Abstract
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory disease characterized by prolonged symptoms and frequent recurrences. According to clinical and pathological characteristics, patients can be classified into different endotypes. Limited data exist on the endotype distribution of CRSwNP in Southern China. OBJECTIVE: This study aimed to delineate the clinical characteristics and inflammatory endotypes of CRSwNP in Southern China, with a focus on the impact of asthma and allergic comorbidities on disease severity and recurrence. METHODS: This multi-center, cross-sectional study analyzed 375 adult patients with CRSwNP from 3 hospitals in Southern China. Patients were classified into type 2 and non-type 2 endotypes based on clinical criteria, including blood eosinophil counts, serum immunoglobulin E levels, and tissue eosinophil percentages. Data on demographics, clinical symptoms, comorbidities, and histopathological features were collected. Statistical analyses identified factors associated with disease severity and recurrence. RESULTS: Among the 375 patients, 75.7% had type 2 CRSwNP. Patients with type 2 CRSwNP, particularly those with asthma, had more severe symptoms and lower quality of life scores than those with non-type 2 CRSwNP. Allergic rhinitis (AR) was associated with a higher risk of recurrence but not with disease severity. Middle-aged and older patients were more likely to exhibit type 2 features and asthma as a comorbidity. CONCLUSIONS: Type 2 CRSwNP is predominant in Southern China, with significant implications for disease management. The presence of asthma as a comorbidity exacerbates symptoms and reduces quality of life. AR as a comorbidity was not relevant to the severity of CRSwNP.