title: Peripheral blood eosinophilia correlates with hyperplastic nasal polyp growth.
abstract: Eosinophils are thought to play a significant role in nasal polyposis, but the exact mechanism by which they contribute to polyposis remains unclear. Therefore, we proposed to test the hypothesis that peripheral blood eosinophilia (PBE) is a surrogate and biomarker for polyp load. To do this, we examined whether PBE levels correlate with nasal polyp load in a longitudinal manner.
  
  
  
  We retrospectively analyzed the fluctuation of PBE and nasal polyp load in each patient (n = 61) assessed preoperatively, 1-2 months postoperatively, and 3-12 months postoperatively. Nasal polyp load was assessed using computed tomography (CT) scan preoperatively and nasal endoscopy postoperatively. Correlation coefficients were analyzed using parametric statistics.
  
  
  
  There was a positive correlation between initial preoperative baseline PBE and CT scan staging of polyp load (r = 0.35, p < 0.01). When patients were analyzed longitudinally, we found that the change in PBE correlated with the change in nasal endoscopy scores obtained at or near the same timepoint (r = 0.82, p < 2.0 × 10(-10) ). When nasal polyp load increased with time, we observed a stepwise increase in eosinophil counts (r = 0.37, p < 0.02).
  
  
  
  PBE correlates with nasal polyp load. PBE levels may be used along with nasal endoscopy to prospectively follow nasal polyp load postoperatively in chronic rhinosinusitis patients with hyperplastic nasal polyposis who have eosinophilia, asthma, and/or aspirin-exacerbated respiratory disease.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, University of Maryland Medical School, Baltimore, MD.
authors.forename: Virginia E
authors.initials: VE
authors.lastname: Drake
authors.affiliation: Center for Bioinformatics, University of Colorado Denver, Denver, CO.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Rafaels
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Johns Hopkins Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, MD. jeankim@jhmi.edu.
authors.forename: Jean
authors.initials: J
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004724:Endoscopy; D004802:Eosinophilia / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D009298:Nasal Polyps / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012220:Rhinitis / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery; D012852:Sinusitis / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: chronic rhinosinusitis with nasal polyposis; nasal endoscopy; paranasal sinus CT scan; peripheral blood eosinophilia