Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps

IntroductionThe histopathologic study of nasal polyps establishes endotype features of chronic rhinosinusitis (CRS). A tissular eosinophil count greater than 10 per high power field (HPF) classifies this condition as type 2 inflammation. Blood and mucosal eosinophils are suggested as biomarkers of s...

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Main Authors: Julissa Vizcarra-Melgar, Serafín Sánchez-Gómez, Nuria López-González, Ramón Moreno-Luna, Jaime González-García, Juan Maza-Solano
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Allergy
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Online Access:https://www.frontiersin.org/articles/10.3389/falgy.2025.1549332/full
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author Julissa Vizcarra-Melgar
Serafín Sánchez-Gómez
Serafín Sánchez-Gómez
Nuria López-González
Ramón Moreno-Luna
Jaime González-García
Juan Maza-Solano
Juan Maza-Solano
author_facet Julissa Vizcarra-Melgar
Serafín Sánchez-Gómez
Serafín Sánchez-Gómez
Nuria López-González
Ramón Moreno-Luna
Jaime González-García
Juan Maza-Solano
Juan Maza-Solano
author_sort Julissa Vizcarra-Melgar
collection DOAJ
description IntroductionThe histopathologic study of nasal polyps establishes endotype features of chronic rhinosinusitis (CRS). A tissular eosinophil count greater than 10 per high power field (HPF) classifies this condition as type 2 inflammation. Blood and mucosal eosinophils are suggested as biomarkers of severity and control of CRS. Additionally, a tissular eosinophil count greater than 55 per HPF has been related to a high risk of recurrence in the Asian population. Our study aims to determine whether tissue eosinophil count is associated with the control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP).MethodsAn observational study of patients with CRSwNP who underwent nasal mucosa biopsy was conducted between June 2021 and November 2023. Histopathologic features, asthma control, CRSwNP control and severity according to the POLINA consensus, quality of life parameters, recurrence of CRSwNP, and laboratory markers were recorded and compared with the tissular eosinophil count.ResultsA total of 108 cases were included. The majority (70.4%) had concomitant asthma, with 31.5% of the cases having well-controlled disease. Most patients had uncontrolled (57.4%) and severe (62%) CRSwNP. Fifty-four cases underwent surgery and 43.5% experienced recurrence. More than half had a SNOT-22 score greater than 50 points. Eighty-one percent of patients had a tissular eosinophil count greater than 10 per HPF, and 60.2% had blood eosinophilia greater than 0.3×103. Blood eosinophilia was related to CRSwNP severity and control. No significant differences were found between tissue eosinophil count and the severity, control, and recurrence of CRSwNP.ConclusionTissue eosinophil levels were not a marker of control, severity, and recurrence of CRSwNP in our data. Blood eosinophil levels, however, were a marker of CRSwNP control and severity.
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spelling doaj-art-6f40d0c247094f8a8d2ca1adb3d305332025-08-20T02:18:29ZengFrontiers Media S.A.Frontiers in Allergy2673-61012025-04-01610.3389/falgy.2025.15493321549332Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal PolypsJulissa Vizcarra-Melgar0Serafín Sánchez-Gómez1Serafín Sánchez-Gómez2Nuria López-González3Ramón Moreno-Luna4Jaime González-García5Juan Maza-Solano6Juan Maza-Solano7Department of Otorhinolaryngology and Head and Neck Surgery, Consorci Sanitari Integral, Sant Joan Despí Moisés Broggi Hospital, Barcelona, SpainDepartment of Surgery, University of Seville, Seville, SpainDepartment of Otorhinolaryngology and Head and Neck Surgery, Virgen Macarena Hospital, Rhinology Unit, Seville, SpainDepartment of Otorhinolaryngology and Head and Neck Surgery, Virgen Macarena Hospital, Rhinology Unit, Seville, SpainDepartment of Otorhinolaryngology and Head and Neck Surgery, Virgen Macarena Hospital, Rhinology Unit, Seville, SpainDepartment of Otorhinolaryngology and Head and Neck Surgery, Virgen Macarena Hospital, Rhinology Unit, Seville, SpainDepartment of Surgery, University of Seville, Seville, SpainDepartment of Otorhinolaryngology and Head and Neck Surgery, Virgen Macarena Hospital, Rhinology Unit, Seville, SpainIntroductionThe histopathologic study of nasal polyps establishes endotype features of chronic rhinosinusitis (CRS). A tissular eosinophil count greater than 10 per high power field (HPF) classifies this condition as type 2 inflammation. Blood and mucosal eosinophils are suggested as biomarkers of severity and control of CRS. Additionally, a tissular eosinophil count greater than 55 per HPF has been related to a high risk of recurrence in the Asian population. Our study aims to determine whether tissue eosinophil count is associated with the control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP).MethodsAn observational study of patients with CRSwNP who underwent nasal mucosa biopsy was conducted between June 2021 and November 2023. Histopathologic features, asthma control, CRSwNP control and severity according to the POLINA consensus, quality of life parameters, recurrence of CRSwNP, and laboratory markers were recorded and compared with the tissular eosinophil count.ResultsA total of 108 cases were included. The majority (70.4%) had concomitant asthma, with 31.5% of the cases having well-controlled disease. Most patients had uncontrolled (57.4%) and severe (62%) CRSwNP. Fifty-four cases underwent surgery and 43.5% experienced recurrence. More than half had a SNOT-22 score greater than 50 points. Eighty-one percent of patients had a tissular eosinophil count greater than 10 per HPF, and 60.2% had blood eosinophilia greater than 0.3×103. Blood eosinophilia was related to CRSwNP severity and control. No significant differences were found between tissue eosinophil count and the severity, control, and recurrence of CRSwNP.ConclusionTissue eosinophil levels were not a marker of control, severity, and recurrence of CRSwNP in our data. Blood eosinophil levels, however, were a marker of CRSwNP control and severity.https://www.frontiersin.org/articles/10.3389/falgy.2025.1549332/fullChronic Rhinosinusitis with Nasal Polypseosinophilic inflammationtissue eosinophiliatype 2 inflammationdisease controlbiomarkers
spellingShingle Julissa Vizcarra-Melgar
Serafín Sánchez-Gómez
Serafín Sánchez-Gómez
Nuria López-González
Ramón Moreno-Luna
Jaime González-García
Juan Maza-Solano
Juan Maza-Solano
Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps
Frontiers in Allergy
Chronic Rhinosinusitis with Nasal Polyps
eosinophilic inflammation
tissue eosinophilia
type 2 inflammation
disease control
biomarkers
title Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps
title_full Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps
title_fullStr Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps
title_full_unstemmed Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps
title_short Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps
title_sort tissue eosinophil level as a predictor of control severity and recurrence of chronic rhinosinusitis with nasal polyps
topic Chronic Rhinosinusitis with Nasal Polyps
eosinophilic inflammation
tissue eosinophilia
type 2 inflammation
disease control
biomarkers
url https://www.frontiersin.org/articles/10.3389/falgy.2025.1549332/full
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