To the Editor,
Chronic rhinosinusitis (CRS) is a common otorhinolaryngological disease with a high global incidence and a significant impact on the patient’s quality of life. It is often divided into chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) according to the phenotype, together with division into eosinophilic CRS (eCRS) and noneosinophilic CRS (non-eCRS) according to the endotype [1]. Associations between ABO blood groups and various diseases have been reported [2]. However, little is known of the relationship between ABO blood groups and CRS. Therefore, the objective of this study was to explore the association between ABO blood groups and CRS to determine which blood types predominate in the different subtypes of the disease.
This retrospective study included consecutive CRS patients who received surgical treatment at our hospital between 2012 and 2022. The diagnosis of CRS was based on the European position paper on rhinosinusitis and nasal polyps (EPOS) 2012 [3]. Complete blood counts, blood type tests, and sinus computed tomography examinations were conducted on all patients in the week before surgery and the results of these, together with demographic data, were collected. Patients were divided into eCRS and non-eCRS groups according to the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis scores [4] and parameters were compared between the groups using chi-square tests. P < 0.05 was considered statistically significant.
A total of 1,352 patients with CRS were included in the study. The demographic and clinical characteristics of the patients are presented in Table S1; http://links.lww.com/PA9/A59. Initial investigation of the association between the A, B, AB, and O blood types and CRS phenotypes showed no significant correlation (Fig. 1A). The relationships between the different blood types and CRS endotypes were then analyzed but the results were also not statistically significant (Fig. 1B). Based on previous literature reports, the distribution of different CRS subtypes in individuals with type-O and non-type-O blood groups was then evaluated. The results showed that there were significantly fewer type-O individuals in the CRSwNP group than in the CRSsNP group (P = 0.0029) (Fig. 1C), while no significant differences between the different endotypes were observed (Fig. 1D).
Figure 1.
The composition ratio of ABO blood types in different subtypes of CRS. CRS, chronic rhinosinusitis; CRSsNP, chronic rhinosinusitis without nasal polyps; eCRS, eosinophilic chronic rhinosinusitis; non-CRSwNP, chronic rhinosinusitis with nasal polyps; non-eCRS, noneosinophilic chronic rhinosinusitis.
ABO blood types are closely associated with various conditions and diseases. However, little is known about the relationship between the ABO blood type and nasal diseases. Dahalan et al. conducted a scoping review of the correlation between ABO blood types and allergic diseases, revealing a significant association. These authors observed that individuals with blood group O were more susceptible to allergic rhinitis and asthma compared with those with non-O blood groups [5]. In a study on nasal polyps, Jelavic et al. examined the distribution of ABO and RhD blood groups in patients with nasal polyposis to determine whether specific blood group phenotypes were associated with susceptibility or protection against nasal polyps. No relationship between blood group and the development of nasal polyps was observed [6]. The findings of the present study also found no significant correlation between ABO blood groups and different CRS phenotypes and endotypes. Interestingly, however, individuals with blood group O were found to be significantly less likely to have CRSwNP than CRSsNP. Previous studies have demonstrated that blood type O is linked to a higher incidence of infectious diseases, including cholera, plague, tuberculosis, mumps, norovirus, and Helicobacter pylori. Glycosylation polymorphisms in ABO blood groups may influence host–pathogen interactions, resulting in variations in susceptibility among individuals with differing glycosylation profiles [7]. However, for CRS, the underlying mechanism remains unclear and requires further investigation.
The study has several limitations. First, the study was purely descriptive and did not address the underlying mechanisms. Additionally, it is important to note that both ABO blood types and CRS are influenced by factors such as geography and ethnicity.
In conclusion, the present study did not support a link between the ABO blood type and CRS. Future research should focus on conducting more comprehensive studies with larger samples from different regions and ethnicities.
Conflicts of interest
The authors have no financial conflicts of interest.
Author contributions
All authors contributed to the study conception and design. LY, SL, and ZZ performed data collections. ZQ and XH performed data analysis. LY wrote the first draft of the manuscript. LW and YJ commented on previous versions of the manuscript. YJ provided financial support for the research process. All authors read and approved the final manuscript.
Supplementary material
Table S1 can be found via 10.5415/apallergy.2022.12.e38
Table S1
Click here to view
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