Long-Term Particulate Matter Exposure May Increase Risk of Chronic Rhinosinusitis with Nasal Polyposis: Results from an Exposure-Matched Study

COMMENT: While we would intuitively suspect that pollution may contribute to more severe sinonasal inflammatory disease, progressive interest in PM2.5 (or particulate matter≤2.5 µm in diameter) has begun to produce clearer evidence of the association. This study took the investigation a step further, focusing specifically on cytokine changes and manifestations in chronic rhinosinusitis without nasal polyps (CRSsNP) versus chronic rhinosinusitis with nasal polyps (CRSwNP) phenotypes in the context of PM2.5. They found that reduced IL-10 levels were associated with higher PM2.5 exposure, and PM2.5 exposure was an independent risk factor for CRSwNP in regression analysis. Interestingly, this relationship was not identified in CRSsNP.—Ashoke Khanwalkar, MD