度普利尤单抗对重度CRSwNP患者鼻腔黏液纤毛清除功能的影响：糖精试验作为客观结局指标的评估
Effects of dupilumab on nasal mucociliary clearance in severe CRSwNP: evaluation of the saccharin test as an objective outcome measure.
文献信息
| PMID | 42806130 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Giulio Pagliuca |
| 作者单位 | Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 伴鼻息肉的慢性鼻窦炎（CRSwNP）是一种慢性、复发性疾病，与生活质量显著受损相关。持续性炎症可导致黏液纤毛清除功能障碍。度普利尤单抗（IL-4Rα抑制剂）是一种成熟的治疗药物，在减少2型炎症和改善对药物和/或手术治疗难治的重度CRSwNP患者生活质量方面已显示出显著疗效。本研究旨在评估度普利尤单抗治疗是否能改善CRSwNP患者的黏液纤毛清除功能。
方法： 纳入21例重度CRSwNP患者。所有患者均根据处方标准接受度普利尤单抗治疗（300 mg皮下注射，每2周一次）。在基线以及第4、8和12周后，患者接受SNOT-22、鼻内镜检查伴鼻息肉评分（NPS）以及使用糖精试验（ST）评估黏液纤毛清除功能。比较各时间点的鼻腔黏液纤毛清除时间（NMCT）值。
结果： SNOT-22、NPS和NMCT均观察到显著改善。使用ST测量的平均NMCT值从基线的14.3分钟降至4周时的10.1分钟（p<.01）、8周时的7.75分钟和12周时的5.84分钟，表明黏液纤毛清除功能呈进行性且具有统计学意义的增强。
结论： 短期度普利尤单抗治疗与重度CRSwNP患者鼻腔黏液纤毛清除功能的显著改善相关。这些初步发现支持糖精试验作为监测生物制剂治疗反应的简单、客观工具的潜在作用。
英文摘要
OBJECTIVE: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic, relapsing condition associated with a significant impairment in quality of life. Persistent inflammation contributes to dysfunction of mucociliary clearance. Dupilumab (IL-4Rα inhibitor) is a well-established therapeutic agent that has demonstrated significant efficacy in reducing type 2 inflammation and improving quality of life in patients with severe CRSwNP refractory to medical and/or surgical treatment. This study aimed to evaluate whether dupilumab therapy improves mucociliary clearance in patients with CRSwNP.
METHODS: Twenty-one patients with severe CRSwNP were enrolled. All received dupilumab (300 mg subcutaneously every 2 weeks) according to prescribing criteria. At baseline and after 4, 8, and 12 weeks, patients underwent evaluation with SNOT-22, nasal endoscopy with Nasal Polyp Score (NPS), and assessment of mucociliary clearance using the saccharin test (ST). Nasal mucociliary clearance time (NMCT) values were compared across time points..
RESULTS: Significant improvements were observed in SNOT-22, NPS, and NMCT. Mean NMCT values measured using the ST values decreased from 14.3 minutes at baseline to 10.1 minutes at 4 weeks (p<.01), 7.75 minutes at 8 weeks, and 5.84 minutes at 12 weeks, indicating a progressive and statistically significant enhancement of mucociliary clearance.
CONCLUSIONS: Short-term dupilumab therapy was associated with a significant improvement in nasal mucociliary clearance in patients with severe CRSwNP. These preliminary findings support the potential role of the saccharin test as a simple, objective tool for monitoring response to biologic therapy.