Rhinologists at the Texas Sinus Institute of the Department of Otorhinolaryngology-Head and Neck Surgery at The University of Texas Medical School at Houston and Memorial Hermann-Texas Medical Center are engaged in research efforts that drive the innovation that provides tomorrow’s advances. The following report was presented at the 56th Annual Meeting of the American Rhinologic Society, held in Boston on September 25, 2010.
Chronic rhinosinusitis (CRS) is grossly divided into two subtypes – CRS with nasal polyps and CRS without nasal polyps. Many studies in the literature have focused on polyps alone as the representative disease. In this study, researchers at UTHealth’s Texas Sinus Institute and otorhinolaryngology department and Memorial Hermann-Texas Medical Center examined the cytokine profiles of two different types of tissue – nasal polyp and inflamed ethmoid mucosa – hypothesizing that the profiles are different.
Study subjects included three controls and 13 patients with CRS with nasal polyps, who were older than 18 and were undergoing a medically indicated sinus surgery. Tissue was harvested over the last year from three sites: the inferior turbinate, which provided a non-diseased control; the nasal polyp; and the inflamed ethmoid sinus mucosa. The tissue was quick frozen in liquid nitrogen and using quantitative RT-PCR, cDNA was isolated by first extracting RNA from the tissue and then generating the cDNA.
The investigators found that representative Th1 and Th2 cytokine gene expressions are not significantly different between inflamed mucosa and nasal polyps; however, there is a trend toward higher Th2 cytokine gene expression in inflamed mucosa. They also reported that protease activated receptor-2 (PAR-2) represents an example cytokine that has statistically different expression within inflamed ethmoid mucosa as compared to nasal polyps and non-diseased mucosa.
“Chronic rhinosinusitis is characterized by the presence of nasal polyps,” says Amber U. Luong, MD, PhD, an assistant professor of otorhinolaryngology—head and neck surgery at the UT Medical School and an assistant professor of immunology at The University of Texas M. D. Anderson Cancer Center. “Our initial study suggests that nasal polyps may not be the only tissue representative of the disease process. Because of the sensitivity of available assays and the observation that cytokine profiles for various tissues within a single patient can be very different, it’s important for researchers in future studies to be very specific about the tissue being analyzed.”
Future research will be aimed at characterizing the genetic expression from the patients studied and examining expression patterns to help differentiate the various subtypes of CRS.