Non-invasive prediction of olfactory recovery in severe CRSwNP: a cross-compartment translational nomogram based on secretory IL-17A.
9 affiliations
- 1Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
- 2Guangdong Engineering Research Center of Otorhinolaryngology Diagnosis and Treatment, Guangzhou, Guangdong, China.
- 3Otorhinolaryngology Institute of Sun Yat-en University, Guangzhou, Guangdong, China.
- 4Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou, Guangdong, China.
- 5Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of SunYat-Sen University, Guangzhou, China.
- 6Department of Allergy, The First Affiliated Hospital of Sun Yat-sen University, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, Guangdong, China.
- 7Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen Peking University-the Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China.
- 8Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, China.
- 9Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Abstract
Predicting olfactory recovery after surgery for severe chronic rhinosinusitis with nasal polyps (CRSwNP) remains challenging. To overcome the reliance on invasive tissue biopsies, this study aimed to identify non-invasive liquid biopsy biomarkers reflecting the deep mucosal inflammatory microenvironment, ultimately developing a point-of-care prognostic model. A "tissue-to-secretion" dual-cohort validation strategy was employed. A Random Forest (RF) algorithm screened deep-tissue proteomes (Luminex) in a discovery cohort (N = 67). An independent RF model evaluated non-invasive nasal secretions (Olink) in a validation cohort (N = 62). Bidirectionally convergent targets were assessed for continuous dose-response relationships with absolute olfactory improvement [Δ(visual analog scale)VAS] score at 6 months. A clinical-molecular nomogram was developed and internally validated using 1,000 bootstrap resamples. The tissue-based RF identified interleukin (IL)-17A as a core prognostic candidate. The independent secretion-based RF model also prioritized secretory IL-17A, achieving bidirectional convergence. While canonical Type 2 cytokines (IL-5, IL-13) lost predictive significance in secretions (P > 0.05), secretory IL-17A demonstrated a robust dose-response correlation (r = 0.334, P = 0.0003) and emerged as an independent protective factor for olfactory recovery ([odds ratio] OR = 1.408, 95% [confidence interval] CI: 1.03-2.03). The joint nomogram, seamlessly integrating baseline VAS and secretory IL-17A, yielded an optimism-corrected (area under the receiver operating characteristic curve) AUC of 0.793 (95% CI: [0.6908-0.9079]) with adequate calibration and substantial net clinical benefit. Through cross-compartment translation, we identified secretory IL-17A as a robust, non-invasive indicator of mucosal plasticity and olfactory reversibility. The derived joint nomogram provides an actionable framework for personalized pre-operative counseling and risk stratification in severe CRSwNP.
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BibTeX
@article{zhang2026noninvasive,
title = {{Non-invasive prediction of olfactory recovery in severe CRSwNP: a cross-compartment translational nomogram based on secretory IL-17A.}},
author = {Hangtian Zhang and Linlu Wang and Tong Lu and Yilin Hou and Yi Wei and Wenhao Huang and Shaolin Liu and Yanran Huang and Zhaofeng Xu and Jian Li and Weiping Wen and Hua Zhong},
journal = {Frontiers in allergy},
year = {2026},
month = oct,
doi = {10.3389/falgy.2026.1978136},
url = {https://europepmc.org/article/MED/42952741},
note = {CC BY},
}
RIS
TY - JOUR
TI - Non-invasive prediction of olfactory recovery in severe CRSwNP: a cross-compartment translational nomogram based on secretory IL-17A.
AU - Hangtian Zhang
AU - Linlu Wang
AU - Tong Lu
AU - Yilin Hou
AU - Yi Wei
AU - Wenhao Huang
AU - Shaolin Liu
AU - Yanran Huang
AU - Zhaofeng Xu
AU - Jian Li
AU - Weiping Wen
AU - Hua Zhong
PY - 2026
DA - 2026/10/14
JO - Frontiers in allergy
DO - 10.3389/falgy.2026.1978136
UR - https://europepmc.org/article/MED/42952741
AB - Predicting olfactory recovery after surgery for severe chronic rhinosinusitis with nasal polyps (CRSwNP) remains challenging. To overcome the reliance on invasive tissue biopsies, this study aimed to identify non-invasive liquid biopsy biomarkers reflecting the deep mucosal inflammatory microenvironment, ultimately developing a point-of-care prognostic model. A "tissue-to-secretion" dual-cohort validation strategy was employed. A Random Forest (RF) algorithm screened deep-tissue proteomes (Luminex) in a discovery cohort (N = 67). An independent RF model evaluated non-invasive nasal secretions (Olink) in a validation cohort (N = 62). Bidirectionally convergent targets were assessed for continuous dose-response relationships with absolute olfactory improvement [Δ(visual analog scale)VAS] score at 6 months. A clinical-molecular nomogram was developed and internally validated using 1,000 bootstrap resamples. The tissue-based RF identified interleukin (IL)-17A as a core prognostic candidate. The independent secretion-based RF model also prioritized secretory IL-17A, achieving bidirectional convergence. While canonical Type 2 cytokines (IL-5, IL-13) lost predictive significance in secretions (P > 0.05), secretory IL-17A demonstrated a robust dose-response correlation (r = 0.334, P = 0.0003) and emerged as an independent protective factor for olfactory recovery ([odds ratio] OR = 1.408, 95% [confidence interval] CI: 1.03-2.03). The joint nomogram, seamlessly integrating baseline VAS and secretory IL-17A, yielded an optimism-corrected (area under the receiver operating characteristic curve) AUC of 0.793 (95% CI: [0.6908-0.9079]) with adequate calibration and substantial net clinical benefit. Through cross-compartment translation, we identified secretory IL-17A as a robust, non-invasive indicator of mucosal plasticity and olfactory reversibility. The derived joint nomogram provides an actionable framework for personalized pre-operative counseling and risk stratification in severe CRSwNP.
SN - 2673-6101
ER -