{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T22:10:28Z","timestamp":1785190228043,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic Rhinosinusitis (CRS) is a common condition causing a significant worldwide burden, affecting 5%\u201312% of the general population. CRS is classified into type 2 and non-type 2 disease based on endotype dominance. Type 2 inflammation is distinguished by the presence of IL-4, IL-5, and IL-13 cytokines, along with eosinophil and mast cell activation and recruitment. Evidence of type 2 inflammation is ascertained by tissue eosinophil count &amp;gt;10\/high-power field (HPF) or serum eosinophil &amp;gt;250\u2005cells\/mcL or total immunoglobulin E (IgE)\u2009&amp;gt;\u2009100\u2005IU\/ml.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the prevalence and characteristics of type 2 inflammation in patients who presented with nasal polyps and underwent Endoscopic Sinus Surgery (ESS) in Saudi Arabia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cross-sectional Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was conducted among patients who presented with nasal polyps and underwent ESS at King Saud University Medical City (KSUMC) from 2015 to 2020. Patients with nasal\/sinus diseases other than Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) were excluded. Demographic data, olfaction status, and co-morbidities were collected, and radiological images were evaluated. Type 2-CRS was determined by meeting at least one of three predictor criteria (blood eosinophils \u2265250\u2005cells\/mcL, tissue eosinophils \u226510\/HPF, or total IgE levels \u2265100\u2005IU\/ml). Blood parameters and histopathologic analysis were obtained for each patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 381 patients included in the study, the prevalence of type 2-CRS, based on the EPOS2020 criteria, was 99.7% in our population. Among these patients, 47.5% had hyposmia, 38.8% had anosmia, and 13.6% had normal olfaction. The most prevalent co-morbidity was allergic rhinitis, followed by bronchial asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study aimed to determine the prevalence of type 2 inflammation among patients Diagnosed with CRSwNP and underwent ESS in Saudi Arabia. The results showed a prevalence of 99.7%, indicating that almost all recorded patients with CRSwNP in our population had type 2 inflammation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2024.1421140","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T04:29:52Z","timestamp":1720585792000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence of type 2 inflammation in patients with chronic rhinosinusitis with nasal polyps in Saudi Arabia"],"prefix":"10.3389","volume":"11","author":[{"given":"Ahmad","family":"Aldajani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Alroqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Alramyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nujud","family":"Alhejin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Alswayyed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed A.","family":"Alrajban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saud","family":"Alromaih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad O.","family":"Aloulah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz S.","family":"Alrasheed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surayie","family":"Aldousary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Alsaleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"82","DOI":"10.4193\/Rhin20.601","article-title":"Executive summary of EPOS 2020 including integrated care pathways","volume":"58","author":"Fokkens","year":"2020","journal-title":"Rhinology"},{"key":"B2","volume-title":"Recurrent Acute Rhinosinusitis","author":"Sharma","year":"2022"},{"key":"B3","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1016\/j.jaci.2011.03.051","article-title":"Using biomarkers in the assessment of airways disease","volume":"128","author":"Taylor","year":"2011","journal-title":"J Allergy Clin Immunol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1002\/alr.21032","article-title":"Structured histopathology profiling of chronic rhinosinusitis in routine practice","volume":"2","author":"Snidvongs","year":"2012","journal-title":"Int Forum Allergy Rhinol"},{"key":"B5","author":"Fokkens","year":""},{"key":"B6","author":"Mmiksgaard","year":""},{"key":"B7","doi-asserted-by":"publisher","first-page":"239","DOI":"10.2332\/allergolint.10-RAI-0231","article-title":"Eosinophilic chronic rhinosinusitis in Japan","volume":"59","author":"Ishitoya","year":"2010","journal-title":"Allergol Int"},{"key":"B8","doi-asserted-by":"publisher","first-page":"89","DOI":"10.31436\/imjm.v16i2.332","article-title":"Prevalence of eosinophilic\/non eosinophillic nasal polyps and analysis of their presentation in Hospital Universiti Sains Malaysia Kelantan, Malaysia","volume":"16","author":"Ramza Ramli","year":"2017","journal-title":"Int Med J Malays"},{"key":"B9","first-page":"689","article-title":"Clinical and histopathological classification of nasal polyps in Thais","volume":"54","author":"Jareonchharsri","year":"2002","journal-title":"Siriraj Hosp Gaz"},{"key":"B10","doi-asserted-by":"publisher","first-page":"73","DOI":"10.4103\/sjoh.sjoh_18_22","article-title":"Changes in the histological characteristics of patients from a Southern Saudi population with chronic rhinosinusitis with nasal polyps over time","volume":"24","author":"Magboul","year":"2022","journal-title":"Saudi J Otorhinolaryngol Head Neck Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2812","DOI":"10.1016\/j.jaip.2019.05.009","article-title":"Associations between inflammatory endotypes and clinical presentations in chronic rhinosinusitis","volume":"7","author":"Stevens","year":"2019","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.1016\/j.jaci.2008.02.018","article-title":"T-cell regulation in chronic paranasal sinus disease","volume":"121","author":"van Bruaene","year":"2008","journal-title":"J Allergy Clin Immunol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1111\/j.1398-9995.2006.01225.x","article-title":"Differentiation of chronic sinus diseases by measurement of inflammatory mediators","volume":"61","author":"van Zele","year":"2006","journal-title":"Allergy"},{"key":"B14","doi-asserted-by":"publisher","first-page":"54","DOI":"10.4193\/Rhin09.078","article-title":"Chronic sinusitis and rhinitis: clinical terminology \u201cchronic rhinosinusitis\u201d further supported","volume":"48","author":"van Crombruggen","year":"2010","journal-title":"Rhinology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1016\/j.jaci.2009.05.017","article-title":"Distinct immunopathologic characteristics of various types of chronic rhinosinusitis in adult Chinese","volume":"124","author":"Cao","year":"2009","journal-title":"J Allergy Clin Immunol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"137","DOI":"10.3109\/00016488709134709","article-title":"A histological study of formation and growth of nasal polyps","volume":"103","author":"Kakoi","year":"1987","journal-title":"Acta Otolaryngol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1017\/S0022215112000771","article-title":"Nasal polyposis in patients with asthma and allergic rhinitis","volume":"126","author":"Ahmadiafshar","year":"2012","journal-title":"J Laryngol Otol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"231","DOI":"10.2500\/108854196778662246","article-title":"Epidemiology of nasal polyps","volume":"17","author":"Settipane","year":"1996","journal-title":"Allergy Asthma Proc"},{"key":"B19","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1373\/jalm.2018.026526","article-title":"Component-resolved diagnosis in allergic rhinitis and asthma","volume":"3","author":"Eiringhaus","year":"2019","journal-title":"J Appl Lab Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1111\/j.1365-2222.2009.03439.x","article-title":"Nasal eosinophilia: an indicator of eosinophilic inflammation in asthma","volume":"40","author":"Amorim","year":"2010","journal-title":"Clin Exp Allergy"},{"key":"B21","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1111\/j.1398-9995.2008.01841.x","article-title":"Predictors of bronchial hyperresponsiveness in chronic rhinosinusitis with nasal polyp","volume":"64","author":"Han","year":"2009","journal-title":"Allergy"},{"key":"B22","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1007\/s11882-010-0096-0","article-title":"Rhinosinusitis and asthma: a link for asthma severity","volume":"10","author":"Bachert","year":"2010","journal-title":"Curr Allergy Asthma Rep"},{"key":"B23","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1016\/j.otohns.2009.01.027","article-title":"The comparison of histopathological characteristics of polyps in asthmatic and nonasthmatic patients","volume":"140","author":"Ardehali","year":"2009","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1111\/j.1365-2273.2005.00969.x","article-title":"Activated eosinophils in nasal polyps: a comparison of asthmatic and non-asthmatic patients","volume":"30","author":"Bateman","year":"2005","journal-title":"Clin Otolaryngol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1067\/mai.2002.122458","article-title":"Chronic sinusitis in severe asthma is related to sputum eosinophilia","volume":"109","author":"ten Brinke","year":"2002","journal-title":"J Allergy Clin Immunol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1111\/j.1398-9995.2005.00830.x","article-title":"EAACI Position paper on rhinosinusitis and nasal polyps executive summary","volume":"60","author":"Fokkens","year":"2005","journal-title":"Allergy"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2210","DOI":"10.1002\/lary.26555","article-title":"Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients","volume":"127","author":"Lavin","year":"2017","journal-title":"Laryngoscope"},{"key":"B28","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1002\/alr.21687","article-title":"A pilot study of symptom profiles from a polyp vs an eosinophilic-based classification of chronic rhinosinusitis","volume":"6","author":"Thompson","year":"2016","journal-title":"Int Forum Allergy Rhinol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1177\/1945892418779451","article-title":"Systemic predictors of eosinophilic chronic rhinosinusitis","volume":"32","author":"Ho","year":"2018","journal-title":"Am J Rhinol Allergy"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1080\/1744666X.2020.1679626","article-title":"Endotype-driven precision medicine in chronic rhinosinusitis","volume":"15","author":"Lou","year":"2019","journal-title":"Expert Rev Clin Immunol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.jaci.2012.07.047","article-title":"Omalizumab is effective in allergic and nonallergic patients with nasal polyps and asthma","volume":"131","author":"Gevaert","year":"2013","journal-title":"J Allergy Clin Immunol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1016\/j.jaci.2017.05.044","article-title":"Reduced need for surgery in severe nasal polyposis with mepolizumab: randomized trial","volume":"140","author":"Bachert","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.jaip.2019.07.016","article-title":"Dupilumab efficacy in uncontrolled, moderate-to-severe asthma with self-reported chronic rhinosinusitis","volume":"8","author":"Maspero","year":"2020","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jcm10153346","article-title":"Short term Pre-operative oral corticosteroids-tissue remodeling in chronic rhinosinusitis with nasal polyps","volume":"10","author":"Radajewski","year":"2021","journal-title":"J Clin Med"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1421140\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T04:29:56Z","timestamp":1720585796000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1421140\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,10]]},"references-count":34,"alternative-id":["10.3389\/fsurg.2024.1421140"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2024.1421140","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,10]]},"article-number":"1421140"}}