘要背景慢性鼻窦炎（CRS）的表达是多维的。 CRS患者的疾病异质性仍然清晰差不多。本研究旨在通过整合多维特征和探索与治疗结果的关联来识别CRS的子型。方法使用主成分分析共分析总共28个临床变量和39粘膜细胞和分子变量。在246例前瞻性招聘中，在术后至少有1年的术后随访时间进行集群分析。难以治疗的CRS在每个生成的群集中表征。结果确定了七种主题簇。簇1（13.01％）与具有息肉的经典明确定义的嗜酸性嗜酸性CRS相当，具有严重的疾病和难以治疗CR的最高比例。患者2（16.26％）和簇4（13.82％）的息肉的存在比例相对较低，并呈现温和炎症，具有中等比例的难以治疗的病例。集群2的受试者具有高度特征性的。群体3（7.31％）和簇6（21.14％）的特征在于严重或中性嗜中性炎症，并且升高的IL -8水平和高比例的难以治疗的CRS。群集5（4.07％）是一个独特的群体，其特征在于IL -10最高水平，缺乏难以治疗的病例。群集7（24.39％）证明了症状严重程度最低，难以治疗的难度比例低，炎症载荷低。最后，我们发现难以治疗的CRS与不同簇中不同的临床特征和生物标志物相关。结论CRS明显的临床病理学簇显示临床反应临床响应的差异和难以治疗CR的特征。

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  • 来源
    《Allergy》 |2018年第7期|共11页
  • 作者

    Liao B.; Liu J.‐X.; Li Z.‐Y.; Zhen Z.; Cao P.‐P.; Yao Y.; Long X.‐B.; Wang H.; Wang Y.; Schleimer R.; Liu Z.;

  • 作者单位

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

    Department of PediatricsUniversity of Maryland School of MedicineBaltimore MD USA;

    Division of Allergy‐ImmunologyNorthwestern University School of MedicineChicago IL USA;

    Department of Otolaryngology‐Head and Neck SurgeryHuazhong University of Science and;

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  • 正文语种 eng
  • 中图分类 医学免疫学;
  • 关键词

    chronic rhinosinusitis; cluster analysis; difficult‐to‐treatment; nasal polyps;

    机译：慢性鼻窦炎;聚类分析;难以治疗;鼻息肉;

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