Scholarlink

<p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease requiring endotype-driven management. Histopathology is invasive and impractical for preoperative evaluation. Nasal nitric oxide (nNO) is a non-invasive biomarker of upper airway inflammation, but its role in differentiating CRSwNP endotypes remains unclear. This cross-sectional study enrolled 100 CRSwNP patients and 40 healthy controls at a tertiary care center. Histology classified patients into eosinophilic CRSwNP (Eos, ≥10% tissue eosinophils) and non-eosinophilic CRSwNP (Non-Eos, &lt;10%). nNO was measured using an electrochemical analyzer. Associations between nNO, clinical scores, and peripheral blood eosinophil counts (PEAC) were analyzed. Diagnostic accuracy was assessed by receiver operating characteristic (ROC) curves and logistic regression. Of&#xa0;100 CRSwNP patients, 58 were Eos and 42 Non-Eos. Mean nNO levels were significantly reduced in Eos CRSwNP (146.3 ± 103.9 ppb) compared with Non-Eos (232.5 ± 105.4 ppb, <i>p</i> = 0.010) and controls (368.7 ± 91.2 ppb, <i>p</i> &lt; 0.001). Atopic patients had higher nNO than non-atopic patients (<i>p</i> &lt; 0.05). nNO alone discriminated CRSwNP from controls (AUC = 0.944; sensitivity = 78.0%; specificity = 97.5%) and Eos from Non-Eos CRSwNP (AUC = 0.716). Combining nNO with PEAC and VAS symptom score improved classification (AUC = 0.902). Multivariate analysis confirmed nNO as an independent predictor of endotype (OR 1.01; 95% CI 1.003–1.016; <i>p</i> = 0.002).&#xa0;nNO is a robust, non-invasive biomarker for diagnosing CRSwNP and identifying eosinophilic inflammation. In combination with PEAC and symptom burden, it enhances precision endotyping. Atopy influences nNO levels and should be considered in clinical interpretation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Redefining Chronic Rhinosinusitis with Nasal Polyps: Nasal Nitric Oxide as a Gateway to Precision Endotyping

  • 期刊论文

  • 发表日期：

    2025年12月29日

查看全文
  • Inna Fayaz,
  • Ruchi Singh,
  • Aadil Bashir

摘要

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease requiring endotype-driven management. Histopathology is invasive and impractical for preoperative evaluation. Nasal nitric oxide (nNO) is a non-invasive biomarker of upper airway inflammation, but its role in differentiating CRSwNP endotypes remains unclear. This cross-sectional study enrolled 100 CRSwNP patients and 40 healthy controls at a tertiary care center. Histology classified patients into eosinophilic CRSwNP (Eos, ≥10% tissue eosinophils) and non-eosinophilic CRSwNP (Non-Eos, <10%). nNO was measured using an electrochemical analyzer. Associations between nNO, clinical scores, and peripheral blood eosinophil counts (PEAC) were analyzed. Diagnostic accuracy was assessed by receiver operating characteristic (ROC) curves and logistic regression. Of 100 CRSwNP patients, 58 were Eos and 42 Non-Eos. Mean nNO levels were significantly reduced in Eos CRSwNP (146.3 ± 103.9 ppb) compared with Non-Eos (232.5 ± 105.4 ppb, p = 0.010) and controls (368.7 ± 91.2 ppb, p < 0.001). Atopic patients had higher nNO than non-atopic patients (p < 0.05). nNO alone discriminated CRSwNP from controls (AUC = 0.944; sensitivity = 78.0%; specificity = 97.5%) and Eos from Non-Eos CRSwNP (AUC = 0.716). Combining nNO with PEAC and VAS symptom score improved classification (AUC = 0.902). Multivariate analysis confirmed nNO as an independent predictor of endotype (OR 1.01; 95% CI 1.003–1.016; p = 0.002). nNO is a robust, non-invasive biomarker for diagnosing CRSwNP and identifying eosinophilic inflammation. In combination with PEAC and symptom burden, it enhances precision endotyping. Atopy influences nNO levels and should be considered in clinical interpretation.