Clinical use of nasal differential cytology for the prediction of therapy response and monitoring of CRSwNP-Patients under Dupilumab – a monocentric, prospective, clinical trial

Introduction This study aims to investigate the cellular composition of the nasal mucous membranes and the inflammatory cells of patients suffering from chronic sinusitis with nasal polyps undergoing Dupilumab therapy. The correlation between nasal differential cytology and therapy response is investigated in order to evaluate the diagnostic value of differential cytology as a predictive marker for Dupilumab therapy and as a marker for therapy monitoring.

Methods 22 CRSwNP- Patients with the indication of Dupilumab therapy have been included in the study so far. In total, five study visits are conducted from the beginning of therapy in an interval of 3 months, with ambulatory nasal differential cytology. First, the samples are stained with the May-Grunwald-Giemsa method (MGG) and the percentage of cells is analyzed. An immunocytochemical (ICC) ECP- staining is performed to detect eosinophilic granulocytes. Additionally, during each study visit the polyp score, SNOT20 questionnaire and the total IgG concentration in peripheral blood is recorded.

Results So far in both MGG and ICC- analysis a significant decrease of eosinophilic cells can be seen throughout the therapeutic process, which correlates with a decrease of the polyp score and the SNOT20 questionnaire.

Discussion The nasal differential cytology, as a non-invasive biomarker, has the potential to predict the success of cost intensive Dupilumab therapy in order to allow optimal and personalised therapy planning and management for CRSwNP patients.

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Artikel online veröffentlicht:
24. Mai 2022