Correlation between systemic inflammatory response and quality of life in patients with chronic rhinosinusitis

Identification of DIO2 as a Molecular Therapeutic Target for Depression in Chronic Rhinosinusitis: A Comprehensive Bioinformatics and Experimental Study

Chronic rhinosinusitis (CRS) and depression are both common conditions with significant socioeconomic impact. The high co-occurrence of depression in CRS patients suggests a common pathophysiology, but the mechanisms are unclear. This study aimed to identify potential molecular links between the two conditions. We retrieved gene expression datasets for CRS and depression from the GEO database. Using differentially expressed genes (DEGs) analysis and weighted gene co-expression network analysis (WGCNA), we identified co-expression genes associated with CRS and depression. Enrichment analyses including GO, KEGG, and GSEA were performed to explore biological pathways. Machine learning algorithms including random forest and LASSO regression were engaged to screen for shared hub genes predictive of CRS and depression. Single-cell RNA sequencing (scRNA-seq) data were analyzed to delineate the expression profiles of the shared hub genes across different cell types. Animal experiments were employed to validate the role of core genes in CRS-related depression. We identified five shared hub genes: CHRDL1, DIO2, HSD17B6, PDE3A, and PLA2G5, with the TGF-β signaling, cytokine-cytokine interaction receptors, and cell adhesion as key biological pathways. DIO2, as identified by machine learning, is a promising diagnostic biomarker for CRS and depression. The scRNA-seq analysis showed that DIO2 is primarily expressed in neurons and astrocytes. Animal experiments showed that overexpression of DIO2 improved the depressive-like behaviors in CRS mice. This study sheds new light on the molecular basis of the comorbidity between CRS and depression. DIO2 is a potential diagnostic and therapeutic target for CRS patients with comorbid depression.

Cinnamaldehyde reduces inflammatory responses in chronic rhinosinusitis by inhibiting TRPM8 expression

OBJECTIVE

This study aimed to investigate the effects of cinnamaldehyde (CA) intervention on transient receptor potential melastatin 8 (TRPM8) expression in human nasal epithelial cells (HNECs) and mouse models of chronic rhinosinusitis (CRS) and determine the alleviating effects of CA on CRS.

METHODS

HNECs were treated with CA, and the protein levels and mRNA expression of pro-inflammatory cytokines, namely, interleukin-25 (IL-25), IL-33, and thymic stromal lymphopoietin (TSLP), were measured by enzyme-linked immunosorbent assay and real-time reverse-transcription polymerase chain reaction (RT-PCR). TRPM8 expression levels were examined by RT-PCR and western blot. The C57BL/6 mice were randomly divided into three groups (control group, model group, CA group). The model and CA groups were induced by intranasal drip intervention of ovalbumin (OVA) three times a week for 9 weeks. Each mouse was individually observed in a single cage to record the frequency of nose scratching and sneezing within 10 minutes. Histologic examination of nasal mucosa in mice was done using hematoxylin-eosin staining to compare the degree of inflammation. Pro-inflammatory cytokine levels and TRPM8 expression levels were measured in mouse nasal lavage fluid.

RESULTS

In vitro experiments demonstrated that CA intervention in HNECs significantly reduced the protein and mRNA of IL-25, IL-33, TSLP, and TRPM8. In vivo analysis showed that the CA group exhibited fewer nose scratching and sneezing symptoms and reduced nasal mucosal inflammation as well as lower levels of IL-25, IL-33, and TSLP in nasal lavage fluid and tissues than the model group.

Chemokine CCL19 and Its Receptors CCR7 and CCRL1 in Chronic Rhinosinusitis

Background

CCL19 has been shown to predict disease severity in COVID-19 and treatment response in rheumatoid arthritis. CCL19 can exert both pro- and anti-inflammatory effects and is elevated in chronic rhinosinusitis (CRS). However, its role in CRS remains unknown. This study sought to determine the transcriptional changes in CCL19, its receptors, and associated cytokines and their association with disease severity in CRS.

Methods

A clinical database of control subjects and patients with CRS was examined. Lund-Kennedy, Lund-Mackay, Sinonasal Outcomes Test 22 (SNOT-22), and rhinosinusitis disability index (RSDI) scores were collected at enrollment. mRNA was extracted from sinonasal tissues and subjected to multiplex gene expression analysis. Gene transcript differences between patients with CRS and controls were compared and correlated with disease severity metrics. Immunohistochemical analyses of CCL19, CCR7, and CCRL1 were conducted to compare differences in protein expression between cohorts. A subgroup analysis was performed to compare transcriptional and protein expression difference between patients with (CRSwNP) and without (CRSsNP) nasal polyps and controls.

Results

Thirty-eight subjects (control group, n=7; CRS group, n=31) were included in this study. CCRL1 (p=0.0093) and CCR7 (p=0.017) levels were significantly elevated in CRS compared to those in controls. CCL19 (p=0.038) and CCR7 (p=0.0097) levels were elevated in CRSwNP and CCRL1 was elevated in CRSsNP (p=0.0004). CCR7 expression was significantly elevated in sinonasal epithelial cells in CRSwNP (p=0.04). CCL19 expression was positively correlated with TNFA expression (p<0.0002). CCL19 and CCR7 expression was positively correlated with SNOT-22 and RSDI scores (p<0.05).

Conclusion

CCL19 and CCR7 may modulate TNF-α-driven pro-inflammatory signaling and contribute to increased disease severity in CRS. Mechanistic studies are required to further elucidate the role of CCRL1 in CRS.

Evaluation of the incidence of inflammatory and tumor pathology of nose and nasal sinus region

Inflammatory and nasal-sinus tumor pathology is a field of great interest in rhinology worldwide. The aim of the paper is to determine the prevalence of nasal and nasal-sinus inflammatory diseases, as well as nasal and nasosinusal rhinosinusitis tumors, in association or not with inflammatory diseases, using histopathological (HP) examination. It is also desired to identify the association of chronic inflammatory pathology with the tumor one, considering inflammation and immunodeficiency as local susceptibility factors. A retrospective study was performed on a group of 254 patients hospitalized between 2018–2019 in Department of Otorhinolaryngology, Emergency County Hospital, Târgu Mureş, Romania. Based on the clinical and HP examination, the distribution by inflammatory pathologies was made as follows: 175 nasal polyposis, 108 chronic rhinitis, 39 sinusitis – strictly affecting the sinus and 28 chronic polyposis rhinosinusitis – nasal and sinus association. Considering the evaluation of the incidence of benign tumor pathology, the following were found: out of the total examined cases, 4% squamous papilloma, 4% exophytic papilloma, 44% Schneiderian papilloma, 4% benign fibrous histiocytoma, 18% hemangioma, 4% hamartoma, and 4% osteoma were identified. The incidence of malignant tumors is 26% squamous cell carcinoma, 12% intestinal adenocarcinoma, 2% nonintestinal type adenocarcinoma, 2% large B-cell lymphoma, 2% plasma cell, 2% olfactory neuroblastoma, 7% malignant melanoma, 16% basal cell carcinoma. The paper draws attention to the increased incidence of tumor and inflammatory pathology both individually and in combination, considering the involvement of the clinical correlation with the HP result completed, if necessary, with immunohistochemical examinations, for a precise diagnosis.

Decreased retinal nerve fiber and choroidal thickness in chronic rhinosinusitis

PURPOSE

The assessment of the retina and choroid of patients with chronic rhinosinusitis (CRS), via spectral domain-optical coherence tomography (SD-OCT), was aimed in this study. We proposed that chronic upper airway restriction caused by chronic sinusitis could deteriorate the retinal and choroid morphology.

METHODS

This prospective controlled study included a total of 90 eyes of 90 patients, 30 of whom were CRS with nasal polyposis (CRSwNP), 30 of whom were CRS without nasal polyposis (CRSsNP) and 30 of whom were healthy controls (HC). Only the right eye of the patients were evaluated. All patients underwent full otorhinolaryngologic and ophthalmologic examinations, including SD-OCT.

RESULTS

Average retinal nerve fiber layer (RNFL) and RNFL in superior and inferior quadrants were measured significantly lower in CRS patients compared to HC. Ganglion cell-inner plexiform layer (GCIPL) thickness in all sectors was thinner in patients with CRS than in HC with significantly lower values in all sectors except inferior. Mean average GCIPL thickness and GCIPL thickness in the inferior sector were significantly lower in CRSwNP than CRSsNP patients.

CONCLUSION

CRS may lead to thinning in the choroidal thickness, RNFL thickness, especially in the superior and inferior quadrants and GCIPL thickness, presumably related with hypoxia, endothelial dysfunction, inflammation and vascular dysregulation. Ocular manifestations of the CRS should be taken in the consideration during the management of this disease.