Introduction This study aims to investigate the cellular composition of the nasal mucous membranes
and the inflammatory cells of patients suffering from chronic sinusitis with nasal
polyps undergoing Dupilumab therapy. The correlation between nasal differential cytology
and therapy response is investigated in order to evaluate the diagnostic value of
differential cytology as a predictive marker for Dupilumab therapy and as a marker
for therapy monitoring.
Methods 22 CRSwNP- Patients with the indication of Dupilumab therapy have been included in
the study so far. In total, five study visits are conducted from the beginning of
therapy in an interval of 3 months, with ambulatory nasal differential cytology. First,
the samples are stained with the May-Grunwald-Giemsa method (MGG) and the percentage
of cells is analyzed. An immunocytochemical (ICC) ECP- staining is performed to detect
eosinophilic granulocytes. Additionally, during each study visit the polyp score,
SNOT20 questionnaire and the total IgG concentration in peripheral blood is recorded.
Results So far in both MGG and ICC- analysis a significant decrease of eosinophilic cells
can be seen throughout the therapeutic process, which correlates with a decrease of
the polyp score and the SNOT20 questionnaire.
Discussion The nasal differential cytology, as a non-invasive biomarker, has the potential to
predict the success of cost intensive Dupilumab therapy in order to allow optimal
and personalised therapy planning and management for CRSwNP patients.
