title: Correlation of Symptoms, Clinical Signs, and Biomarkers of Inflammation in Postsurgical Chronic Rhinosinusitis.
abstract: OBJECTIVE
  The study aimed to evaluate symptoms described by patients with chronic rhinosinusitis with polypoid changes/nasal polyps and their correlation with computed tomography (CT), nasal endoscopy, and intranasal biomarkers.
  
  
  METHODS
  Prospective multicenter study symptom data from postsurgical adult chronic rhinosinusitis study participants with recurrent disease refractory to medical therapy were analyzed in comparison with objective data.
  
  
  METHODS
  Using logistic regression analysis, participant-rated 16-question surveys from 258 participants were assessed for correlation with nasal endoscopy scores, CT percentage of sinus occlusion, and intranasal biomarkers of fungal antigens (Alternaria and Aspergillus), eosinophilic inflammation (eosinophil-derived neurotoxin [EDN] and major basic protein [MBP]), and inflammatory cytokines (interleukins 5 and 13).
  
  
  RESULTS
  Study participant assessments revealed increased CT occlusion in participants presenting with greater inability to smell ( P < .019). Mucosal inflammation identified on nasal endoscopy was positively correlated with congestion ( P < .028), runny nose ( P < .002), and ear pain ( P < .007). Elevated EDN was positively correlated in patients with bothersome congestion ( P < .031) and runny nose ( P < .011). Sneezing was positively correlated with multiple markers: Alternaria ( P < .024), interleukin-13 ( P < .027), MBP ( P < .034), and interleukin-5 ( P < .019).
  
  
  CONCLUSIONS
  Nasal endoscopy, not CT imaging, has the strongest correlation with the 2 cardinal symptoms of congestion and runny nose in CRS patients; these correlate with biomarkers of eosinophilic inflammation.
authors.affiliation: 1 Department of Otorhinolaryngology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Gromo Institute and Sinus Center, Buffalo, New York, USA.
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Racette
authors.affiliation: 1 Department of Otorhinolaryngology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Gromo Institute and Sinus Center, Buffalo, New York, USA.
authors.forename: Rohan C
authors.initials: RC
authors.lastname: Wijewickrama
authors.affiliation: 2 Division of Cancer Prevention & Population Sciences, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Vijayvel
authors.initials: V
authors.lastname: Jayaprakash
authors.affiliation: 1 Department of Otorhinolaryngology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Gromo Institute and Sinus Center, Buffalo, New York, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Sherris
authors.affiliation: 3 Accentia Biopharmaceuticals, Inc, Tampa, Florida, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Santos
authors.affiliation: 4 Department of Medicine, Division of Allergic Disease, Mayo College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kita
authors.affiliation: 1 Department of Otorhinolaryngology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Gromo Institute and Sinus Center, Buffalo, New York, USA.
authors.forename: Frank E
authors.initials: FE
authors.lastname: O'Donnell
authors.affiliation: 1 Department of Otorhinolaryngology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Gromo Institute and Sinus Center, Buffalo, New York, USA.
authors.forename: Jens U
authors.initials: JU
authors.lastname: Ponikau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis*; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000737:chemistry; D009298:Nasal Polyps / Q000175:diagnosis / Q000209:etiology; D011184:Postoperative Period; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: CT scan; biomarker; chronic rhinosinusitis; nasal endoscopy; nasal polyposis