The diagnostic importance of periostin as a biomarker in chronic rhinosinusitis with nasal polyp

Serum and Tissue Periostin Expression in Unilateral Benign Lesions of the Nose and the Paranasal Sinuses

Background/Objectives: Periostin's role in the pathogenesis of inflammatory diseases, particularly in the nose and paranasal sinuses, is an area of growing interest. This study aims to evaluate the expression of periostin in mucoceles, inverted papillomas, choanopolyps and retention cysts. Methods: Tissue samples collected during functional endoscopic sinus surgery (FESS) were analyzed for POSTN gene mRNA expression using qPCR. Periostin protein levels were measured via ELISA and Western Blot. Serum periostin levels were also assessed through ELISA in both patients (n = 54) and controls (n = 12). Results: A total of 66 participants were recruited, including 18 with inverted papillomas, 10 with mucoceles, 10 with choanopolyps, 16 with retention cysts and 12 controls. There were no significant alternations between tissue and serum samples of inverted papilloma compared to the control group. Choanopolyp tissues exhibited elevated POSTN protein expression, though POSTN mRNA and serum levels remained unchanged. In mucoceles, periostin levels were significantly elevated in both tissues and serum. Retention cyst tissues demonstrated an increase in POSTN mRNA and protein expression, whereas serum periostin levels remained consistent with those observed in the control group. Conclusions: The findings suggest that periostin may play a role in the pathophysiology of benign non-neoplastic lesions of the nose and paranasal sinuses such as mucoceles, retention cysts and choanopolyps, highlighting a need for more investigation in this subject.

Effect of antihypertensive treatment on the quality of life of patients with chronic rhinosinusitis with nasal polyps

AIM

Nasal polyposis (CRSwNP) shares type 2 inflammation biomarkers with asthma, allergy or arterial hypertension (AH), including periostin, a predictive marker of severity and post-surgical recurrence of polyposis. Antihypertensives have been shown to decrease periostin expression. We set out to evaluate the effect of antihypertensives on the quality of life of patients with CRSwNP.

MATERIALS AND METHODS

Retrospective study of 43 patients with CRSwNP and ah with at least 1year of follow-up and antihypertensive treatment prescribed after the diagnosis of CRSwNP. Phenotypes were analyzed (F1: isolated CRSwNP; F2: CRSwNP with asthma and/or NERD) and aspects related to quality of life (SNOT-22), clinical severity (VAS), polypoid size (NPS), exacerbations and surgical needs after the initiation of antihypertensive treatment.

RESULTS

The predominant phenotype was F1 (62.8%). The number of exacerbations was 19.2% for F1, compared to 31.3% for F2. 34.8% underwent surgery after the start of antihypertensive treatment (F1=27.9% and F2=6.97%). A significant reduction in polypoid size, SNOT22 (16.4±19.6 points), and VAS scales (p<.05) was obtained.

CONCLUSIONS

polypoid size, and reduce the risk of postoperative recurrence.

The functional role and the clinical application of periostin in chronic rhinosinusitis

INTRODUCTION

Chronic rhinosinusitis (CRS) comprises several heterogenous groups, now classified based on endotype more often than on phenotype. A number of studies aimed at finding a useful biomarker for type 2 CRS suggest that periostin is a promising surrogate.

AREAS COVERED

A comprehensive overview of the clinical significance of tissue periostin expression and serum periostin in CRS patients is provided. The effects of comorbid asthma on serum periostin and samples other than serum in which periostin can be detected in CRS patients are also discussed. Moreover, the functional roles of periostin in CRS pathogenesis are summarized.

EXPERT OPINION

The position of periostin as a signature biomarker of type 2 CRS has been well established, enabling us to classify CRS patients by endotyping. Serum periostin is useful not only for endotyping CRS patients, but also for estimating disease severity, comorbidity, prognosis, and response to treatment, and in particular, predicting recurrence after surgery. However, it remains to be addressed how we apply serum periostin to using biologics for CRS patients. Further studies aimed at showing periostin to be a therapeutic target for CRS are awaited.

Effects of Pendrin Protein in Nasal Epithelial Cells on Mucin Production in the Context of Type 2 Inflammation

Background: Chronic rhinosinusitis (CRS) is a heterogeneous disease. The pathogenesis of chronic sinusitis is still unclear; however, the nasal cavity and paranasal sinuses are commonly affected by type 2 inflammation, which is caused by Th2 cytokines such as interleukin (IL)-5, IL-4, and IL-13. Previous studies have shown that pendrin promotes local infiltration of neutrophils through the production of human neutrophil elastase (HNE), which is essential for the secretion of mucin 5AC (MUC5AC) in chronic inflammatory diseases of the lower respiratory tract. This study investigated pendrin expression and its relationship to mucin in type 2 inflammation. Methods: A total of 40 patients (10 CRS patients with nasal polyps,10 CRS patients without nasal polyps, and 20 nasal septum deviation patients) were included in this study and were divided into the CRS group and the NC group. A normal nasal mucosa tissue culture model was established in vitro. IL-13 was used to stimulate primary cultures of human nasal epithelial cells (HNECs). Western blot (WB), enzyme-linked immunosorbent assay (ELISA), and quantitative real-time polymerase chain reaction (qRT-PCR) were used to detect the expression of pendrin, MUC5AC, and MUC5B. After transfecting HNECs with siRNA pendrin or negative control (NC), EGF receptor (EGFR), HNE, MUC5AC, and MUC5B expression were analyzed using qRT-PCR, WB, or ELISA in terms of their relationships with pendrin. Pendrin expression in the tissue was also analyzed. Results: After IL-13 stimulation, pendrin, MUC5AC, and MUC5B expression levels were upregulated; the optimal concentration of IL-13 was 50 ng/mL. The expression levels of HNE, EGFR, MUC5AC, and MUC5B were downregulated after transfection with siRNA pendrin-1650. Pendrin expression in the NC group was lower than in the CRS group. Conclusion: IL-13 is implicated in the inflammation of nasal mucosa, and pendrin is closely related to the excessive secretion of mucin. The expression of mucin is downregulated after transfection with siRNA pendrin. There is a positive relationship between pendrin and EFGR/HNE. Moreover, pendrin plays an important role in type 2 inflammation.