Increased IL-17A levels linked to increased prior surgery for chronic rhinosinusitis: Study
USA: Higher IL-17A levels is associated with an increased number of prior sinus surgeries for chronic rhinosinusitis (CRS), finds a recent study in the International Forum of Allergy & Rhinology. The findings show that the presence of type 3 inflammatory markers may be indicative of a particularly difficult‐to‐treat, recalcitrant CRS endotype.
The identification of potential inflammatory endotypes of CRS have been possible due to the recent advances in molecular biology. Prior work has suggested differential short‐term surgical outcome trajectories based on cytokine signatures. However, there is a lack of data assessing long‐term treatment failure and need for revision surgery based on inflammatory biomarkers. To determine the same, Nikita Chapurin, Vanderbilt University Medical Center, Nashville, TN, USA, and colleagues performed a retrospective analysis of prospectively collected cross‐sectional data from 231 patients electing surgical therapy for CRS.
The researchers quantitatively sampled intraoperative mucus specimens for inflammatory cytokines using a multiplex flow cytometric bead assay. Univariate Spearman correlations between cytokine levels and prior number of surgeries were assessed. Patient‐reported prior sinus surgery counts as a function of cytokine levels was modeled using a stepwise adjusted multivariate Poisson regression analysis.
Key findings of the study include:
- Several cytokines (interleukin [IL]‐1β, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐13, IL‐17A, tumor necrosis factor α [TNF‐α], interferon γ [IFN‐γ], and eotaxin) demonstrated significant positive correlations with number of prior surgeries.
- Only higher IL‐17A levels were independently associated with a higher number of prior sinus surgeries (β = 0.345) after adjusting for the significant covariates of age (β = 0.018), Lund‐Mackay score (β = –0.046), history of aspirin‐exacerbated respiratory disease (β = 1.01) and allergic fungal rhinosinusitis (β = 1.08).
- Higher levels of regulated on activation, normal T‐cell expressed and secreted (RANTES) were conversely associated with a lower number of prior surgeries (β = –0.17)
"An IL‐17A–predominant cytokine profile is linked to an increased number of prior sinus surgeries. Thus, type 3 inflammatory markers may indicate a particularly difficult‐to‐treat, recalcitrant CRS endotype," wrote the authors.
The study titled, "Elevated mucus interleukin‐17A levels are associated with increased prior sinus surgery for chronic rhinosinusitis," is published in the journal International Forum of Allergy & Rhinology.
DOI: https://onlinelibrary.wiley.com/doi/abs/10.1002/alr.22652
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