A Comparison of Allergen Sensitivities in Chronic Rhinosinusitis

Tuesday, October 1, 2024

8:00 AM – 8:06 AM EDT

Location: MBCC, 230

Disclosure(s):

Lauren O. Trzcinski, B.S.:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Suhas R. Bharadwaj, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kent K. Lam, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) are sinonasal conditions that often occur simultaneously. CRS broadly describes CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP). CRSwNP can be further classified into subphenotypes (i.e., aspirin exacerbated respiratory disease, allergic fungal rhinosinusitis, eosinophilic mucin sinusitis, central compartment atopic disease) and endotypes, including type II and non-type II inflammation. The purpose of this study is to determine if sensitivity to allergens can distinguish between CRS phenotypes and endotypes.

Methods: This was a retrospective review of all patients diagnosed with CRS and AR who underwent skin prick testing or in vitro-radioallergosorbent testing at a tertiary academic center between January 2014 and December 2020. The rates of allergen sensitivities in CRSwNP patients were compared to those in CRSsNP patients with subgroup analysis of the subphenotypes and endotypes. Endotype was categorized through analysis of total IgE levels, blood eosinophil counts, and pathological specimen analysis.

Results: 762 patients were identified to have concurrent CRS and AR. 239 (31%) of these patients had recorded sensitization testing and met study criteria. Sensitizations to shellfish (OR=7.71, p=0.01), mold (OR=2.64, p=0.02), house dust mite (OR=2.39, p=0.02) were predictive of CRSwNP when compared to CRSsNP. Mold was significantly predictive for AFRS (OR 2.81:, p=.048), Patients with type II inflammation were more likely to have sensitization to molds (OR 2.28, p=.01).

Conclusions: Sensitization to perennial allergens is associated as a comorbidity with CRSwNP to a greater degree than CRSsNP. Patients with type II inflammation showed increased sensitivity to specifically molds.

Presenting Author(s)

Lauren O. Trzcinski, B.S.

Medical Student
Eastern Virginia Medical School
Norfolk, VA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

SB

Suhas R. Bharadwaj, MD

Resident
Eastern Virginia Medical School
Norfolk, VA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
RB

Randall Bloch, MD

Massachusetts General Hospital, United States

Disclosure information not submitted.
JH

Joseph K. Han, MD

Chief of the Division of Rhinology
EVMS Otolaryngology
Virginia Beach, VA, United States

Disclosure information not submitted.

Senior Author(s)

KL

Kent K. Lam, MD

Associate Professor
Eastern Virginia Medical School
Norfolk, VA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.