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Multidimensional endotypes of chronic rhinosinusitis and their association with treatment outcomes

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.

Allergy (Copenhagen), 2018-07, Vol.73 (7), p.1459-1469 [Periódico revisado por pares]

Denmark: Blackwell Publishing Ltd

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Título:
Multidimensional endotypes of chronic rhinosinusitis and their association with treatment outcomes
Autor: 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.
Assuntos: Adult ; Atopy ; Biomarkers ; Chronic Disease ; chronic rhinosinusitis ; Clinical outcomes ; Cluster analysis ; Cytokines - metabolism ; difficult‐to‐treatment ; Disease Management ; Eosinophils - immunology ; Eosinophils - metabolism ; Eosinophils - pathology ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Leukocytes (eosinophilic) ; Leukocytes (neutrophilic) ; Male ; Middle Aged ; Molecular chains ; Mucosa ; Multidimensional methods ; Nasal Mucosa - immunology ; Nasal Mucosa - metabolism ; Nasal Mucosa - pathology ; nasal polyps ; Nasal Polyps - pathology ; Patients ; Phenotype ; Polyps ; Principal components analysis ; Rhinitis - diagnosis ; Rhinitis - therapy ; Rhinosinusitis ; Sinusitis - diagnosis ; Sinusitis - therapy ; Treatment Outcome
É parte de: Allergy (Copenhagen), 2018-07, Vol.73 (7), p.1459-1469
Notas: Funding information
This study was supported by National Natural Science Foundation of China (NSFC) grants 81325006, 81570899 and 81630024 (ZL), 81200733 (HW), 81400448 (XBL), 81700893 (BL), and 81400449 (PPC), and Hubei Province Natural Science Foundation grant 2017CFA016 (ZL). Dr. Schleimer was supported in part by Grants R37HL068546 and U19AI106683 (Chronic Rhinosinusitis Integrative Studies Program (CRISP)) from the NIH, and by the Ernest S. Bazley Foundation.
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DR. ZHENG LIU (Orcid ID : 0000-0002-4168-6702)
Descrição: 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.
Editor: Denmark: Blackwell Publishing Ltd
Idioma: Inglês

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Multidimensional endotypes of chronic rhinosinusitis and their association with treatment outcomes

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.

Denmark: Blackwell Publishing Ltd

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