Eosinophil Peroxidase as a Dynamic Indicator of Treatment Response in Eosinophilic Chronic Rhinosinusitis

Jacquelyn K Callander; Annabelle R Charbit; Camryn Marshall; Kritika Khanna; Steven D Pletcher; Jose G Gurrola 2nd; Andrew H Murr; Monica Tang; Andrew N Goldberg; Patricia A Loftus

doi:10.1002/alr.70076

Eosinophil Peroxidase as a Dynamic Indicator of Treatment Response in Eosinophilic Chronic Rhinosinusitis

Int Forum Allergy Rhinol. 2026 Jan;16(1):110-113. doi: 10.1002/alr.70076. Epub 2025 Nov 29.

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA.
² Cardiovascular Research Institute, University of California, San Francisco, California, USA.
³ Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
⁴ Division of Pulmonary, Critical Care, Allergy and Sleep and the Department of Medicine, University of California, San Francisco, California, USA.

Abstract

Eosinophil peroxidase (EPX) correlates with local type 2 inflammation and may serve as a noninvasive biomarker of eosinophilic chronic rhinosinusitis. EPX declines after surgery and dupilumab, highlighting its potential to track treatment response. High baseline EPX predicts patients likely to achieve a clinically meaningful Sinonasal Outcome Test-22 change.

Keywords: biomarker; chronic rhinosinusitis; cytokine; endotype; eosinophil peroxidase; nasal polyp; type 2 inflammation.

MeSH terms

Antibodies, Monoclonal, Humanized / therapeutic use
Biomarkers / metabolism
Chronic Disease
Eosinophil Peroxidase* / metabolism
Eosinophilia* / diagnosis
Eosinophilia* / drug therapy
Eosinophils
Humans
Male
Rhinitis* / diagnosis
Rhinitis* / drug therapy
Rhinitis* / therapy
Rhinosinusitis
Sinusitis* / diagnosis
Sinusitis* / drug therapy
Sinusitis* / therapy
Treatment Outcome

Substances

Eosinophil Peroxidase
Antibodies, Monoclonal, Humanized
Biomarkers
dupilumab