Calprotectin in nasal secretion: a new biomarker of non-type 2 inflammation in CRSwNP

Eugenio De Corso Silvia Baroni Maria Elisabetta Onori Laura Tricarico Stefano Settimi Giacomo Moretti Eliana Troiani Rodolfo Francesco Mastrapasqua Daniela Furno Fabrizio Crudo Andrea Urbani Jacopo Galli.

Acta Otorhinolaryngol Ital. 2022 Aug;42(4):355-363. doi: 10.14639/0392-100X-N1800.

Abstract

Objective. We analysed calprotectin in sinonasal secretions of different chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes to assess its role as a biomarker of non-type 2 inflammation.

Methods. We included primary diffuse CRSwNP patients (n = 41) and three different control groups [non-allergic rhinitis (NAR) (n = 13), non-allergic eosinophilic syndrome (NARES) (n = 10) and healthy subjects (n = 12)].

Calprotectin levels were detected in nasal secretions using a chemiluminescent immunoassay (CLIA).

Results. Calprotectin levels in nasal secretions were significantly higher in all non-type 2 endotypes of CRSwNP compared to healthy controls (p < 0.05). In contrast, in type-2 CRSwNP calprotectin was significantly lower compared to controls (p < 0.05). A significant correlation between calprotectin levels and neutrophilic count/HPF was found in CRSwNP (p < 0.01). Clinically, mean levels of calprotectin and neutrophilia were significantly higher in patients who previously underwent 3 or more endoscopic sinus surgeries (p < 0.05).

Conclusions. Calprotectin in nasal secretions may be a biomarker of non-type 2 inflammation. Low levels of calprotectin are indicative of a type-2 immune response in both CRSwNP and non-allergic rhinitis. We observed that calprotectin levels significantly increased based on the number of previous surgeries.

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