August 11, 2020

Risk marker for repeat sinus surgery

An inflammatory factor in mucus could be a biomarker of treatment-resistant chronic sinusitis used to determine which patients are at risk for repeat sinus surgery.

by Leigh MacMillan

Endoscopic sinus surgery is a frequent treatment for patients with chronic rhinosinusitis — long-term inflammation of the spaces inside the nose and head — that does not respond to medical therapies. However, up to 20% of patients are at risk for repeat revision surgery. 

To explore whether inflammatory factors present in mucus might be used to estimate risk of revision surgery, Naweed Chowdhury, MD, and colleagues conducted a retrospective analysis of samples from 231 patients who had surgery for chronic rhinosinusitis. 

They discovered that elevated mucus levels of the cytokine IL-17A were associated with a high number of prior sinus surgeries, independent of other risk factors such as age, severity of disease or a history of allergic fungal rhinosinusitis. The findings suggest that elevations of IL-17A, the prototypic cytokine for type 3 inflammation, may reflect long-term treatment-resistant disease. 

Their report in the International Forum of Allergy & Rhinology supports further study of IL-17A in prospective and mechanistic studies.

This research was supported by the National Institutes of Health (grant AI142321).