Rhinology
Published: 2022-06-30
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Calprotectin in nasal secretion: a new biomarker of non-type 2 inflammation in CRSwNP

A. Gemelli Hospital Foundation IRCCS, Unit of Otorhinolaryngology, Head and Neck Surgery, Rome, Italy
A. Gemelli Hospital Foundation IRCCS, Unit of Chemistry, Biochemistry and Clinical Molecular Biology, Rome, Italy; Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
A. Gemelli Hospital Foundation IRCCS, Unit of Otorhinolaryngology, Head and Neck Surgery, Rome, Italy
Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
A. Gemelli Hospital Foundation IRCCS, Unit of Chemistry, Biochemistry and Clinical Molecular Biology, Rome, Italy; Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
A. Gemelli Hospital Foundation IRCCS, Unit of Otorhinolaryngology, Head and Neck Surgery, Rome, Italy; Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy
sinusitis nasal polyps rhinitis immunophenotyping precision medicine

Abstract

Objective. We analysed calprotectin in sinonasal secretions of different chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes to assess its role as a biomarker of non-type 2 inflammation.
Methods. We included primary diffuse CRSwNP patients (n = 41) and three different control groups [non-allergic rhinitis (NAR) (n = 13), non-allergic eosinophilic syndrome (NARES) (n = 10) and healthy subjects (n = 12)]. Calprotectin levels were detected in nasal secretions using a chemiluminescent immunoassay (CLIA).
Results. Calprotectin levels in nasal secretions were significantly higher in all non-type 2 endotypes of CRSwNP compared to healthy controls (p < 0.05). In contrast, in type-2 CRSwNP calprotectin was significantly lower compared to controls (p < 0.05). A significant correlation between calprotectin levels and neutrophilic count/HPF was found in CRSwNP (p < 0.01). Clinically, mean levels of calprotectin and neutrophilia were significantly higher in patients who previously underwent 3 or more endoscopic sinus surgeries (p < 0.05).
Conclusions. Calprotectin in nasal secretions may be a biomarker of non-type 2 inflammation. Low levels of calprotectin are indicative of a type-2 immune response in both CRSwNP and non-allergic rhinitis. We observed that calprotectin levels significantly increased based on the number of previous surgeries.

Affiliations

Eugenio De Corso

A. Gemelli Hospital Foundation IRCCS, Unit of Otorhinolaryngology, Head and Neck Surgery, Rome, Italy

Silvia Baroni

A. Gemelli Hospital Foundation IRCCS, Unit of Chemistry, Biochemistry and Clinical Molecular Biology, Rome, Italy; Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Maria Elisabetta Onori

Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Laura Tricarico

Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Stefano Settimi

A. Gemelli Hospital Foundation IRCCS, Unit of Otorhinolaryngology, Head and Neck Surgery, Rome, Italy

Giacomo Moretti

Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Eliana Troiani

Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Rodolfo Francesco Mastrapasqua

Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Daniela Furno

Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Fabrizio Crudo

Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Andrea Urbani

A. Gemelli Hospital Foundation IRCCS, Unit of Chemistry, Biochemistry and Clinical Molecular Biology, Rome, Italy; Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Jacopo Galli

A. Gemelli Hospital Foundation IRCCS, Unit of Otorhinolaryngology, Head and Neck Surgery, Rome, Italy; Catholic University of the Sacred Hearth, Faculty of Medicine and Surgery, Rome, Italy

Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2022

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