背景:B细胞活化因子(BAFF)是一种参与炎症和过敏性疾病的促炎细胞因子,但其在慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)中的作用尚不清楚。本研究旨在探讨循环BAFF在CRSwNP基因型与术后复发的预测价值。
方法:我们招募了120名CRSwNP患者,包括68例非嗜酸性粒细胞性CRSwNP(neCRSwNP)患者,52例嗜酸性粒细胞性CRSwNP(CRSwNP)患者,和60名健康对照(HCs)。通过酶联免疫吸附试验(ELISA)测量所有参与者的循环BAFF水平,以及接受者操作特征(ROC)和逻辑回归分析用于评估BAFF水平在区分CRSwNP基因型中的预测能力。所有CRSwNP患者随访3年以上,评价循环BAFF对术后复发的预测价值。
结果:与HCs相比,CRSwNP患者的血清BAFF水平升高(P<0.01),而eCRSwNP患者的血清BAFF水平明显升高。血清BAFF浓度升高与血嗜酸性粒细胞计数和百分比呈正相关。组织嗜酸性粒细胞计数,血清总IgE(P<0.05)。ROC曲线显示血清BAFF对eCRSwNP具有较强的辨别能力。最后,99名CRSwNP患者完成了随访计划,65例患者归入无复发组,34例患者归入复发组。复发组血清BAFF水平明显高于未复发组(P<0.001),ROC曲线提示血清BAFF对预测术后复发具有较高的预测价值。此外,Logistic回归和Kaplan-Meier曲线显示血清BAFF是术后复发的独立危险因素(P<0.05)。
结论:我们的数据表明CRSwNP患者的血清BAFF水平上调,并与粘膜嗜酸性粒细胞浸润严重程度相关。血清BAFF似乎是术前区分CRSwNP基因型和预测术后复发的新生物标志物。
BACKGROUND: B cell-activating factor (BAFF) is a proinflammatory cytokine involved in inflammatory and allergic diseases, but its role in chronic rhinosinusitis with nasal polyps (CRSwNP) remains unclear. This study aims to explore the predictive value of circulating BAFF in CRSwNP endotypes and postoperative recurrence.
METHODS: We recruited 120 CRSwNP patients, including 68 non-eosinophilic CRSwNP (neCRSwNP) patients, 52 eosinophilic CRSwNP (CRSwNP) patients, and 60 healthy controls (HCs). Circulating BAFF levels of all participants were measured by enzyme-linked immunosorbent assay (ELISA), and receiver-operating characteristic (ROC) and logistic regression analyses were applied to assess the predictive ability of BAFF levels in distinguishing CRSwNP endotypes. All CRSwNP patients were followed for more than 3 years, and the predictive value of circulating BAFF for postoperative recurrence was evaluated.
RESULTS: Serum BAFF levels were elevated in CRSwNP patients compared with the HCs (P < 0.01) and significantly higher in eCRSwNP patients. The increased serum BAFF concentrations positively correlated with blood eosinophil counts and percentages, tissue eosinophil counts, and serum total IgE (P < 0.05). The ROC curve showed that serum BAFF exhibited strong discriminative ability for eCRSwNP. Finally, 99 CRSwNP patients completed the follow-up schedule, 65 patients were classified into non-recurrence group and the other 34 patients were categorized into recurrence group. Serum BAFF levels were significantly higher in recurrence group than non-recurrence group (P < 0.001), and the ROC curve suggested a high predictive value of serum BAFF in predicting postoperative recurrence. Moreover, logistic regression and Kaplan-Meier curves showed that serum BAFF was an independent risk factor for postoperative recurrence (P < 0.05).
CONCLUSIONS: Our data suggested that serum BAFF levels were upregulated in CRSwNP patients and correlated with mucosal eosinophil infiltration severity. Serum BAFF seemed to be a novel biomarker for preoperatively distinguishing CRSwNP endotypes and predicting postoperative recurrence.