Nasal Cytology as a Biomarker of Inflammatory Respiratory Pathology Type 2: Results of a Cross-Sectional Analysis

The epidemiological, clinical and phenotypic correlation between asthma and chronic rhinosinusitis (CRS), in particular with nasal polyps (CRSwNP), type 2 inflammatory respiratory pathologies, spread and addressed the research for a biomarker able to identify different phenotypes in asthma and CRSwNP at first, but also monitoring the effect of therapy, giving a right prognostic value in treatment. The nasal cytology has been proposed in this study as the biomarker: 31 patients (diagnosed as “severe or difficult-tocontrol asthma) were subjected to nasal cytology and were divided, on the basis of rhinocyte observation on the optic microscope in 5 categories: NARES (non-allergic rhinitis with eosinophilia), NARMA (NAR with mastocytosis), NARESMA, NARNE (neutrophils) and some patients had a normal cytology. In the study have been valued: CRSwNP, ASA hypersensibility atopia, mycotype specific IgE and staphylococcus toxins, total IgE, current and maximum eosinophilic count, oral corticosteroid treatment (OCS), TC score according with Lund-Mackay; it was evaluate the treatment with biological drugs (immunoclonal antibody). Patients with type 2 inflammatory respiratory pathology with asthma (severe or difficult-to-control) and CRSwNP associated the nasal cytology can provide a differentiation of patients in phenotype with eosinophilia (NARES), from the one with mastocytosis (NARMA). Blood eosinophilia, atopy, ongoing use of systemic treatment (OCS, biological drugs) do not appear to effect on the cytology panel).