Expression And Clinical Significance Of Eosinophil-derived Neurotoxin In Chronic Rhinosinusitis

Objective:To evaluate the expression of serum EDN levels in ECRSw NP and non-ECRSw NP as well as to analyze the predictive value of serum EDN levels for ECRSw NP.To evaluate the expression and correlation of EDN protein and MMP-9protein in ECRSw NP and non-ECRSw NP,and to investigate the role of EDN protein in tissue remodeling of ECRSw NP.Method:1.Thirty-eight patients with chronic rhinosinusitis with nasal polyps who underwent endoscopic sinus surgery in the Department of Otorhinolaryngology,Fujian Provincial Hospital from April 2019 to November 2019 were recruited in the study.These patients were subsequently classified into ECRSw NP and non-ECRSw NP subgroup according to tissue eosinophil counts(>55/HPF).2.Enzyme-linked immunosorbent assay was used to detect serum EDN levels in ECRSw NP and non-ECRSw NP groups.The correlation between serum EDN levels and peripheral blood eosinophil counts and percentage,SNOT-22 score,Lund-Kennedy score and Lund-Mackay score were evaluated.Predictive value and optimal cutoff points of serum EDN levels for ECRSw NP were determined by receiver operating characteristic curves and the Youden index.3.Immunohistochemistry were used to evaluate the expression and correlation of EDN protein and MMP-9 protein in ECRSw NP and non-ECRSw NP group.Results:1.Serum EDN levels were significantly higher in patients with ECRSw NP than in those with non-ECRSw NP.2.Serum EDN levels were positively correlated with peripheral blood eosinophil count and percentage,but there was no correlation between serum EDN levels and SNOT-22 score,Lund-Kennedy score and Lund-Mackay score.3.Serum EDN levels have a moderate predictive value for ECRSw NP(AUC =0.816,P <0.05).A cutoff value of 49.29 ng/ml for serum EDN level was able to predict ECRS with 80% sensitivity and 87% specificity.4.Immunohistochemistry analysis revealed intense staining of both EDN and MMP-9 in nasal polyps from patients with ECRSw NP.There was a positive correlation between the expression of EDN protein and MMP-9 protein.Conclusion:1.Serum EDN level has a good predictive diagnostic value for ECRSw NP,and can be used as a serological marker for early diagnosis of ECRSw NP and guiding individualized treatment.2.EDN protein and MMP-9 protein show intense expression in nasal polyps from patients with ECRSw NP,and there is a positive correlation between the two protein,indicating that EDN protein maybe involved in tissue remodeling of ECRSw NP.