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Increased serum amyloid A in nasal polyps is associated with systemic corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps: a pilot study

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

Serum amyloid A (SAA) was involved in the pathogenesis of glucocorticoid resistance in lung diseases. However, their association with systemic corticosteroid insensitivity in chronic rhinosinusitis with nasal polyps (CRSwNP) patients remains to be assessed.

Methods

This study enrolled 32 CRSwNP patients to evaluate the association between SAA expression in NP and corticosteroid insensitivity, and the value of polyp SAA level for predicting the response to oral corticosteroids in CRSwNP patients. All patients were given a course of oral prednisone (30 mg daily for 2 weeks) and subdivided into glucocorticoid(GC)-sensitive and -insensitive subgroup according to the change in polyp size scores. The polyp specimens were obtained before and after corticosteroid treatment. SAA levels in polyp tissues were evaluated by enzyme-linked immunosorbent assay and quantitative reverse transcription polymerase chain reaction. Regression analysis was performed to analyze the association between SAA protein levels and corticosteroid insensitivity.

Results

13/32 (40.62%) CRSwNP patients were insensitive to the oral corticosteroid therapy. SAA mRNA and protein levels were significantly increased in GC-insensitive NP compared to those in GC-sensitive NP. Tissue SAA protein levels were positively correlated with tissue neutrophil numbers. Regression analysis revealed tissue SAA levels were significantly correlated with corticosteroid insensitivity (P < 0.01). ROC curves indicated that the area under the curve was 0.87. When the polyp SAA protein level was 122.2 ng/ml or higher, the sensitivity and specificity were 76.92 and 73.68%, respectively.

Conclusions

Our findings suggest that increased SAA in NP is associated with reduced response to oral corticosteroids in CRSwNP. SAA levels in NP may have potential value in predicting corticosteroid insensitivity in CRSwNP patients.

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Acknowledgements

The study was supported by Grants from National Natural Science Foundation of China (no. 81500768), the Natural Science Foundation of Guangdong Province, China (no. 2014A030310392) and the Science and Technology Planning Project of Guangdong Province, China (no. 2016A020215049).

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Authors and Affiliations

  1. Department of Otolaryngology, Shantou Central Hospital, Shantou, 515030, China

    Hangui Lu, Xin-Sheng Lin, Dan-Mian Yao, Ying-Ying Zhuang & Guo-Feng Wen

  2. Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, Guangdong, China

    Jianbo Shi & Yue-Qi Sun

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  1. Hangui Lu
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  2. Xin-Sheng Lin
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  3. Dan-Mian Yao
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  5. Guo-Feng Wen
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  6. Jianbo Shi
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Correspondence to Jianbo Shi or Yue-Qi Sun.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the first affiliated hospital of Sun Yat-sen University and the Shantou Central Hospital research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Lu, H., Lin, XS., Yao, DM. et al. Increased serum amyloid A in nasal polyps is associated with systemic corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps: a pilot study. Eur Arch Otorhinolaryngol 275, 401–408 (2018). https://doi.org/10.1007/s00405-017-4809-z

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  • DOI: https://doi.org/10.1007/s00405-017-4809-z

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