Patients with chronic rhinosinusitis with nasal polyps who had a higher concentration of Charcot-Leyden crystals in nasal secretions were more likely to respond to glucocorticoid therapy, according to a study published in the Journal of Allergy and Clinical Immunology.
The concentration of Charcot-Leyden crystals in the nasal secretions of patients with chronic rhinosinusitis with nasal polyps was measured by enzyme-linked immunosorbent assay. Associations were then analyzed between the concentration of Charcot-Leyden crystals measured and patient response to oral glucocorticoid therapy. Response to glucocorticoid therapy was measured by the nasal polyp size scoring (NPSS) system following 2 weeks of treatment.
Of the 89 participants enrolled in the study, 48 had changes in NPSS >1 point and were considered responders, and 41 patients had changes in NPSS <1 point and were considered nonresponders. Furthermore, the average concentration of Charcot-Leyden crystals in nasal secretions was significantly higher in patients in the responder group than in patients in the nonresponder group (105.3 ng/mL vs 0.646 ng/mL; P <.001).
“Considering the efficacy and accuracy of [glucocorticoid] therapy, it is important to predict [glucocorticoid] response of patients prior to administration of [glucocorticoid] therapy for long periods,” the researchers wrote. “[O]ur study has demonstrated that [Charcot-Leyden crystal] concentration in nasal secretions is a suitable noninvasive biomarker that could predict [glucocorticoid] response for [chronic rhinosinusitis with nasal polyps] patients.”
Wu D, Yan B, Wang Y, Zhang L, Wang C. Charcot-Leyden crystal concentration in nasal secretions predicts clinical response to glucocorticoids in patients with chronic rhinosinusitis with nasal polyps [published April 16, 2019]. J Allergy Clin Immunol. doi:10.1016/j.jaci.2019.03.029