A study on neutrophilic versus eosinophilic predominance in chronic rhinosinusitis patients

Suresh A, Cheruvu SC, Lakshmanasamy H, Sunitha M, Hassan RFM

Pdf Page Numbers :- 189-194

Abinayaah Suresh^1,*, Saranya Chithra Cheruvu¹, Haribalan Lakshmanasamy¹, Sunitha M¹ and Rukhaiya Fatima Mohamed Hassan¹

¹Department of ENT, Sri Muthukumaran Medical College and Research Institute, Mangadu, Chennai – 600069, India

*Corresponding author: Dr. Abinayaah Suresh, MBBS; MS (ENT), Sri Muthukumaran Medical College Hospital and Research Institute, Chikkarayapuram, Mangadu, Chennai – 600069, India. Email: abin004doc@gmail.com.

Received 29 March 2024; Revised 4 June 2024; Accepted 11 June 2024; Published 18 June 2024

Citation: Suresh A, Cheruvu SC, Lakshmanasamy H, Sunitha M, Hassan RFM. A study on neutrophilic versus eosinophilic predominance in chronic rhinosinusitis patients. J Med Sci Res. 2024; 12(3):189-194. DOI: http://dx.doi.org/10.17727/JMSR.2024/12-36

Copyright: © 2024 Suresh A et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Rhinosinusitis is defined as a multifactorial disorder with persistence of symptoms caused by inflammation of the sinonasal mucosa for 12 or more weeks with confirmation by diagnostic nasal endoscopy and computed tomography. The main aim of this study is to analyze the neutrophilic or eosinophilic predominance among CRS patients with histopathological examination for appropriate management, and to understand the association between the endotypes of CRS and blood parameters.

Materials and methods: A prospective cohort study was conducted on 137 patients over a period of two years at a tertiary centre. Diagnostic nasal endoscopy (DNE), computed tomography of the nose and paranasal sinus (CT PNS), complete haemogram (CBC), absolute eosinophil count (AEC), erythrocyte sedimentation rate (ESR), immunoglobulin E(IgE) was done. Patients were planned for functional endoscopic sinus surgery (FESS) and specimen was sent for histopathological examination.

Results: The comparison between DNE and AEC groups showed statistical significance and so did the comparison between CT and IgE. When we compared the groups of CRS with and without polyps with DNE and CT, there was no statistical significance. Also 64.2% of patients had an eosinophilic predominance.

Conclusion: It has also been reported that CRS are highly eosinophilic, also have substantial levels of neutrophils. Importantly, tissue neutrophilia has been associated with a poor response to corticosteroid therapy in patients with CRS with nasal polyps.

Keywords: nasal polyp; eosinophils; neutrophils; sinusitis; allergy; asthma; inflammation