伴鼻息肉的慢性鼻窦炎患者的整合组学内型分型及其对糖皮质激素治疗的反应
Integrated-omics endotyping of patients with chronic rhinosinusitis with nasal polyps and their response to glucocorticoid therapy.
文献信息
| PMID | 42854989 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Bing Yan |
| 作者单位 | Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Beijing Laboratory of Allergic Diseases, Beijing Key Laboratory of New Medicine and Diagnostic Technology Research for Nasal Disease, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing 100005, China; Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing 100005, China. |
| 期刊 | The Journal of allergy and clinical immunology |
| SCI 分区 | Q1 |
| IF | 11.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 整合组学方法可更深入地揭示疾病异质性，但伴鼻息肉的慢性鼻窦炎（CRSwNP）中宿主免疫与鼻腔微生物群联合特征仍缺乏充分表征。
目的： 本研究旨在通过整合鼻腔刷取样本的转录组学和微生物群数据，识别生物学上不同的CRSwNP内型，并评估这些内型对皮质类固醇治疗的反应。
方法： 采用相似性网络融合和层次聚类，整合来自多中心COMPASS队列（ClinicalTrials.gov注册号：NCT05598424）的基线转录组学和微生物群数据。进行差异基因表达和细菌属丰度分析以表征每个内型。在COMPASS队列中，双侧鼻息肉评分（NPS）≥4分的CRSwNP患者被纳入并接受4周鼻内皮质类固醇（INCS）治疗。INCS治疗后NPS仍≥4分的患者接受2周附加全身皮质类固醇（SCS）治疗。使用χ2或Fisher精确检验比较各内型之间的应答率。
结果： 在来自中国20家医院的132例患者中，识别出四种内型：一种非2型炎症内型（聚类A）和三种以微生物群组成区分的2型炎症内型：以棒状杆菌为主的特征（聚类B）、以葡萄球菌为主的特征（聚类C）和多种微生物特征（聚类D）。在接受附加SCS治疗的患者中，聚类C的观察应答率最高（94.1%），其次为聚类D（72.7%）、聚类B（62.5%）和聚类A（56.7%）。
结论： 整合转录组和微生物群分析识别出四种具有不同免疫-微生物特征和可变皮质类固醇反应性的CRSwNP内型，支持在CRSwNP中开展以内型驱动的精准治疗的可能性。
英文摘要
BACKGROUND: Integrated omics approaches provide deeper insights into disease heterogeneity, but combined host immune and nasal microbiota profiles in chronic rhinosinusitis with nasal polyps (CRSwNP) remain poorly characterized.
OBJECTIVE: This study aimed to identify biologically distinct CRSwNP endotypes by integrating transcriptomic and microbiota data from nasal brushings and to assess responses to corticosteroid therapy across these endotypes.
METHODS: Baseline transcriptomic and microbiota data from the multicenter COMPASS cohort (ClinicalTrials.gov registration: NCT05598424) were integrated using similarity network fusion and hierarchical clustering. Differential gene expression and bacterial genus abundance analyses were performed to characterize each endotype. In the COMPASS cohort, patients with CRSwNP who had a bilateral nasal polyp score (NPS) ≥ 4 points were enrolled and received 4 weeks of intranasal corticosteroid (INCS) treatment. Those whose NPS remained ≥4 after INCS treatment received a 2-week course of add-on systemic corticosteroid (SCS) therapy. Response rates were compared across endotypes using χ2 or Fisher's exact tests.
RESULTS: Among 132 patients from 20 hospitals in China, four endotypes were identified: one non-type 2 inflammatory endotype (Cluster A) and three type 2 inflammatory endotypes distinguished by microbiota composition: a Corynebacterium-dominated profile (Cluster B), a Staphylococcus-dominated profile (Cluster C), and a polymicrobial profile (Cluster D). Among patients receiving add-on SCS therapy, Cluster C showed the highest observed response rate (94.1%), followed by Cluster D (72.7%), Cluster B (62.5%), and Cluster A (56.7%).
CONCLUSION: Integrated transcriptome and microbiota analysis identified four CRSwNP endotypes with distinct immune-microbial signatures and variable corticosteroid responsiveness, supporting the potential for endotype-driven precision therapy in CRSwNP.