Zhidi Zhang, Qiang Zuo, Yali Du, Hailing Jiang, Furong Ma, Yinghong Zhang

Department, Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, People’s Republic of China

Correspondence: Yinghong Zhang, Department, Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, People’s Republic of China, Email yinghongzhang@bjmu.edu.cn Furong Ma, Department, Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, People’s Republic of China, Email furongma@126.com

Objective: Osteitis is more prevalent in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), making the disease refractory and prone to recurrence. However, the pathophysiologic mechanism of osteitis formation in CRS has not been fully elucidated, and this study aimed to further elucidate the association of eosinophils and type 2 inflammatory mediators with osteitis in patients with CRSwNP.
Methods: This retrospective study collected clinical data on 125 cases of CRSwNP. The participants were categorized into two groups based on the presence or absence of osteitis in their sinus CT scan. The groups were classified as the osteitis group and the non-osteitis group. The clinical baseline data, type 2 inflammatory mediators, and eosinophils were compared between the two groups. The correlation between these factors and the Global Osteitis score scale (GOSS) was also evaluated.
Results: There were 69 cases in the osteitis group and 56 cases in the non-osteitis group of CRSwNP patients. The prevalence of concomitant asthma (P=0.009), SNOT-22 score, LUND-MAKAY score, and LUND-KEDENY score were significantly higher in the osteitis group than in the non-osteitis group (All P values were < 0.001); the absolute values of IL-13 (P< 0.001), periosteal proteins (P< 0.001), and tissue eosinophils (P < 0.05) were significantly higher in the osteitis group as compared with the non-osteitis group. Logistic regression analysis showed that IL-13 and periosteal proteins were risk factors for CRSwNP osteitis (P< 0.001). ROC curve analysis revealed that IL-13 had the highest predictive value (AUC=0.786) with a cut-off value of 5.8059 pg/mL, the sensitivity of 58.0%, and a specificity of 89.3% respectively.
Conclusion: Osteitis could indicate the more severe symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP), and elevated IL-13, periosteal proteins, and tissue eosinophils are risk factors for osteitis formation in patients with CRSwNP.

Keywords: chronic rhinosinusitis, osteitis, eosinophils, type 2 inflammatory mediators