Not all stuffy
noses are alike. That’s the conclusion
of a research study by Tomassen and colleagues published this month in the
Journal of Allergy and Clinical Immunology (J Allergy Clin Immunol 2016; 137(5): 1449-1456).
Despite affecting one out of eight Americans, little is really known
about chronic rhinosinusitis and treatment is often really frustrating. To figure out more personalized approaches to
tackling chronic rhinosinusitis, Tomassen’s group collected tissue samples from
patients with chronic rhinosinusitis, as well as people who had no history of
chronic rhinosinusitis. They then analyzed
14 bio-markers to see if they could find groups of patients who had particular
patterns of inflammation.
Ten distinct
endotypes, or subgroups linked to biological pathways, that correlated to
different features were identified. The
biggest differentiator was the level of IL-5.
Patients with higher levels were more likely to have polyps (outgrowths
of the mucous membranes associated with more severe disease) and/or concomitant
asthma. Combined with the other markers,
these findings can help identify people who would be expected to respond to
different types of medications. Since
there are new medications that target individual inflammatory markers, such as
IL-5, this information can provide valuable insight into personalizing an
approach to reduce the frustration in treating chronic rhinosinusitis.
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