Section: 
Science articles
Science articlesApplication of eosinophil-neutrophil index eni and degree of inflammatory infiltration to assess the inflammatory process in polypous rhinosinusitis
E. L. Savlevich (1), (2), L. V. Gaganov (3), V. I. Egorov (2), O. M. Kurbacheva (4), E. S. Mitrofanova (5), T. G. Pelishenko (6), E. V. Lyubimova (7)
(1) Central State Medical Academy of Department for Presidential Affairs of the Russian Federation, Moscow, 121359, Russia, (2) Vladimircky Moscow Regional Clinical Research Institute, Moscow, 129090, Russia, (3) City Clinical Hospital No. 51, Moscow, 121309, Russia, (4) NRC Institute of Immunology FMBA of Russia, Moscow, 115478, Russia, (5) Federal Research and Clinical Center FMBA of Russia, Moscow, 115682, Russia, (6) Clinical hospital №(1) of Department for Presidential Affairs of the Russian Federation, Moscow, 12135(2) Russia, (7) LLC „LOR clinic“, Ekaterinburg, 620130, Russia
UDK: УДК 616.211-002-006-031.81:576.31
DOI: https://doi.org/10.18692/1810-4800-2022-5-70-81
ABSTRACT
Introduction. Identification of the cellular composition of polyps in polypous rhinosinusitis (PRS) is important. In practice, to determine the quantitative indicators of the number and ratio of eosinophilic and neutrophilic leukocytes in polyp tissue, the eosinophil-neutrophil index (ENI) was introduced, which is equal to the ratio of the arithmetic mean number of eosinophils to the arithmetic mean number of neutrophils in 10 considered fields of view at a magnification of the microscope ×400, and the indicator degree of cellular inflammatory infiltration. Objective. To conduct a pathomorphological study of the tissue of resected nasal polyps with the determination of ENI parameters and the degree of cellular inflammatory infiltration in various PRS phenotypes and evaluate the possibility of using these indicators as predictors of PRS drug control. Materials and methods. We examined 292 people (126 men, 166 women), mean age 52.12±13.04 years, with bilateral PRS, which were divided into 4 phenotypic groups: I group: PRS without concomitant bronchial asthma (BA) and respiratory allergies; IIa group: PRS + allergic BA (aBA) and allergic rhinitis (AR); IIb group: PRS + AR without BA; III group: PRS + nonallergic BA (nBA). During pathological examination, polyps were divided into 3 histological types: «eosinophilic,» «neutrophilic,» and «mixed»; the ENI index was determined, 3 degrees of inflammatory infiltration were established: weak (I degree) when the arithmetic mean of eosinophils, lymphocytes, neutrophils, macrophages, histiocytes, and mast cells in 10 representative fields of view does not exceed 200 cells; moderate (II degree) when the arithmetic mean varies from 201 to 400 cells; and significant (III degree) where the arithmetic mean is > 400 cells. In the PRS+BA groups, the state of BA control was determined using the ACQ-7 (Asthma Control Questionnaire). An analysis of the dynamics of ENI indicators and the degree of inflammatory infiltration was carried out depending on the effectiveness of conservative therapy with topical glucocorticoids (GCs) during the observation period of 1 year. The patients were divided into 3 groups: group 1, patients with positive dynamics, with a decrease in the degree of nasal polyps; group 2, the severity of polyps remained at the same level; group 3, the prevalence of polyps was higher than a year ago. Results. In all phenotypes of PRS, the eosinophilic type of inflammation prevails. The minimum indicators of ENI (11 [6;16]) and the degree of inflammatory infiltration (1 [1; 1]) were in the PRS +AR group, the highest intensity of inflammation was found in the PRS+nBA group (2.03 [2; 2]). According to the cellular composition of polyps in group 1, eosinophilic polyps were 87%; neutrophilic, 8%; mixed type, 5%; in group 2a, 97% of eosinophilic and 3% of mixed type in the absence of neutrophilic polyps, in group 2b ORS + AR, eosinophilic polyps were detected in 100%; in group 3, eosinophilic 88%, neutrophilic 6%, and mixed polyps 6% were diagnosed. Changes in ENI parameters and the intensity of inflammatory infiltration depending on the effectiveness of conservative therapy were revealed. In the group with positive dynamics, there was a decrease in these two indicators after 6 months of usin
Publication date:
18.09.2022
Keywords:
polypous rhinosinusitis (PRS), eosinophil-neutrophil index (ENI), severity of inflammatory infiltrate, eosinophils, neutrophils, phenotypes, pathological examination, bronchial asthma (BA). For citation:
Savlevich E. L., Gaganov L. V., Egorov V. I., Kurbacheva O. M., Mitrofanova E. S., Pelishenko T. G., Lyubimova E. V. Application of eosinophil-neutrophil index eni and degree of inflammatory infiltration to assess the inflammatory process in polypous rhinosinusitis. Rossiiskaya otorinolaringologiya. 2022;21(5):70-81. https://doi.org/10.18692/1810-4800-2022-5-70-81