Diagnostic biomarkers for chronic rhinosinusitis in adult asthmatics in real-world practice

Jae-Hyuk Jang; Eun-Mi Yang; Youngsoo Lee; Yoo Seob Shin; Young-Min Ye; Hae-Sim Park

doi:10.1016/j.waojou.2024.100879

Diagnostic biomarkers for chronic rhinosinusitis in adult asthmatics in real-world practice

World Allergy Organ J. 2024 Feb 15;17(3):100879. doi: 10.1016/j.waojou.2024.100879. eCollection 2024 Mar.

Authors

Jae-Hyuk Jang¹, Eun-Mi Yang¹, Youngsoo Lee¹, Yoo Seob Shin¹, Young-Min Ye¹, Hae-Sim Park¹

Affiliation

¹ Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.

Abstract

Background: Chronic rhinosinusitis (CRS) is a common comorbid condition of asthma that affects the long-term outcome of asthmatic patients. CRS is a heterogeneous disease requiring multiple biomarkers to explain its pathogenesis. This study aimed to develop potential biomarkers for predicting CRS in adult asthmatic patients in a real-world clinical setting.

Methods: This study enrolled 108 adult asthmatic patients who had maintained anti-asthmatic medications, including medium-to-high doses of inhaled corticosteroid plus long-acting β2-agonists, and compared clinical characteristics between patients with CRS (CRS group) and those without CRS (non-CRS group). CRS was diagnosed based on the results of paranasal sinus X-ray and/or osteomeatal-unit CT as well as clinical symptoms. Type-2 parameters, including blood eosinophil count, serum levels of periostin/dipeptidyl peptidase 10 (DPP10) and clinical parameters, such as FEV1% and fractional exhaled nitric oxide (FeNO), were analyzed. All biomarkers were evaluated by logistic regression and classification/regression tree (CRT) analyses.

Results: The CRS group had higher blood eosinophil counts/FeNO levels and prevalence of aspirin-exacerbated respiratory disease (AERD) than the non-CRS group (n = 57, 52.8% vs. n = 75, 47.2%; P < 0.05), but no differences in sex/smoking status or asthma control status were noted. The CRS group had higher serum periostin/DPP10 levels than the non-CRS group. Moreover, logistic regression demonstrated that serum periostin/DPP10 and the AERD phenotype were significant factors for predicting CRS in asthmatic patients (adjusted odds ratio, 2.14/1.94/12.39). A diagnostic algorithm and the optimal cutoff values determined by CRT analysis were able to predict CRS with 86.27% sensitivity (a 0.17 negative likelihood ratio).

Conclusion: Serum periostin, DPP10 and the phenotype of AERD are valuable biomarkers for predicting CRS in adult asthmatic patients in clinical practice.

Keywords: Asthma; Biomarkers; Dipeptidyl-peptidases and tripeptidyl-peptidases; Eosinophils; Fractional exhaled nitric oxide testing; Periostin; Rhinitis; Sinusitis.