Cystatin SN can strongly predict chronic rhinosinusitis with nasal polyps: Study
China: Cystatin SN can help in the management of patients with chronic rhinosinusitis with nasal polyps (CRSwNP), finds a recent study in the Journal of Allergy and Clinical Immunology. According to the study, the levels of cystatin SN in nasal secretion have strong prognostic value and can aid medical guidance on CRSwNP.
Integrated care pathways (ICPs) can improve the management of CRSwNP patients. ICPs application requires development of endotype-based biomarkers to stratify patients. The value of markers and cytokines induced by cytokines for CRSwNP management is largely unknown.
Luo Zhang, Capital Medical University, Beijing, China, and colleagues aimed to determine the pharmacologic and prognostic value of type 2, non-type 2 cytokines, and markers associated with type 2 inflammation including CCL26, periostin, and cystatin SN, in nasal secretions for CRSwNP.
For the purpose, the researchers conducted a retrospective study in which 151 patients with CRSwNP were divided into discovery and validation phases. Using Luminex and ELISA, concentrations of cytokines, CCL26, periostin, and cystatin SN in nasal secretions were determined.
Predictive significance was assessed with receiver-operating characteristic curves. Survival analysis was performed using Kaplan-Meier curves and Cox regression models.
Key findings of the study include:
- Cystatin SN was an independent predictor of the uncontrolled status of CRSwNP over a 2-year follow-up after adjusting for other risk factors (hazard ratio [HR] of 1.168 and 1.132 in discovery and validation phases, respectively).
- Patients with high cystatin SN concentrations presented with a faster onset and higher rate of uncontrolled status than those with low levels.
- Enhanced medical treatment for patients with high cystatin SN levels postponed the uncontrolled status in discovery and validation phases but did not completely abolish it by the end of the follow-up.
"Cystatin SN levels in nasal secretions hold strong prognostic value and can facilitate medical instructions for managing CRSwNP," wrote the authors.
The study titled, "Prognostic and pharmacologic value of cystatin SN for chronic rhinosinusitis with nasal polyps," is published in the Journal of Allergy and Clinical Immunology.
DOI: https://www.jacionline.org/article/S0091-6749(21)00347-X/abstract
