MicroRNAs: Potential Biomarkers of Disease Severity in Chronic Rhinosinusitis with Nasal Polyps

The Emerging Role of MicroRNAs in Nasal Inflammatory Diseases and Tumors: From Bench to Bedside

BACKGROUND/OBJECTIVES

MicroRNAs (miRNAs) play a crucial role in regulating immune responses and have been implicated in the pathogenesis of various nasal diseases, including chronic rhinosinusitis (CRS), allergic rhinitis (AR), and sinonasal tumors. This review comprehensively explores the emerging role of miRNAs in inflammatory and oncological nasal diseases, highlighting their diagnostic, prognostic, and therapeutic potential.

METHODS

A comprehensive review of the literature was conducted to summarize current findings on miRNA expression in nasal inflammatory conditions and tumors. Key studies evaluating miRNA-mediated regulatory mechanisms, potential biomarker applications, and therapeutic approaches were analyzed.

RESULTS

Altered miRNA expression profiles contribute to the pathogenesis of CRS, AR, and sinonasal tumors. Specific miRNAs, such as miR-125b and miR-155 are upregulated in CRS and AR, promoting inflammation and tissue remodeling. In sinonasal tumors, dysregulated miRNAs, including miR-126 and miR-34/miR-449 clusters, influence tumor progression and therapeutic response. Exosome-mediated miRNA delivery emerges as a promising avenue for precision medicine, offering novel strategies for miRNA-based diagnostics and therapies.

CONCLUSIONS

miRNAs are key regulators of nasal diseases, with potential applications in non-invasive diagnostics and targeted therapies. Further research into miRNA-based interventions may improve treatment outcomes and contribute to the development of personalized medicine approaches for nasal inflammatory disorders and malignancies.

Epigenetic Mechanisms in CRSwNP: The Role of MicroRNAs as Potential Biomarkers and Therapeutic Targets

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory disease of the upper airway, contributing significantly to the global disease burden. CRSwNP is characterized by sustained and exaggerated inflammation, accompanied by marked changes in gene and protein expression regulated through intricate molecular mechanisms. MicroRNAs (miRNAs), small single-stranded RNA molecules that regulate gene expression at transcriptional and post-transcriptional levels, have emerged as pivotal players in CRSwNP pathophysiology. Dysregulated miRNA expression is implicated in numerous human diseases, including cancer, asthma, and inflammatory disorders, highlighting their broad clinical relevance. In CRSwNP, miRNAs influence important inflammatory pathways, including T2 immune responses and epithelial-mesenchymal transition (EMT), which leads to chronic inflammation and tissue remodeling. Profiling studies have identified specific miRNAs as potential biomarkers for disease severity, prognosis, and therapeutic response, offering a pathway to personalized medicine. Furthermore, advances in small extracellular vesicles (sEVs) and exosomes, which naturally transport miRNAs, provide innovative avenues for targeted miRNA delivery, minimizing systemic side effects. This review explores current knowledge on miRNA expression and function in CRSwNP, emphasizing their role in disease pathogenesis and their potential as biomarkers and therapeutic targets.

Machine Learning Model Predicts Postoperative Outcomes in Chronic Rhinosinusitis With Nasal Polyps

OBJECTIVE

Evaluating the possibility of predicting chronic rhinosinusitis with nasal polyps (CRSwNP) disease course using Artificial Intelligence.

METHODS

We prospectively included patients undergoing first endoscopic sinus surgery (ESS) for nasal polyposis. Preoperative (demographic data, blood eosinophiles, endoscopy, Lund-Mackay, SNOT-22 and depression PHQ scores) and follow-up data was standardly collected. Outcome measures included SNOT-22, PHQ-9 and endoscopy perioperative sinus endoscopy (POSE) scores and two different microRNAs (miR-125b, miR-203a-3p) from polyp tissue. Based on POSE score, three labels were created (controlled: 0-7; partial control: 8-15; or relapse: 16-32). Patients were divided into train and test groups and using Random Forest, we developed algorithms for predicting ESS related outcomes.

RESULTS

Based on data collected from 85 patients, the proposed Machine Learning-approach predicted whether the patient would present control, partial control or relapse of nasal polyposis at 18 months following ESS. The algorithm predicted ESS outcomes with an accuracy between 69.23% (for non-invasive input parameters) and 84.62% (when microRNAs were also included). Additionally, miR-125b significantly improved the algorithm's accuracy and ranked as one of the most important algorithm variables.

CONCLUSION

We propose a Machine Learning algorithm which could change the prediction of disease course in CRSwNP.

MicroRNA-125b Is a Potential Predictor of Surgical Outcomes in Chronic Rhinosinusitis with Nasal Polyps

BACKGROUND

Despite advances in surgical techniques, recurrence rates after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP) remain high and difficult to predict.

OBJECTIVE

This study aimed to evaluate the potential role of microRNA 125b (miR-125b) in predicting disease evolution following ESS.

METHODS

We conducted a prospective study including patients undergoing first ESS for CRSwNP in our department between January 2020 and November 2021. We determined miR-125b levels from nasal polyps and pursued a standardized follow-up for at least 18 months for each patient.

RESULTS

A total of 86 patients were included in the study. Higher postoperative endoscopy scores were associated with more severe disease at presentation on computed tomography scan, presence of concomitant asthma, and higher values of miR-125b. Even after multivariate repeated measures analysis and adjustments for confounders, miR-125b remained statistically significant. Moreover, miR-125 was the most important factor in predicting disease evolution at 18 months.

CONCLUSION

A clear, robust relation between nasal polyp control evaluated through objective measures and miR-125b values was observed. This finding indicates the potential role of miR-125b in predicting the course of the disease following ESS.