Pathogenesis of eosinophilic vs. non-eosinophilic chronic rhinosinusitis with nasal polyposis in Vietnamese
The study of the characteristics of non-eosinophilic and eosinophilic chronic polyposis rhinosinusitis (CRSwNP) is necessary to improve understanding of the pathophysiological mechanisms of this disease and determine the optimal treatment strategy. We studied the specific features of eosinophilic and non-eosinophilic CRSwNP in Vietnamese patients. Patients (48 male and 35 female) with a diagnosis of CRSwNP took part in the work. Patients were operated on at the National ENT Hospital from 9/2017 to 8/2018. Based on a study of the pathology of nasal polyps, CRSwNPs were classified as eosinophilic or non-eosinophilic. In men, 35% had eosinophilic CRSwNP and 65% had non- eosinophilic CRSwNP. In the subgroup of women, eosinophilic CRSwNP was observed in 31% and non-eosinophilic CRSwNP in 69%. In total, 34% of 83 people had eosinophilic CRSwNP. The average duration of eosinophilic CRSwNP disease was 45.0 ± 43.1 months; non-eosinophilic CRSwNP was 25.5 ± 20.5 months. In this cohort of patients, 8.4% suffered from bronchial asthma, and a high probability of this pathology was found in combination with the eosinophilic CRSwNP (OR = 5.76; 1.04-31.89 CI 95%; P = 0.045). The proportion of allergic rhinitis with eosinophilic CRSwNP was 39.3%, and with non-eosinophilic CRSwNP was 12.7%. The share of uni-and bilateral eosinophilic CRSwNPs was 10.7 and 89.3%, while non- eosinophilic CRSwNPs were 41.8 and 58.2%, respectively. Thus, CRSwNP is a complex heterogeneous inflammatory disease. Eosinophilia plays an important role in the pathogenesis of this disease and significantly worsens the clinical picture. There are significant differences in the duration of the pathological manifestations, the presence of allergic rhinitis, bronchial asthma and the severity of polyps in patients with eosinophilic and non-eosinophilic CRSwNP.