Deep immune profiling of chronic rhinosinusitis in allergic and non-allergic cohorts using mass cytometry

Abstract

ABSTRACTBackgroundChronic rhinosinusitis (CRS) is characterized by persistent nasal and paranasal sinus mucosa inflammation. It comprises two phenotypes, namely CRS with nasal polyps (CRSwNP) and without (CRSsNP). CRSwNP can be associated with asthma and hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) in a syndrome known as NSAID-exacerbated respiratory disease (N-ERD). Furthermore, CRS frequently intertwines with respiratory allergies.ObjectiveThis study investigated the phenotypic characteristics of peripheral blood mononuclear cells (PBMCs) within cohorts of CRS patients, additionally examining the influence of comorbid respiratory allergies on these parameters.Methods24 participants were grouped into controls, CRSsNP, CRSwNP, and N-ERD (n=6/group), with half of the patients in each group having respiratory allergies. Levels of cytokines were quantified in nasal secretions and sera. The abundance and phenotypic features of immune cells in PBMCs were evaluated through mass cytometry and clustering methods.ResultsN-ERD patients showed heightened type 2 nasal cytokine levels. Mass cytometry analysis revealed increased activated naive B cell levels in CRSwNP and N-ERD, while resting naive B cells were higher in CRSsNP. Th2a cell levels did not differ between CRS subtypes but were significantly elevated in allergic subjects. In CRSwNP and N-ERD patients, naive B cells had a lower CXCR5 and higher CD45RA expression, while NK cells displayed reduced CD56 levels.ConclusionsThere are distinct immunological features in PBMCs of CRS phenotypes and allergy, characterized by elevated resting naive B cells in CRSsNP, increased activated naive B cells in CRSwNP and N-ERD, and higher Th2a cell levels in allergic subjects.Capsule summaryThis study examines immunological profiles in different phenotypes of CRS with and without comorbid allergy patients, highlighting immune cell intricacies in CRS subtypes and immune differences in CRS and respiratory allergy.