Rhinosinusitis with nasal polyposis is a clinical predictor of type 2 inflammation in bronchiectasis: an EMBARC registry analysis

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Introduction: Chronic rhinosinusitis (CRS) and nasal polyposis (NP) are common comorbidities in bronchiectasis. We aimed to assess the prevalence, impact, and association of CRS and NP with type 2 inflammatory biomarkers in people with bronchiectasis. Methods: Using the EMBARC bronchiectasis registry, we categorized patients as having no CRS, CRS with NP (CRSwNP), or CRS without NP (CRSnNP). Regression models assessed the effect of CRS and NP on symptoms and outcomes. A multivariate model evaluated type 2 biomarkers, defined as elevated blood eosinophils or total IgE≥150/μl. Results: Among 16,640 patients, 2,703 (20.9%) had CRSnNP, and 1,223 (7.3%) had CRSwNP. CRS was associated with worse symptoms and more exacerbations but fewer hospitalizations and lower mortality. Type 2 biomarkers were elevated in people with idiopathic bronchiectasis and CRSwNP, but not in those with PCD or immune deficiency. In multivariable analysis, asthma and CRSwNP remained independently linked to elevated type 2 inflammation. Female sex, PCD, and immune deficiency were negatively correlated with type 2 biomarkers (Figure). erj;66/suppl_69/PA5991/F1 F1 F1 Conclusions: CRS is a frequent comorbidity in bronchiectasis and is associated with type 2 inflammation, particularly in idiopathic cases. The relationship between CRS and type 2 biomarkers varies by bronchiectasis aetiology, with no significant association in PCD or immune deficiency.

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