Improved Patient Convenience Compared to Tissue Biopsy
A new method has been developed to distinguish between different types of chronic rhinosinusitis using nasal mucus.
On August 8, Professor Na Minseok from the Department of Otorhinolaryngology at Severance Hospital, Professor Moon Seojin from the Department of Otorhinolaryngology at Yongin Severance Hospital, and Dr. Moon Seongmin from the Department of Otorhinolaryngology at Yonsei University College of Medicine announced that their research team has found that type 2 chronic rhinosinusitis can be diagnosed by analyzing proteins present in nasal mucus. The results of this study were published in the European journal Allergy (IF 12.0).
Chronic rhinosinusitis is a chronic inflammatory disease that occurs in the mucous membranes of the nasal cavity and paranasal sinuses. The main symptoms include nasal congestion, runny nose, facial pain or pressure, and reduced sense of smell.
Chronic rhinosinusitis is broadly classified into type 2 and non-type 2 based on the pattern of inflammation. Since type 2 and non-type 2 have different pathogenesis and treatment responses, accurate pre-diagnosis is crucial for developing precise treatment plans tailored to each type. The most accurate way to diagnose type 2 is through pathological examination of mucosal tissue, but this involves invasive procedures such as surgery or tissue biopsy, which are burdensome for patients and time-consuming, making them difficult to apply in routine clinical practice.
To address this, the research team identified biomarkers that can diagnose type 2 chronic rhinosinusitis in a non-invasive way by using nasal mucus, a specimen that can be easily collected without causing pain or discomfort to patients.
The team collected nasal mucus and nasal mucosal tissue samples from patients with chronic rhinosinusitis and, through single-cell RNA sequencing, identified the CST1 gene, which showed increased expression in type 2 inflammatory epithelial cells, as a candidate marker. When comparing nasal mucus samples from type 2, non-type 2, and healthy groups using immunofluorescence staining and enzyme-linked immunosorbent assay, they found that the expression of cystatin SN protein produced by the CST1 gene was significantly higher only in the type 2 group.
The level of cystatin SN protein in nasal mucus showed a significant correlation with clinical indicators such as symptom severity and degree of olfactory dysfunction, and also accurately reflected the degree of type 2 inflammation in tissue. In addition, ROC curve analysis was performed to evaluate the predictive accuracy of cystatin SN protein in nasal mucus. Compared to previously suggested blood markers, it demonstrated superior predictive accuracy. The AUC value, which indicates higher predictive accuracy the closer it is to 1, was 0.894.
Professor Na Minseok said, "To realize personalized precision medicine based on individual inflammatory patterns in patients with chronic rhinosinusitis, it is important to identify the patient's inflammatory pattern before starting treatment. This study is significant in that it has discovered a new biomarker that can predict type 2 inflammation with high accuracy using the simple specimen of nasal mucus."
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