Nasal cytology: Cornerstone and future directions in precision nasal disease management

作者：Yuan Zhang, Luo Zhang · 发表于：Asia Pacific Allergy · 年份：2025 · DOI：10.5415/apallergy.0000000000000239 · 被引用次数：5 · 研究领域：Sinusitis and nasal conditions、Allergic Rhinitis and Sensitization、Nasal Surgery and Airway Studies

Nasal cytology (NC) has reemerged in precision rhinology as a key diagnostic tool that bridges microscopic cellular patterns with macroscopic clinical decisions, providing a unique, real-time, minimally invasive, and cost-effective approach. Different types of rhinitis show distinct NC manifestations. In bacterial rhinitis, NC reveals dense neutrophil infiltration, often with intracellular and extracellular bacteria; in allergic rhinitis (AR), it shows abundant eosinophilic infiltration and mast cells [1,2]. However, the true strength of NC lies in its ability to transcend traditional symptom-based classifications by identifying specific cellular profiles—such as eosinophils, mast cells, and neutrophils—thereby enabling endotype-driven and personalized treatment strategies [3,4]. In chronic rhinosinusitis with nasal polyps (CRSwNP) management, it identifies the eosinophil-mast cell inflammatory endotype, which is closely associated with disease severity and recurrence risk [5]. The development of the Clinical-Cytological Grading and the Prognostic Index of Relapse allows for risk stratification based on cytological findings, guiding targeted therapeutic strategies, including the selection of candidates for biologic therapies [3,6]. Furthermore, NC enables dynamic monitoring of treatment response; for instance, cytological changes following dupilumab treatment can precede clinical improvement, offering an objective measure of efficacy [7]. NC enables inflammatory phenotyping o...