Inflammatory characteristics of central compartment atopic disease

Kolin E. Rubel, Rory J. Lubner, Andrea A. Lopez, Ping Li, Li Ching Huang, Quanhu Sheng, Jeffanie Wu, Sarah K. Wise, John M. DelGaudio, Rakesh K. Chandra, Naweed Chowdhury, Justin H. Turner

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Central compartment atopic disease (CCAD) is an emerging phenotype of chronic rhinosinusitis with nasal polyposis (CRSwNP) characterized by prominent central nasal inflammatory changes. This study compares the inflammatory characteristics of CCAD relative to other phenotypes of CRSwNP. Methods: A cross-sectional analysis of data from a prospective clinical study was performed on patients with CRSwNP who were undergoing endoscopic sinus surgery (ESS). Patients with CCAD, aspirin-exacerbated respiratory disease (AERD), allergic fungal rhinosinusitis (AFRS), and non-typed CRSwNP (CRSwNP NOS) were included and mucus cytokine levels and demographic data were analyzed for each group. Chi-squared/Mann-Whitney U tests and partial least squares discriminant analysis (PLS-DA) were performed for comparison and classification. Results: A total of 253 patients were analyzed (CRSwNP, n = 137; AFRS, n = 50; AERD, n = 42; CCAD, n = 24). Patients with CCAD were the least likely to have comorbid asthma (p = 0.0004). The incidence of allergic rhinitis in CCAD patients did not vary significantly compared to patients with AFRS and AERD, but was higher compared to patients with CRSwNP NOS (p = 0.04). On univariate analysis, CCAD was characterized by less inflammatory burden, with reduced levels of interleukin 6 (IL-6), IL-8, interferon gamma (IFN-γ), and eotaxin relative to other groups and significantly lower type 2 cytokines (IL-5, IL-13) relative to both AERD and AFRS. These findings were supported by multivariate PLS-DA, which clustered CCAD patients into a relatively homogenous low-inflammatory cytokine profile. Conclusions: CCAD has unique endotypic features compared to other patients with CRSwNP. The lower inflammatory burden may be reflective of a less severe variant of CRSwNP.

Original languageEnglish (US)
Pages (from-to)2133-2143
Number of pages11
JournalInternational Forum of Allergy and Rhinology
Issue number12
StatePublished - Dec 2023
Externally publishedYes

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  • central compartment atopic disease
  • cytokine
  • endotype
  • nasal polyp
  • phenotype

PubMed: MeSH publication types

  • Journal Article


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