Enhanced oxidative stress is associated with tissue neutrophilia and poor steroid response in chronic rhinosinusitis with nasal polyps

Objective To analyze the oxidative stress status and its association with tissue neutrophilia and oral steroid response in chronic rhinosinusitis with nasal polyps (CRSwNP) patients. Methods The levels of total oxidant status (TOS) were detected in the sinonasal tissues by using specific assay kits. Tissue neutrophil was examined by immunohistochemical staining, and oxidant status index (OSI) was evaluated in polyps tissues, and the messenger RNA (mRNA) levels of superoxide dismutase 2 (SOD2), aldehyde dehydrogenase 1 (ALDH1A1), and microsomal glutathione S‐transferase 1 (MGST1) were examined using quantitative real‐time polymerase chain reaction in the sinonasal tissues. The receiver operating characteristics (ROCs) curve of ALDH1A1, MGST1, and SOD2 mRNA levels were evaluated to determine the steroid response of CRSwNP patients. Results The levels of TOS and OSI were significantly higher in CRSwNP and CRSsNP than in normal controls, and OSI in polyps tissues was positively associated with tissue neutrophilia and poor steroid response. The ALDH1A1, MGST1, and SOD2 mRNA levels showed comparable accuracy as predictors of poor steroid response indicated by the area under the curve. Conclusion These findings provided evidence that the increased level of oxidative stress contributes to enhanced tissue neutrophilia and poor steroid response in CRSwNP patients. In brief, oxidative stress plays an important role in the pathogenesis of chronic rhinosinusitis. Hu et al. identified enhanced oxidative stress, especially in chronic rhinosinusitis with nasal polyps patients, which could be associated with tissue neutrophilia and poor steroid response. Antioxidative drug rottlerin and curcumin might be an add‐on therapeutic way. Highlights Total oxidant status and oxidant status index levels, aldehyde dehydrogenase 1,microsomal glutathione S‐transferase 1, and superoxide dismutase 2 messenger RNA levels are significantly increased in chronic rhinosinusitis with nasal polyps (CRSwNP) patients. Oxidase stress contributes to neutrophilic mucous inflammation and poor steroid response in Eastern CRSwNP patients. Rottlerin and curcumin might be used as an add‐on therapy on poor‐steroid‐response (or neutrophilic) CRSwNP patients.