Comparison of subjective and objective assessment of glucocorticoid response in nasal polyps: a preliminary study. (2nd January 2019)

• Record Type: Journal Article
• Authors: Zheng, Rui; Wang, Kai; Yang, Qintai; Chen, Yang; Wang, Dan; Gao, Wenxiang; Zhou, Min; Cao, Yu-Jie; Shi, Jianbo; Sun, Yueqi
• Is Part Of: Acta oto-laryngologica. Volume 139:Number 1(2019)
• Page Start: 57
• Page End: 63
• Publication Date: 2019-01-02
• Subjects: Chronic rhinosinusitis -- Nasal polyps -- Glucocorticoid -- Total nasal symptom score -- Nasal polyp size score; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2018.1541507
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: Glucocorticoids (GC) therapeutic response in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) varies markedly. Aims/Objectives: To compare the utility between subjective and objective assessment of GC sensitivity in reflecting the impact of GC on systemic and local eosinophilia in CRSwNP patients. Material and methods: Twenty-six patients with CRSwNP were enrolled. All patients were given 30 mg of prednisone once daily for 7 days and subsequently classified into subjectively GC-sensitive and -insensitive subgroup or objectively GC-sensitive and -insensitive subgroup. The numbers of eosinophils and neutrophils in blood and polyp tissues were compared between GC-sensitive and GC-insensitive subgroup. Results: 17/26 (65.4%) patients were subjectively and 8/26 (30.8%) patients objectively sensitive to GC treatment. The absolute number and percentage of eosinophils in blood were decreased both in GC-sensitive and -insensitive subjects after GC treatment. In addition, a significant reduction in tissue eosinophil percentage was only observed in objectively GC-sensitive subjects after GC treatment. Furthermore, the change of tissue eosinophil percentage in objectively GC-sensitive subjects was significantly higher than that in objectively GC-insensitive subjects. Conclusions and significance: Objective assessment may better reflect oral GC response in tissue eosinophilic inflammation than subjective assessment in patients with CRSwNP.