Article record

慢性鼻窦炎伴鼻息肉生物制剂治疗期间鼻后嗅觉恢复：一项同步进行鼻前嗅觉评估的前瞻性纵向研究

Retronasal olfactory recovery during biologic therapy for chronic rhinosinusitis with nasal polyps: a prospective longitudinal study with parallel orthonasal assessment.

临床研究鼻科IF 4.9Q1

文献信息

PMID	42958882
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	P Boscolo-Rizzo 查看其他 12 位作者 L Raimondo；G Spinato；A Tracanelli；E Provenzano；M Tattoni；G Giunta；E Biancoli；F Copersito；A Maniaci；L A Vaira；G Tirelli；G Ottaviano
作者单位	Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy. 查看其他 4 条单位信息 Division of Otolaryngology, Humanitas Gradenigo Hospital, Torino, Italy.；Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy.；Department of Medicine and Surgery, University of Enna Kore, Enna, Italy.；Department of Medicine, Surgery and Pharmacy, Maxillofacial Surgery Operative Unit, University of Sassari, Sassari, Italy.
期刊	Rhinology
SCI 分区	Q1
IF	4.9
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

背景： 嗅觉功能障碍是慢性鼻窦炎伴鼻息肉（CRSwNP）的关键特征。虽然生物制剂可改善鼻前嗅觉，但关于鼻后功能的纵向数据以及不同炎症靶点之间的差异仍然有限。本研究评估了生物制剂治疗期间鼻后嗅觉随时间的恢复情况，并比较了IL-4/IL-13与IL-5通路阻断。
方法： 在这项前瞻性纵向研究中，开始使用生物制剂的成人重度CRSwNP患者在基线以及第4、12和24周后接受评估。鼻前嗅觉采用Sniffin' Sticks（TDI）测量，鼻后功能采用经过验证的20项识别测试评估。临床结局包括鼻息肉评分（NPS）、峰值鼻吸气流量和SNOT-22。采用重复测量方差分析评估纵向变化及时间与治疗的交互作用。
结果： 共纳入69例患者（44例dupilumab，25例mepolizumab）。基线时，平均TDI为15.0，鼻后评分为7.2，提示严重损害。所有结局随时间均显著改善。鼻后功能在4周内迅速改善（7.2至10.4）。TDI逐渐升高（24周时从15.0升至26.0）。在鼻后识别、TDI、SNOT-22和NPS方面观察到显著的时间与治疗交互作用，提示恢复模式不平行，与mepolizumab相比，dupilumab与鼻后功能和症状的更大改善相关。
结论： 生物制剂治疗可使CRSwNP患者的鼻后和鼻前嗅觉均获得显著恢复，且具有不同的时间动态。鼻后功能显示快速改善，可能对IL-4/IL-13阻断特别敏感，支持其作为生物制剂治疗反应早期功能标志物的潜在作用。

英文摘要

BACKGROUND: Olfactory dysfunction is a key feature of chronic rhinosinusitis with nasal polyps (CRSwNP). While biologics improve orthonasal olfaction, longitudinal data on retronasal function and differences between inflammatory targets remain limited. This study evaluated retronasal olfactory recovery over time during biologic therapy and compared IL-4/IL-13 versus IL-5 pathway blockade.
METHODS: In this prospective longitudinal study, adults with severe CRSwNP starting biologics were assessed at baseline and after 4, 12, and 24 weeks. Orthonasal olfaction was measured using Sniffin' Sticks (TDI), and retronasal function with a validated 20-item identification test. Clinical outcomes included nasal polyp score (NPS), peak nasal inspiratory flow, and SNOT-22. Repeated-measures ANOVA was used to evaluate longitudinal changes and time-by-treatment interactions.
RESULTS: Sixty-nine patients were included (44 dupilumab, 25 mepolizumab). At baseline, mean TDI was 15.0 and retronasal score 7.2, indicating severe impairment. All outcomes improved significantly over time. Retronasal function improved rapidly within 4 weeks (7.2 to 10.4). TDI increased progressively (15.0 to 26.0 at 24 weeks). Significant time-by-treatment interactions were observed for retronasal identification, TDI, SNOT-22, and NPS, indicating non-parallel recovery patterns with dupilumab being associated with greater improvements in retronasal function and symptoms compared with mepolizumab.
CONCLUSIONS: Biologic therapy leads to substantial recovery of both retronasal and orthonasal olfaction in CRSwNP, with distinct considetemporal dynamics. Retronasal function shows rapid improvement and may be particularly sensitive to IL-4/IL-13 blockade, supporting its potential role as an early functional marker of response to biologic therapy.