[The correlation between FCER2 gene polymorphism and the efficacy of inhaled corticosteroids in patients with chronic rhinosinusitis]

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Nov;37(11):856-863. doi: 10.13201/j.issn.2096-7993.2023.11.002.
[Article in Chinese]

Abstract
in English, Chinese

Objective:To investigate the correlation between FCER2（2206A>G） gene polymorphism and the efficacy of inhaled corticosteroids（ICS） in patients with chronic rhinosinusitis（CRS）. Methods:A total of 208 CRS patients were routinely treated with functional endonasal sinus surgery and postoperative ICS. DNA extraction, PCR amplification and gene sequencing were performed to observe the FCER2（2206A>G） gene polymorphism and calculate the allele frequency. The visual analog scale（VAS） score, Lund-Kennedy score, and computed tomography（CT） Lund-Mackay score were determined 6 months after surgery among patients with different genotypes. Moreover, the polymorphism frequency was compared among different subgroups（chronic rhinosinusitis with nasal polyps versus chronic rhinosinusitis without nasal polyps, eosinophilic chronic rhinosinusitis versus non-eosinophilic chronic rhinosinusitis）. Results:There were FCER2（2206A>G） gene polymorphism in patients with CRS, and the phenotypes included 3 genotypes, AA, AG and GG, with distribution frequencies of 68（32.7%）, 116（55.8%） and 24（11.5%） cases, respectively. No significant differences were found in age, VAS score, nasal endoscopic Lund-Kennedy score and CT imaging Lund-Mackay score among patients with CRS of each genotype before surgery. In patients with the AA genotype, the changes in VAS score（5.74±1.10）, Lund Kennedy score（5.92 ± 1.14）, and CT imaging Lund-Mackay score（13.26±4.26） were significantly higher than in patients with the AG（4.37±0.86, 5.37±1.24, 10.82±3.77） and GG（4.26±0.80, 5.18±1.56, 10.10±3.53） genotype（P<0.05）. However, there were no marked difference between patients with the AG genotype and those with the GG genotype（P>0.05）. Compared with patients with non-eosinophilic sinusitis, Among them, the differences between the GG genotype and AG /AA genes were more significant in eosinophilic sinusitis compared to non-eosinophilic sinusitis（P<0.01）. Conclusion:The FCER2（2206A>G） gene in patients with CRS has genetic polymorphism and is associated with the recovery of CRS patients after surgery, individual corticosteroid sensitivity, and subgroup variability.

目的：探讨慢性鼻窦炎（chronic rhinosinusitis，CRS）患者FCER2（2206A>G）基因多态性与吸入糖皮质激素（inhaled corticosteroids，ICS）治疗疗效的相关性。 方法：208例CRS患者均接受功能性内镜鼻窦手术（functional endoscopic sinus surgery，FESS），术后使用ICS，并应用DNA提取、PCR扩增、基因测序观察FCER2（2206A>G）基因多态性，计算等位基因频率。比较不同基因型CRS术后半年VAS评分，鼻内镜Lund-Kennedy评分及CT影像Lund-Mackay评分变化的差异，并对不同CRS亚群（鼻窦炎伴鼻息肉与不伴鼻息肉，嗜酸性鼻窦炎与非嗜酸性鼻窦炎）的多态频度进行分析。 结果：CRS患者存在FCER2（2206A>G）基因多态现象，表型包括AA、AG和GG 3种基因型，分布频率分别为68例（32.7％）、116例（55.8％）、24例（11.5％）。术前各基因型的CRS患者的年龄、VAS评分、鼻内镜Lund-Kennedy评分及CT影像Lund-Mackay评分差异无统计学意义，经过术后半年治疗，AA基因型的VAS评分变化值为（5.74±1.10），鼻内镜Lund-Kennedy评分变化值为（5.92±1.14），CT影像Lund-Mackay评分变化值为（13.26±4.26），比AG型（4.37±0.86、5.37±1.24、10.82±3.77）、GG基因型（4.26±0.80、5.18±1.56、10.10±3.53）均高，差异有统计学意义（P<0.05），AG与GG 2种基因型间差异无统计学意义（P>0.05）。其中嗜酸粒细胞型鼻窦炎与非嗜酸粒细胞型鼻窦炎比较，GG基因型与AG、AA基因的差异更大（P<0.01）。 结论：CRS患者FCER2（2206A>G）基因存在基因多态性，且与CRS术后的病情恢复、个体激素敏感性有关，并存在亚群差异性。.

Keywords: FCER2 gene; chronic rhinosinusitis; gene polymorphism; inhaled corticosteroids.

Publication types

  • English Abstract

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Chronic Disease
  • Endoscopy / methods
  • Humans
  • Lectins, C-Type
  • Nasal Polyps* / complications
  • Nasal Polyps* / drug therapy
  • Nasal Polyps* / genetics
  • Polymorphism, Genetic
  • Receptors, IgE
  • Rhinitis* / complications
  • Rhinitis* / drug therapy
  • Rhinitis* / genetics
  • Sinusitis* / complications
  • Sinusitis* / drug therapy
  • Sinusitis* / genetics

Substances

  • Adrenal Cortex Hormones
  • FCER2 protein, human
  • Receptors, IgE
  • Lectins, C-Type

Grants and funding

上海市自然科学基金项目(No：23ZR1458000)；上海市卫生健康委员会、上海市中医药管理局上海市综合医院中西医结合专项(No：ZHYY-ZXYJHZX-202118)