Diversity of T_H cytokine profiles in patients with chronic rhinosinusitis: A multicenter study in Europe, Asia, and Oceania.

Abstract

To date, no study has evaluated the diversity of T_H cell cytokine patterns of patients with chronic rhinosinusitis (CRS) among centers in different continents using identical methods. We sought to assess T_H cytokine profiles in patients with CRS from Europe, Asia, and Australia. Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP; n = 435) and control subjects (n = 138) were recruited from centers in Adelaide, Benelux, Berlin, Beijing, Chengdu, and Tochigi. Nasal mucosal concentrations of T_H2, T_H17, and T_H1 cytokines; eosinophilic cationic protein (ECP); myeloperoxidase (MPO); IL-8; and tissue total and Staphylococcus aureus enterotoxin (SE)-specific IgE were measured by using identical tools. Combinations of T_H1/T_H2/T_H17 cytokine profiles in patients with CRSwNP varied considerably between regions. CRSwNP tissues from patients from Benelux, Berlin, Adelaide, and Tochigi were T_H2 biased, whereas those from Beijing mainly demonstrated T_H2/T_H1/T_H17 mixed patterns, and patients from Chengdu showed an even lower T_H2 expression. Concentrations of IL-8 and tissue total IgE in patients with CRSwNP were significantly higher than those in control subjects in all regions. More than 50% of patients with CRSwNP in Benelux, Berlin, Adelaide, and Tochigi showed a predominantly eosinophilic endotype compared with less than 30% of patients in Beijing and Chengdu. SE-specific IgE was found in significantly greater numbers in patients with CRSwNP from Benelux, Adelaide, and Tochigi and significantly lower numbers in patients from Beijing and Chengdu. Moreover, the T_H1/T_H2/T_H17 cytokine profiles in patients with CRSsNP showed diversity among the 6 regions. T_H cytokine levels, eosinophilic/neutrophilic patterns, and SE-specific IgE expressions show extreme diversity among patients with CRS from Europe, Asia, and Oceania.