At the recent American Rhinologic Society, Combined Otolaryngology Spring Meeting (ARS-COSM) in Boston, Massachusetts (May 4-5, 2023), a team of researchers from the University of Utah School of Medicine, Salt Lake City, UT, presented a study highlighting the gene transcriptional changes between chronic rhinosinusitis (CRS) patients with allergic rhinitis (CRSwAR) and without AR (CRSsAR).
CRS is a clinical syndrome associated with relentless inflammation of the sinuses. It is characterized by significant physical impairment, adversely impacting patient quality of life and psychosocial well-being. AR or hay fever is an atopic disease characterized by symptoms of nasal congestion, sneezing, clear rhinorrhea, postnasal drip, and nasal pruritis. CRS impacts one in six individuals and is associated with significant morbidity, loss of productivity, and healthcare costs.
The study aimed to define the gene transcriptional changes found in CRS patients with AR and those without AR and to correlate these changes with objective CRS disease severity measures. The study identified CRS patients from the ethmoid tissue repository and then compared the mRNA expression levels of 594 genes. Finally, the researchers identified the genes with different expressions and correlated them with the disease severity index.
A total of 13 CRS patients were identified, of which 7 were CRSwAR, and 6 were CRSsAR. Moreover, the female-to-male ratio in CRSwAP was 4:3, while in CRSsAR, it was 2:4. In addition, 3 CRSwAR patients and 2 CRSsAP patients were found to have nasal polyposis.
The researchers also observed that TGFBR1 and LILRB5 were significantly upregulated among the different genes and positively correlated with worsening CRS disease severity in CRSwAR compared to CRSsAR. Furthermore, the TGFBR1 gene was found to be more likely implicated in atopic diseases such as asthma, eczema, AR, and food allergy, while the LILRB5 gene could be involved in mast cell regulation; however, its role in atopic diseases such as AR is not understood.
“Our study identified significant gene transcriptional changes in CRSw/sAR, suggesting that there may be pathophysiological differences in CRS associated with AR.”
The authors highlighted that the retrospective study design, small sample size, and inclusion of only sinus patients were some of the limitations of their study. Therefore, large cohort studies encompassing a broader range of patients and clinical conditions should be conducted to obtain more accurate results.
Reference:
Mahomva C, Smith K, Oakley G, et al. Gene Expression Changes in Chronic Rhinosinusitis with and without Allergic Rhinitis. ARS-COSM. May 4-5, 2023.