Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) is an endotype of chronic rhinosinusitis with nasal polyps characterized by more severe symptoms, a stronger association with asthma and a greater recurrence risk. It is unknown whether DNA hydroxymethylation could influence ECRSwNP. Hydroxymethylated DNA immunoprecipitation sequencing was carried out in three distinct groups (control, ECRSwNP and NECRSwNP). Additional qRT-PCR, immunohistochemistry and analysis of the receiver operating characteristic curve were performed. Between ECRSwNP and NECRSwNP, 26 genes exhibited differential DNA hydroxymethylation. Consistent with their hydroxymethylation level, , and expression levels were significantly different between ECRSwNP and the other two groups. The receiver operating characteristic curve revealed that mRNA has a high predictive accuracy for ECRSwNP. DNA hydroxymethylation regulates the expression of multiple genes in ECRSwNP. mRNA was markedly decreased in ECRSwNP polyps and can predict ECRSwNP.
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