Predictive significance of arachidonate 15-lipoxygenase for eosinophilic chronic rhinosinusitis with nasal polyps
Predictive significance of arachidonate 15-lipoxygenase for eosinophilic chronic rhinosinusitis with nasal polyps
复制标题
花生四烯酸15-脂氧合酶对嗜酸性慢性鼻窦炎伴鼻息肉的预测意义
DOI：
10.1186/s13223-020-00480-8
复制
发表时间：
2020-09-16
影响因子：
2.7
通讯作者：
Zhang, Luo
中科院分区：
文献类型：
--
作者：
Liang, Zhuoping;Yan, Bing;Zhang, Luo
背景嗜酸性慢性鼻窦炎合并鼻息肉（ECRSwNP）的预后较非嗜酸性慢性鼻窦炎合并鼻息肉（nonECRSwNP）差，因此鉴别ECRSwNP的有效标志物对指导该类患者的治疗策略具有重要意义。虽然花生四烯酸酯15-脂氧合酶（ALOX15）被定位为嗜酸性粒细胞炎症的标志物，但其在ECRSwNP分化中的研究尚未报道。本研究的目的是评估ALOX15在区分和预测ECRSwNP中的潜力。方法48例慢性鼻窦炎合并鼻息肉（CRSwNP）患者，其中30例为慢性鼻窦炎合并鼻息肉，18例为非慢性鼻窦炎合并鼻息肉。采用实时聚合酶链反应（RT-PCR）检测息肉组织中ALOX15 mRNA水平。评估并分析患者的基线特征与ALOX15的相关性。采用受试者工作特征（ROC）曲线评估ECRSwNP潜在预测因子的预测意义。结果ECRSwNP患者ALOX15 mRNA水平显著高于非ECRSwNP患者（P < 0.001）。ALOX15 mRNA与组织和血液嗜酸性粒细胞百分比（r = 0.565,P < 0.001和r = 0.395,P = 0.006）、嗅觉评分（r = 0.400,P = 0.005）、总视觉模拟量表（VAS）症状评分（r = 0.383,P = 0.007）、筛/上颌窦（E/M）比（r = 0.463,P = 0.001）、内窥镜评分（r = 0.409,P = 0.004）显著相关。Logistic回归分析显示ALOX15 mRNA水平和血嗜酸性粒细胞百分比是ECRSwNP的预测因素（P = 0.004和P = 0.036）。ROC曲线显示ALOX15对ECRSwNP具有较高的预测准确率（曲线下面积(AUC) = 0.909）， ALOX15联合血嗜酸性粒细胞百分比（AUC = 0.933）进一步提高了预测准确率。结论ALOX15相对mRNA水平单独或联合血嗜酸性粒细胞可能是预测ECRSwNP诊断的可靠生物标志物。
Background Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) exhibits a poorer outcome compared with non-eosinophilic chronic rhinosinusitis with nasal polyps (nonECRSwNP), so it is significant to identify effective markers to differentiate ECRSwNP in guiding the treatment strategies of these patients. Although arachidonate 15-lipoxygenase (ALOX15) is positioned as a marker of eosinophilic inflammation, its study in differentiating ECRSwNP has not been reported. The aim of this study is to assess the potential of ALOX15 in distinguishing and predicting ECRSwNP. Methods Forty-eight patients with chronic rhinosinusitis with nasal polyps (CRSwNP), including 30 ECRSwNP and 18 nonECRSwNP patients, were enrolled. ALOX15 mRNA level was determined in polyps by real-time polymerase chain reaction (RT-PCR). The patients' baseline characteristics were evaluated and analyzed for correlations with ALOX15. Receiver operating characteristic (ROC) curve was used to assess the predictive significance of the potential predictors for ECRSwNP. Results ALOX15 mRNA level was significantly higher in ECRSwNP patients than in nonECRSwNP patients (P < 0.001). ALOX15 mRNA was significantly correlated with tissue and blood eosinophil percentages (r = 0.565,P < 0.001 andr = 0.395,P = 0.006), olfaction scores (r = 0.400,P = 0.005), total visual analogue scale (VAS) symptom scores (r = 0.383,P = 0.007), ethmoid/maxillary sinus (E/M) ratio (r = 0.463,P = 0.001), and endoscopy scores (r = 0.409,P = 0.004). Logistic regression analysis showed ALOX15 mRNA level and percentage of blood eosinophils to be predictive factors for ECRSwNP (P = 0.004 andP = 0.036, respectively). ROC curve indicated ALOX15 to have high predictive accuracy for ECRSwNP (area under the curve (AUC) = 0.909), which was further improved by combination of ALOX15 with percentage of blood eosinophils (AUC = 0.933). Conclusions The relative ALOX15 mRNA level alone or in combination with blood eosinophils might be a reliable biomarker for predicting a diagnosis of ECRSwNP.