Identification of biomarkers for chronic rhinosinusitis

Title

Identification of biomarkers for chronic inflammation of the sinonasal cavities and lower airways

Background

Chronic rhinosinusitis (CRS) is characterized by persistent mucosal inflammation of the sinonasal cavities causing congestion or obstruction of the paranasal sinuses leading to long-lasting and recurrent episodes of fatigue, rhinorrhea, facial pain, breathing difficulties and loss of smell. Hence, individuals with a more severe disease usually needs to visit the hospital repeatedly. There is no cure for CRS, and the treatment is mainly focused on alleviating symptoms with decongestant nasal sprays and anti-inflammatory corticosteroids. However, patients with nasal polyps respond poorly to such medication. Nasal polyps are fluid filled outgrowth of the sinonasal mucosa, which is commonly surgically removed and, in some cases, removed repeatedly due to polyp regrowth. The underlying mechanism for polyp growth is currently unknown. Coexistence with asthma and aspirin-hypersensitivity seems to further increase the severity of the disease. The mucosal inflammatory response varies extensively between individuals with CRS. Although, a specific type of response is believed to trigger further disease progression and polyp growth. Newly developed biopharmaceuticals, with inhibitory effect on specific inflammatory reactions, are currently tested with hopes of reducing the surgical need and to improve the quality of life for individuals with CRS.

Purpose

The aim is to identify biomarkers with the ability to discriminate between clinically relevant endotypes within CRS, based on characteristic inflammatory and clinical features. Moreover, we aim to investigate how relevant biomarkers is affected by novel biopharmaceuticals and if beneficial treatment effects or disease progression can be predicted on an individual level.

Method

Numerous biological samples are collected pre- and post-operatively from the patients with and without CRS at the Ear-nose-throat-clinic, Sophiahemmet. Inflammatory biomarkers are measured in blood, urine, saliva, nasal secretions and mucosal tissues, and correlated to disease severity and treatment with novel biopharmaceuticals. Disease severity will be based on degree of polyp(s), co-existing airway comorbidities, and other clinical features; reduced nasal airflow, lung capacity, olfaction and health-related quality of life.

Importance

Relapse of nasal polyps causes great discomfort and lowered quality of life for individuals with CRS who needs repeated surgical intervention. Predictive biomarkers may aid the process of diagnosis, anticipate the preferred medical treatment at an individual level and give insights how effective surgery will be. Hence, predictive biomarkers may improve the disease management substantially, improving the life for individuals with CRS.

Research principal

Sophiahemmet University

Financier

Sophiahemmet Foundation and Astma och allergiförbundet

Contact

Project leader: Maria Kumlin, Professor, Sophiahemmet University. Research group: Marie Svedberg, associate professor, Sophiahemmet University, Mattias Jangard, PhD, otolaryngologist, Sophiahemmet, Michael Ryott, PhD, otolaryngologist, Sophiahemmet, Axel Nordström, PhD student, Sophiahemmet University