Charcot-Leyden crystal concentration in nasal secretions predicts clinical response to glucocorticoids in patients with chronic rhinosinusitis with nasal.

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Charcot-Leyden crystal concentration in nasal secretions predicts clinical response to glucocorticoids in patients with chronic rhinosinusitis with nasal polyps Di Wu, MD, Bing Yan, PhD, Yang Wang, BD, Luo Zhang, MD, PhD, Chengshuo Wang, MD, PhD Journal of Allergy and Clinical Immunology Volume 144, Issue 1, Pages 345-348.e8 (July 2019) DOI: 10.1016/j.jaci.2019.03.029 Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 CLC concentrations in nasal secretions and predictive values. A, The area under curve (AUC) for CLC concentrations in nasal secretions was 0.897 (OR, 1.043; 95% CI, 1.020-1.066), whereas the AUC for eosinophil percentages in polyp tissues was 0.855 (OR, 1.056; 95% CI, 1.025-1.087). B, Distribution of CLC concentrations in nasal secretions in the glucocorticoid (GC) responder group (n = 48, 4 outliers are marked in red) and the glucocorticoid nonresponder group (n = 41, P < .001). The optimal cutoff value determined by using the Youden index was 30.065 ng/mL. C, Distributions of eosinophil percentages in polyp tissues (P < .001) in the glucocorticoid responder group (n = 48) and the glucocorticoid nonresponder group (n = 41). The optimal cutoff value determined by using the Youden index was 41.50%. D and E, Change in nasal CLC concentration before and after glucocorticoid therapy in the glucocorticoid responder group (n = 12; Fig 1, D) and the glucocorticoid nonresponder group (n = 17; Fig 1, E). Journal of Allergy and Clinical Immunology 2019 144, 345-348.e8DOI: (10.1016/j.jaci.2019.03.029) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Differences in clinical characteristics between patients with nasal CLC concentrations less than (n = 37) or greater than (n = 52) the cutoff value. A, Number of glucocorticoid responders (black columns)/nonresponders (gray columns). B, NPSSs after glucocorticoid therapy. C, Changes in NPSSs before and after glucocorticoid therapy. D, Eosinophil percentages in polyp tissues. E, Eosinophil percentages in peripheral blood. F, Neutrophil percentages in polyp tissues. G, Neutrophil percentages in peripheral blood. Journal of Allergy and Clinical Immunology 2019 144, 345-348.e8DOI: (10.1016/j.jaci.2019.03.029) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Effect of sex (black columns for male and gray columns for female subjects; A), age (B), comorbid asthma (C), comorbid allergic rhinitis (D), comorbid atopy (E), and smoking history (F) on nasal CLC concentrations less than or greater than the cutoff value (black columns for yes and gray columns for no in Fig E1, C-F). Journal of Allergy and Clinical Immunology 2019 144, 345-348.e8DOI: (10.1016/j.jaci.2019.03.029) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Severity and incidence of chronic rhinosinusitis symptoms in patients with nasal CLC concentrations less than or greater than the cutoff value: A, nasal obstruction; B, rhinorrhea; C, facial pain; and D, subjective olfactory disorder. Journal of Allergy and Clinical Immunology 2019 144, 345-348.e8DOI: (10.1016/j.jaci.2019.03.029) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 Difference of patients with nasal CLC concentrations less than or greater than the cutoff value in objective olfactory test results (A), Lund-Mackay scores for paranasal sinuses on CT scans (B), and ratios of Lund-Mackay scores of ethmoid sinus/Lund Mackay scores of the maxillary sinus (C). Journal of Allergy and Clinical Immunology 2019 144, 345-348.e8DOI: (10.1016/j.jaci.2019.03.029) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions