Interactive Effects of IL-33 and CCL-11 in the Recurrence of Nasal Polyps in Patients with Allergic Rhinitis

Guojiang LI; Juan WANG; Yan LIN

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Guojiang LI, Juan WANG, Yan LIN. Interactive Effects of IL-33 and CCL-11 in the Recurrence of Nasal Polyps in Patients with Allergic Rhinitis[J]. Journal of Kunming Medical University.

Citation:

Guojiang LI, Juan WANG, Yan LIN. Interactive Effects of IL-33 and CCL-11 in the Recurrence of Nasal Polyps in Patients with Allergic Rhinitis[J]. Journal of Kunming Medical University.

Guojiang LI, Juan WANG, Yan LIN. Interactive Effects of IL-33 and CCL-11 in the Recurrence of Nasal Polyps in Patients with Allergic Rhinitis[J]. Journal of Kunming Medical University.

Citation:

Guojiang LI, Juan WANG, Yan LIN. Interactive Effects of IL-33 and CCL-11 in the Recurrence of Nasal Polyps in Patients with Allergic Rhinitis[J]. Journal of Kunming Medical University.

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Interactive Effects of IL-33 and CCL-11 in the Recurrence of Nasal Polyps in Patients with Allergic Rhinitis

Department of Otorhinolaryngology，Xindu District People's Hospital of Chengdu，Chengdu Sichuan 610500，China

Abstract

Abstract

Objective To investigate the interaction effects of serum interleukin-33 （IL-33） and CC-modified chemokine 11 （CCL-11） on the recurrence of nasal polyps in patients with nasal polyps complicated by allergic rhinitis. Methods A total of 145 patients with nasal polyps complicated by allergic rhinitis admitted to Xindu District People's Hospital of Chengdu from January 2020 to May 2023 were selected, all of whom underwent endoscopic sinus surgery. Based on the examination results at 1 year postoperatively, the patients were divided into a recurrence group （n = 42） and a non-recurrence group （n = 103）. Baseline data and preoperative and 1-week postoperative serum IL-33 and CCL-11 levels were compared between the two groups. The correlations of serum IL-33 and CCL-11 levels with the visual analogue scale （VAS） score and the modified Lund-Kennedy endoscopic score （LKS） were analyzed. Logistic regression was used to analyze factors associated with nasal polyp recurrence in patients with nasal polyps complicated by allergic rhinitis, as well as the interaction between serum IL-33 and CCL-11 on nasal polyp recurrence in these patients. Receiver operating characteristic （ROC） curve analysis was performed to evaluate the predictive value of serum IL-33 and CCL-11 levels for nasal polyp recurrence in patients with nasal polyps complicated by allergic rhinitis. Results The 1-week postoperative VAS and LKS scores, serum IL-33 and CCL-11 levels, and the ratios of 1-week postoperative to preoperative values in the recurrence group were all higher than those in the non-recurrence group, with statistically significant differences （P < 0.05）. Correlation analysis showed that the ratios of serum IL-33 and CCL-11 in patients with nasal polyps complicated by allergic rhinitis were both positively correlated with the ratios of VAS and LKS scores（P < 0.05）. Serum IL-33 and CCL-11 levels at 1 week postoperatively were both independent influencing factors for nasal polyp recurrence in patients with nasal polyps complicated by allergic rhinitis （P < 0.05）. The ratios of serum IL-33 and CCL-11 both had an effect on nasal polyp recurrence in these patients （P < 0.05）. There was no multiplicative interaction between the ratios of serum IL-33 and CCL-11 （P > 0.05）. When both the serum IL-33 and CCL-11 ratios were exposed, the risk of nasal polyp recurrence in patients with nasal polyps complicated by allergic rhinitis was 4.221 times that of non-exposure. When both serum IL-33 and CCL-11 ratios were exposed simultaneously, the risk of nasal polyp recurrence was higher than the sum of the risks of exposure to each alone （RERI = 2.807, 95%CI = 1.734～5.639）, and the synergistic effect was 2.840 times the sum of the individual effects （SI = 2.840, 95%CI = 1.882～6.137）; when both were present, 49% of the risk of nasal polyp recurrence was attributable to their synergistic effect on the additive scale （AP = 0.494, 95%CI = 0.207～0.613）. The AUC values of the serum IL-33 and CCL-11 ratios for predicting nasal polyp recurrence in patients with nasal polyps complicated by allergic rhinitis were 0.758 and 0.766, respectively, indicating certain predictive efficacy. The combined prediction of nasal polyp recurrence using the serum IL-33 and CCL-11 ratios yielded the largest AUC value of 0.873, which was significantly higher than the AUC values of each alone, with the optimal sensitivity and specificity being 78.57% and 79.61%, respectively. In addition, 80 patients with nasal polyps complicated by allergic rhinitis admitted to Xindu District People's Hospital of Chengdu from May 2022 to May 2024 were selected as an external validation set; all underwent endoscopic sinus surgery after admission, with 24 cases of recurrence and 56 cases of non-recurrence at 1 year postoperatively. The combined prediction using serum IL-33 and CCL-11 levels at 1 week postoperatively identified 22 cases of recurrence and 58 cases of non-recurrence, with a prediction accuracy of 95.00% （76/80）, indicating good agreement between the model predictions and the actual outcomes （χ²=10.824, P < 0.05）. Conclusion Serum IL-33 and CCL-11 are closely associated with nasal polyp recurrence in patients with nasal polyps complicated by allergic rhinitis, and a synergistic effect between the two may exist on the additive scale. Monitoring postoperative changes in serum IL-33 and CCL-11 levels can provide a reference basis for the clinical prediction of nasal polyp recurrence and for the development of targeted follow-up intervention plans.
- Allergic rhinitis,
- Nasal polyps,
- Nasal endoscopic resection,
- Recurrence,
- Interleukin-33,
- CC modifies chemokine 11

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