Chronic Rhinosinusitis in Elderly Patients is Associated with an Exaggerated Neutrophilic Pro-Inflammatory Response to Pathogenic Bacteria

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Justin C. Morse, Ping Li, Kim A. Ely, Meghan H. Shilts, Todd J. Wannemuehler, Li-Ching Huang, Quanhu Sheng, Naweed I. Chowdhury, Rakesh K. Chandra, Suman R. Das, Justin H. Turner

Abstract

Background

Potential effects of aging on chronic rhinosinusitis (CRS) pathophysiology have not been well defined, but may have important ramifications given a rapidly aging U.S. and world population.

Objective

The goal of the current study was to determine whether advanced age is associated with specific inflammatory CRS endotypes or immune signatures.

Methods

Seventeen mucus cytokines and inflammatory mediators were measured in 147 CRS patients. Hierarchical cluster analysis was used to identify and characterize inflammatory CRS endotypes as well as determine whether age was associated with specific immune signatures.

Results

A CRS endotype with a pro-inflammatory, neutrophilic immune signature was enriched with older patients. In the overall cohort, patients 60 years and older had elevated mucus levels of IL-1β, IL-6, IL-8, and TNF-α when compared to their younger counterparts. Increases in pro-inflammatory cytokines were associated with both tissue neutrophilia and symptomatic bacterial infection/colonization in aged patients.

Conclusions

Aged CRS patients have a unique inflammatory signature that corresponds to a neutrophilic pro-inflammatory response. Neutrophil-driven inflammation in aged CRS patients may be less likely to respond to corticosteroids and may be closely linked with chronic microbial infection or colonization.

Graphical abstract

https://ift.tt/2DEPHgr