title: Diversity of THcytokine profiles in patients with chronic rhinosinusitis: A multicenter study in Europe, Asia, and Oceania.
abstract: To date, no study has evaluated the diversity of THcell cytokine patterns of patients with chronic rhinosinusitis (CRS) among centers in different continents using identical methods.
  
  
  
  We sought to assess THcytokine profiles in patients with CRS from Europe, Asia, and Australia.
  
  
  
  Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP; n = 435) and control subjects (n = 138) were recruited from centers in Adelaide, Benelux, Berlin, Beijing, Chengdu, and Tochigi. Nasal mucosal concentrations of TH2, TH17, and TH1 cytokines; eosinophilic cationic protein (ECP); myeloperoxidase (MPO); IL-8; and tissue total and Staphylococcus aureus enterotoxin (SE)-specific IgE were measured by using identical tools.
  
  
  
  Combinations of TH1/TH2/TH17 cytokine profiles in patients with CRSwNP varied considerably between regions. CRSwNP tissues from patients from Benelux, Berlin, Adelaide, and Tochigi were TH2 biased, whereas those from Beijing mainly demonstrated TH2/TH1/TH17 mixed patterns, and patients from Chengdu showed an even lower TH2 expression. Concentrations of IL-8 and tissue total IgE in patients with CRSwNP were significantly higher than those in control subjects in all regions. More than 50% of patients with CRSwNP in Benelux, Berlin, Adelaide, and Tochigi showed a predominantly eosinophilic endotype compared with less than 30% of patients in Beijing and Chengdu. SE-specific IgE was found in significantly greater numbers in patients with CRSwNP from Benelux, Adelaide, and Tochigi and significantly lower numbers in patients from Beijing and Chengdu. Moreover, the TH1/TH2/TH17 cytokine profiles in patients with CRSsNP showed diversity among the 6 regions.
  
  
  
  THcytokine levels, eosinophilic/neutrophilic patterns, and SE-specific IgE expressions show extreme diversity among patients with CRS from Europe, Asia, and Oceania.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, the Key Laboratory of Otolaryngology-Head and Neck Surgery (Ministry of Education of China), Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Upper Airways Research Laboratory, Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Otorhinolaryngology, Affiliated Hospital of Logistics, University of Chinese People's Armed Police Forces, Tianjin, China.
authors.forename: Mingyu
authors.initials: M
authors.lastname: Bo
authors.affiliation: Upper Airways Research Laboratory, Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Holtappels
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, the Key Laboratory of Otolaryngology-Head and Neck Surgery (Ministry of Education of China), Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zheng
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, the Key Laboratory of Otolaryngology-Head and Neck Surgery (Ministry of Education of China), Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
authors.forename: Hongfei
authors.initials: H
authors.lastname: Lou
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, the Key Laboratory of Otolaryngology-Head and Neck Surgery (Ministry of Education of China), Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, the Key Laboratory of Otolaryngology-Head and Neck Surgery (Ministry of Education of China), Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China. Electronic address: dr.luozhang@139.com.
authors.forename: Luo
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Upper Airways Research Laboratory, Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium. Electronic address: claus.bachert@ugent.be.
authors.forename: Claus
authors.initials: C
authors.lastname: Bachert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D001315:Australia; D002681:China; D002908:Chronic Disease; D016207:Cytokines / Q000276:immunology*; D004768:Enterotoxins / Q000276:immunology; D004804:Eosinophils / Q000276:immunology; D005060:Europe; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007564:Japan; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000276:immunology*; D009504:Neutrophils / Q000276:immunology; D012220:Rhinitis / Q000276:immunology*; D012852:Sinusitis / Q000276:immunology*; D012882:Skin Tests; D013211:Staphylococcus aureus; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D055815:Young Adult
chemical_list: D000485:Allergens; D016207:Cytokines; D004768:Enterotoxins; D007073:Immunoglobulin E
keywords: Asia; Australia; ECP; Europe; IgE; T(H) cytokines; chronic rhinosinusitis; endotype; phenotype