Chinese Central Compartment Atopic Disease: The Clinical Characteristics and Cellular Endotypes Based on Whole-Slide Imaging

Weifeng Kong; Qingwu Wu; Yubin Chen; Yong Ren; Weihao Wang; Rui Zheng; Huiyi Deng; Tian Yuan; Huijun Qiu; Xinyue Wang; Xin Luo; Xuekun Huang; Qintai Yang; Gehua Zhang; Yana Zhang

doi:10.2147/JAA.S350837

Chinese Central Compartment Atopic Disease: The Clinical Characteristics and Cellular Endotypes Based on Whole-Slide Imaging

J Asthma Allergy. 2022 Mar 15:15:341-352. doi: 10.2147/JAA.S350837. eCollection 2022.

Authors

Weifeng Kong¹, Qingwu Wu¹, Yubin Chen¹, Yong Ren², Weihao Wang¹, Rui Zheng¹, Huiyi Deng¹, Tian Yuan¹, Huijun Qiu¹, Xinyue Wang¹, Xin Luo¹, Xuekun Huang¹, Qintai Yang¹, Gehua Zhang¹, Yana Zhang¹

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
² Guangdong Provincial Key Laboratory of Digestive Cancer Research, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, People's Republic of China.

Abstract

Purpose: Histopathologic characterizations of central compartment atopic disease (CCAD) by whole-slide imaging remains lacking. We aim to study clinical presentations and cellular endotyping diagnosis of Chinese CCAD using artificial intelligence (AI).

Methods: A total of 72 patients diagnosed with chronic rhinosinusitis with nasal polyps (CRSwNP) were enrolled. CCAD was defined by positive result of serology specific IgE, endoscopic and radiological findings. The aeroallergen sensitization status, endoscopic results, radiological findings, and symptoms were evaluated and compared between patients with CCAD (n=14), eosinophilic CRSwNP (ENP, n=32) and non-eosinophilic CRSwNP (NENP, n=26). The cellular endotypes including eosinophils, neutrophils, lymphocytes, and plasma cells were analyzed by the AI chronic rhinosinusitis evaluation platform 2.0.

Results: CCAD was most common in male (71.43%). The positive rate of aeroallergen in patients with CCAD is 100%, which is much higher than those in patients with ENP (40.63%) and NENP (23.08%). Allergic rhinitis incidence was found to be 57.14% in Chinese CCAD subjects, which is obviously higher when compared with those in patients with ENP (21.88%) or NENP (0.00%). The presence of asthma was not significantly different between groups. Chinese CCAD population demonstrated mild symptoms and lower endoscopic and radiological scores than those in patients with ENP and NENP. For cellular endotypes in CCAD subjects, the median of eosinophils, neutrophils, lymphocytes, and plasma cells was 26.55%, 0.49%, 60.85%, and 7.33%, respectively. The proportion of eosinophils in nasal tissue and peripheral blood mononuclear cells from the CCAD group is between the proportions in those patients with ENP and NENP.

Conclusion: Chinese CCAD was associated with aeroallergen sensitivity, and displayed an eosinophil-dominant inflammatory pattern. Thus, proper management with allergy control and topical steroids could be recommended for CCAD treatment.

Keywords: aeroallergen; central compartment atopic disease; chronic rhinosinusitis with nasal polyps; deep learning; eosinophil.

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 82171114, 82000958, U20A20399 and 81870704), the Key-area Research and Development Program of Guangdong Province (No. 2020B0101130015), the Guangdong Provincial Key Laboratory of Digestive Cancer Research (No. 2021B1212040006), Sun Yat-sen University Clinical Research 5010 Program (No. 2019006) and The Natural Science Foundation of Guangdong Province (No. 2021A1515011764).