Serum IgG4 as a biomarker reflecting pathophysiology and post-operative recurrence in chronic rhinosinusitis

Aiko Oka, Takahiro Ninomiya, Tazuko Fujiwara, Soshi Takao, Yasuharu Sato, Yuka Gion, Akira Minoura, Shin ichi Haruna, Naohiro Yoshida, Yasunori Sakuma, Kenji Izuhara, Junya Ono, Masami Taniguchi, Takenori Haruna, Takaya Higaki, Shin Kariya, Takahisa Koyama, Tetsuji Takabayashi, Yoshimasa Imoto, Masafumi SakashitaMasanori Kidoguchi, Kazunori Nishizaki, Shigeharu Fujieda, Mitsuhiro Okano

Research output: Contribution to journalArticle

Abstract

Background: Type 2 chronic rhinosinusitis (CRS), especially eosinophilic CRS (ECRS), is an intractable upper airway inflammatory disease. Establishment of serum biomarkers reflecting the pathophysiology of CRS is desirable in a clinical setting. As IgG4 production is regulated by type 2 cytokines, we sought to determine whether serum IgG4 levels can be used as a biomarker for CRS. Methods: Association between the serum IgG4 levels and clinicopathological factors was analyzed in 336 CRS patients. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value of serum IgG4 levels that can be used to predict the post-operative recurrence. Results: Serum IgG4 levels were significantly higher in patients with moderate to severe ECRS versus those with non to mild ECRS. The levels were also significantly higher in asthmatic patients and patients exhibiting recurrence after surgery compared to controls. ROC analysis determined that the best cut-off value for the serum IgG4 level to predict the post-operative recurrence was 95 mg/dL. The corresponding sensitivity and specificity were 39.7% and 80.5%, respectively. When we combined the two cut-off values for the serum IgG4 and periostin, patients with high serum levels of either IgG4 or periostin exhibited a high post-operative recurrence (OR: 3.95) as compared to patients having low serum levels of both IgG4 and periostin. Conclusions: The present results demonstrate that the serum IgG4 level is associated with disease severity and post-operative course in CRS. In particular, the combination of serum IgG4 and periostin could be a novel biomarker that predicts post-operative recurrence.

Original languageEnglish
Pages (from-to)417-423
Number of pages7
JournalAllergology International
Volume69
Issue number3
DOIs
Publication statusPublished - Jul 2020

Keywords

  • Chronic rhinosinusitis
  • Eosinophils
  • IgG4
  • Severity
  • Surgery

ASJC Scopus subject areas

  • Immunology and Allergy

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    Oka, A., Ninomiya, T., Fujiwara, T., Takao, S., Sato, Y., Gion, Y., Minoura, A., Haruna, S. I., Yoshida, N., Sakuma, Y., Izuhara, K., Ono, J., Taniguchi, M., Haruna, T., Higaki, T., Kariya, S., Koyama, T., Takabayashi, T., Imoto, Y., ... Okano, M. (2020). Serum IgG4 as a biomarker reflecting pathophysiology and post-operative recurrence in chronic rhinosinusitis. Allergology International, 69(3), 417-423. https://doi.org/10.1016/j.alit.2019.12.004