Chronic rhinossinusitis with nasal polyps (CRSwNP) biopsy – when, how and why?
DOI:
https://doi.org/10.34631/sporl.3093Keywords:
Nasal polyps, neutrophils, eosinophils, rhinossinusitisAbstract
Objective: To assess the impact of nasal tissue neutrophilia on dupilumab response in severe, uncontrolled CRSwNP.
Methodology: Retrospective study, 23 CRSwNP patients on dupilumab assessed at baseline and 6 months. Systemic IgE and eosinophilia, tissue eosinophilia and neutrophilia were recorded. Evaluation of Sino-nasal Outcome Test (SNOT-22), Visual Analogue Scale (VAS) total symptoms, Nasal Polyp Score (SPN), Barcelona Smell Test 24 (BAST-24), Nasal Congestion Score (SCN), and Smell Loss Score (SPO).
Results: Mean tissue neutrophil count was 2±2.3, ranging from 0 to 8 per high-power field. Correlation was observed between tissue neutrophilia and SPO variation (r= 0.464, p = 0.034) and direct correlations between tecidual eosinophilia and neutrophilia (r=0.595, p=0.004) and between tecidual neutrophilia and sistemic IgE (r=0.548, p=0.010).
Conclusion: Higher neutrophil levels appear linked to resistance to dupilumab, with less improvement in SPO. Sample size limits data reliability, warranting further studies with larger samples.
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Copyright (c) 2025 Margarida Bulha, Diogo V. Dias, Miguel Padrão, Sofia Cales, Isa Eloi, Sandra Augusto, Luísa Azevedo
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