Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients.
To evaluate if molecular markers of eosinophilia in olfactory-enriched mucosa are associated with olfactory dysfunction.



Cross-sectional study of tissue biopsies from 99 patients, and an additional 30 patients who underwent prospective olfactory testing prior to sinonasal procedures.



Tissue biopsies were processed for analysis of inflammatory markers using quantitative real time polymerase chain reaction (qRT-PCR). Ipsilateral olfactory performance was assessed using the Sniffin' Sticks (Burghart, Wedel, Germany) threshold component and the University of Pennsylvania Smell Identification Test (Sensonics, Haddon Heights, NJ). Age-adjusted data was correlated with inflammatory marker expression and clinical measures of obstruction from computed tomography and endoscopy.



Gene expression of the eosinophil marker CLC (Charcot Leyden crystal protein) was elevated in superior turbinate (ST) tissue in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) compared to ST and inferior turbinate tissue in CRS without nasal polyps (CRSsNP) and control patients (all P < 0.001, respectively). CLC in ST tissue was correlated with IL-5 and eotaxin-1 expression (all P < 0.001; P = 0.65, and 0.49, respectively). CLC expression was strongly correlated with eosinophilic cationic protein levels (P < 0.001; r = -0.76), and ST CLC expression was inversely related to olfactory threshold (P = 0.002, r = -0.57) and discrimination scores (P = 0.05, r = -0.42). In multiple linear regression of CLC gene expression, polyp status, and radiographic and endoscopic findings with olfactory threshold, CLC was the only significantly correlated variable (P < 0.05).



Markers of eosinophils are elevated in the ST of patients with CRSwNP and correlate with olfactory loss. These findings support the hypothesis that olfactory dysfunction in CRS correlates local eosinophil influx into the olfactory cleft.



NA. Laryngoscope, 127:2210-2218, 2017.
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Jennifer
J
Lavin
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Jin-Young
JY
Min
University of Rochester School of Medicine and Dentistry, Rochester, New York, U.S.A.
Alcina K
AK
Lidder
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Julia He
JH
Huang
Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Atsushi
A
Kato
Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, U.S.A.
Kent
K
Lam
Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, Canada.
Eric
E
Meen
Department of Preventive Medicine-Biostatistics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Joan S
JS
Chmiel
Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
James
J
Norton
Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Lydia
L
Suh
Division of Allergy and Immunology, Rush Medical College, Chicago, Illinois, U.S.A.
Mahboobeh
M
Mahdavinia
Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Kathryn E
KE
Hulse
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
David B
DB
Conley
Department of Otolaryngology, Head and Neck Surgery, Vanderbilt School of Medicine, Nashville, Tennessee, U.S.A.
Rakesh K
RK
Chandra
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Stephanie
S
Shintani-Smith
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Robert C
RC
Kern
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.|University of Rochester School of Medicine and Dentistry, Rochester, New York, U.S.A.
Robert P
RP
Schleimer
Department of Otolaryngology-Head and Neck SurgeryDivision of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Bruce K
BK
Tan
D000328:Adult; D000368:Aged; D054413:Chemokine CCL11 / Q000032:analysis; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D047150:Eosinophil Cationic Protein / Q000097:blood; D004802:Eosinophilia / Q000097:blood / Q000150:complications* / Q000473:pathology; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D015848:Interleukin-5 / Q000032:analysis; D008245:Lysophospholipase / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000097:blood / Q000150:complications / Q000473:pathology; D000857:Olfaction Disorders / Q000209:etiology*; D011446:Prospective Studies; D012220:Rhinitis / Q000097:blood / Q000150:complications* / Q000473:pathology; D012852:Sinusitis / Q000097:blood / Q000150:complications* / Q000473:pathology; D014420:Turbinates / Q000473:pathology; D055815:Young Adult
C515456:CCL11 protein, human; D054413:Chemokine CCL11; D006023:Glycoproteins; C508599:IL5 protein, human; D015848:Interleukin-5; D008245:Lysophospholipase; C011711:lysolecithin acylhydrolase; D047150:Eosinophil Cationic Protein
Eosinophils; chronic rhinosinusitis; olfactory dysfunction