{"doi":"10.1002/alr.70027","title":"Factor Analysis‐Based Quantitative Endotyping Improves Associations With CRS Cross‐Sectional and Longitudinal Outcomes","abstract":"BACKGROUND: Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disease characterized by persistent sinonasal inflammation. There is increasing interest in endotype-based classification, which categorizes CRS based on underlying inflammatory pathways. We applied factor analysis to facilitate continuous endotype assignment to CRS patients and assess cross-sectional and longitudinal CRS outcomes. METHODS: We prospectively enrolled 203 patients (52 controls, 88 CRSsNP, and 63 CRSwNP) undergoing endoscopic nasal or sinus surgery (ESS). Middle meatal mucus biomarkers were analyzed pre-ESS (V0) and 6-12 months post-ESS (V1). Factor analysis was performed to identify latent factors. Factor scores were generated, and statistical analyses were conducted to assess correlations with radiographic (Lund-Mackay [LM]) and patient-reported (SNOT-22, CRS-PRO) outcomes measured at V0, V1, and V2 (1.5-5 years post-ESS). RESULTS: Four factors were identified: Type 1 (T1), Type 2 (T2), Type 3 (T3), and macrophage-associated (M). CRSwNP patients had higher T2 and M factor scores than CRSsNP and controls. T2, T3, and M factor scores demonstrated stronger or equivalent associations with radiographic and patient-reported outcomes compared to individual biomarkers. Following ESS, median T2 and M factor scores significantly declined, while T1 and T3 remained stable. V0 T1 and T2 were weakly associated with long-term (V2) radiographic and symptom scores. V1 factor scores were more consistently predictive of long-term (V2) outcomes, with T2, T3, and M demonstrating modest correlations with radiographic severity and CRS-PRO. CONCLUSIONS: Factor analysis identifies distinct, quantifiable patterns of inflammation in CRS, offering improved associations with cross-sectional and longitudinal outcomes compared to individual biomarkers.","journal":"International Forum of Allergy & Rhinology","year":2025,"id":554242,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9486,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1393816,"name":"Zhidi Luo","orcid":"0009-0006-7475-179X","position":1,"is_corresponding":false},{"id":1451503,"name":"Aditi Agarwal","orcid":"0009-0006-8532-6094","position":2,"is_corresponding":false},{"id":1052050,"name":"Siyuan Dong","orcid":"0000-0001-8719-137X","position":3,"is_corresponding":false},{"id":1262544,"name":"Regan L. Harmon","orcid":null,"position":4,"is_corresponding":false},{"id":848058,"name":"Junqin Bai","orcid":"0000-0001-6012-2809","position":5,"is_corresponding":false},{"id":238071,"name":"Chun‐Kang Liao","orcid":"0000-0002-0037-1421","position":6,"is_corresponding":false},{"id":710969,"name":"Julia Huang","orcid":null,"position":7,"is_corresponding":false},{"id":480724,"name":"David B. Conley","orcid":"0000-0002-2611-6795","position":8,"is_corresponding":false},{"id":480725,"name":"Kevin C. Welch","orcid":"0000-0003-4863-7206","position":9,"is_corresponding":false},{"id":386199,"name":"Robert C. Kern","orcid":"0000-0002-8995-9175","position":10,"is_corresponding":false},{"id":520504,"name":"Stephanie S. Smith","orcid":"0000-0002-0605-3993","position":11,"is_corresponding":false},{"id":233266,"name":"Anju T. Peters","orcid":"0000-0003-0745-2379","position":12,"is_corresponding":false},{"id":233265,"name":"Whitney W. Stevens","orcid":"0000-0002-2608-6610","position":13,"is_corresponding":false},{"id":262060,"name":"Atsushi Kato","orcid":"0000-0001-9144-3138","position":14,"is_corresponding":false},{"id":212508,"name":"Lutfiyya N. Muhammed","orcid":"0000-0001-8655-1484","position":15,"is_corresponding":false},{"id":348700,"name":"Bruce K. Tan","orcid":"0000-0001-9210-5050","position":16,"is_corresponding":false},{"id":1128852,"name":"Brooke N. Gleason","orcid":"0009-0008-5614-4990","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-19T02:54:50.112989Z","pmid":"41004123","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}