The Correlation of Tissue’s Endotype Biomarkers and Dominant Inflammation Cell in Chronic Rhinosinusitis

Background and Objectives This study analyzes the relationship between endotype biomarkers and the type of tissue inflammation in chronic rhinosinusitis (CRS) in order to obtain a more accurate division of disease groups and appropriate therapy. Subjects and Method We carried out a cross-sectional study involving 33 samples of CRS patients. We conducted enzyme-linked immunosorbent assay to examine endotype biomarkers and histopathology methods to examine tissue inflammation. Results Statistical analysis with an independent t-test showed significant differences with respect to eosinophil cationic protein (ECP) between the eosinophilic and neutrophilic groups (p<0.05), whereas there were no significant differences between the two groups (p>0.05) with respect to Charcot-Leyden crystal (CLC), interleukin-5 (IL-5), interferon gamma (IFN-γ), interleukin-17A (IL-17A), and oncostatin M (OSM). The Spearman test showed also showed that ECP, CLC, IL-5, IL-17A, IFN-γ and OSM had no significant correlation with the two groups (p>0.05). The receiver operating characteristics analysis showed the optimal cut-off value of ECP of 342.22 pg/mL with sensitivity and specificity of 72.7% for determining the inflammation type (area under cover=0.78, p=0.009). Conclusion The higher level of ECP was more likely to be found in the eosinophilic tissue inflammation. Consequently, we propose using ECP as the main biomarker to identify the CRS type 2. Further research with a larger sample size is required for cut-off points of ECP in order to determine the endotype of CRS.