Use of intraoperative frontal sinus mometasone‐eluting stents decreased interleukin 5 and interleukin 13 in patients with chronic rhinosinusitis with nasal polyps

Use of intraoperative frontal sinus mometasone‐eluting stents decreased interleukin 5 and interleukin 13 in patients with chronic rhinosinusitis with nasal polyps

Background Mometasone‐eluting stents (MES) have demonstrated improvement in short‐term endoscopic outcomes and reduce short‐ to medium‐term rescue interventions. Their effect on the local inflammatory environment, longer‐term patient‐reported outcomes, and radiographic severity have not been studied...

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Published in:International forum of allergy & rhinology Vol. 12; no. 11; pp. 1330 - 1339
Main Authors: Schneider, Alexander L., Racette, Samuel D., Kang, Anthony K., Reddy, Abhita T., Huang, Julia H., Lehmann, David S., Price, Caroline P.E., Eide, Jacob G., Rodeghiero, Samuel R., Conley, David B., Welch, Kevin C., Kern, Robert C., Shintani‐Smith, Stephanie, Peters, Anju T., Kato, Atsushi, Stevens, Whitney S., Schleimer, Robert P., Tan, Bruce K.
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01-11-2022
John Wiley and Sons Inc
Subjects:
Chronic Disease
CRSwNP
Cytokines
Drug-Eluting Stents
Endoscopy
endotype
Eosinophil cationic protein
Frontal Sinus
Humans
Implants
Inflammation
Interleukin 13
Interleukin 5
Interleukin-4
Leukocytes (eosinophilic)
mometasone
Mometasone Furoate - therapeutic use
nasal polyps
Nasal Polyps - surgery
Original
Patients
patient‐reported outcome measures
Polyps
Rhinitis
Rhinitis - surgery
Rhinosinusitis
sinus stent
Sinusitis
Sinusitis - surgery
Surgery
nasal polyps
CRSwNP
endotype
patient-reported outcome measures
mometasone
sinus stent
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Summary:Background Mometasone‐eluting stents (MES) have demonstrated improvement in short‐term endoscopic outcomes and reduce short‐ to medium‐term rescue interventions. Their effect on the local inflammatory environment, longer‐term patient‐reported outcomes, and radiographic severity have not been studied. Methods Middle meatal mucus and validated measures of disease severity were collected before and 6 to 12 months after endoscopic surgery in 52 patients with chronic rhinosinusitis with nasal polyps (CRSwNPs). Operative findings, type 2 mediator concentrations, intraoperative variables, and disease severity measures were compared between those who did and those who did not receive intraoperative frontal MES. Results A total of 52 patients with CRSwNPs were studied; 33 received frontal MES and were compared with 19 who did not. Pre–endoscopic sinus surgery (ESS) middle meatus (MM) interleukin (IL) 13 and eosinophil cationic protein (ECP) were higher in the stented group (p < 0.05), but pre‐ESS clinical measures of disease severity were similar as were surgical extent and post‐ESS medical management. Intraoperative eosinophilic mucin was more frequent in the stented group (58% vs 11%, p = 0.001). IL‐5 (p < 0.05) and IL‐13 (p < 0.001) decreased post‐ESS in the stented group, but this was not observed in the nonstented group. Post‐ESS IL‐4 and IL‐13 were higher in the nonstented vs stented group (p < 0.05 for both). Conclusion Although patients who received intraoperative frontal MES had significantly higher pre‐ESS MM IL‐13 and ECP, patients who received frontal MES had lower concentrations of IL‐4 and IL‐13 than those who did not at a median of 8 months post‐ESS. However, these changes did not correspond to significantly different measures of symptomatic or radiographic disease severity.
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ISSN:2042-6976
2042-6984
DOI:10.1002/alr.23005