Comparative clinical and airway inflammatory features of asthma with or without nasal polyposis

Background: Nasal polyposis (NP) is associated with a more severe and steroid-resistant asthma. Objective: To compare clinical and airway inflammatory features of asthmatics with or without NP. Methods: Two groups of asthmatic patients were studied: group 1 with NP and group 2 without NP. Asthma control was assessed according to the Asthma Control Scoring System (ACSS). Expiratory flows, induced sputum, and blood eosinophils were also measured. Results: The ACSS score was lower (poorer control) in group 1 compared with group 2. FEV1, and the FEV1/FVC ratio was lower in group 1 compared with group 2. Blood and induced sputum eosinophils, as well as fibronectin and eosinophil cationic protein levels were higher in group 1. Conclusion: Asthmatic subjects with NP have increased airway obstruction, more inflammatory cells and reduced asthma control compared to those without NP. This may suggest a contribution of nasal polyps to the severity of asthma or a common susceptibility to develop upper and lower airways mucosal inflammation.