Cytokine Profile in the Upper Airways of Patients With N-ERD Obtained via a Minimally Invasive Method.

Introduction: NSAID-exacerbated respiratory disease (N-ERD) is a bronchial asthma phenotype characterized by the coexistence of NSAID hypersensitivity, lower airway symptoms, and severe chronic sinusitis with nasal polyps. This study examined the cytokine profiles in the upper airways of patients with N-ERD compared to those of patients with NSAID-tolerant asthma, allergic rhinitis (AR), and healthy controls. Methods: 89 patients were included in the N-ERD, AR, asthma, and control groups. The minimally invasive nasosorption technique was used to collect nasal mucosal lining fluid. Inflammatory mediators were quantified using a Bio-Plex Multiplex System. Results: IL-6 levels in nasal samples (NSs) were higher in all patient groups than in the controls. No significant differences were observed in the nasal levels of all analyzed cytokines between patients with N-ERD and those with asthma or AR alone. Cluster analysis identified two distinct inflammatory phenotypes within the N-ERD group based on nasal cytokine profiles, although these did not correlate with clinical features. A logistic regression model showed that only serum TNF-α levels and the severity of nasal obstruction significantly differentiated patients with N-ERD from the other groups. Conclusion: The results demonstrate that while patients with N-ERD exhibit heterogeneity in upper airway inflammatory profiles, this does not necessarily translate into differences in clinical presentation.