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Review
. 2022 Nov;36(6):872-883.
doi: 10.1177/19458924221111830. Epub 2022 Jul 17.

Utilization of Nasal Mucus to Investigate the Pathophysiology of Chronic Rhinosinusitis

Mauricio Parra-Ferro  1 , Jeb M Justice  1   2 , Brian C Lobo  1 , Steven D Munger  1   3   2   4   5 , Rodney J Schlosser  6 , Jennifer K Mulligan  2   7
Affiliations
Review

Utilization of Nasal Mucus to Investigate the Pathophysiology of Chronic Rhinosinusitis

Mauricio Parra-Ferro et al. Am J Rhinol Allergy. 2022 Nov.

Abstract

Background: Nasal mucus is proving to be a useful means by which to study the pathogenesis of chronic rhinosinusitis (CRS). Given the increase in publications examining nasal mucus and the lack of a review on this topic, we will focus on this noninvasive approach to studying CRS. Particular attention will be drawn towards inflammatory cytokines and biomarkers and their influence on disease severity.

Methods: A literature review of papers published in English pertaining to nasal mucus was performed using the PubMed database. The search utilized combinations of the following keywords: sinusitis, polyps, sample collection, nasal mucus, or nasal secretion. Studies solely on acute or bacterial sinusitis, allergic rhinitis, or cystic fibrosis were not included.

Results: A wide variety of materials and methods have been used to collect nasal mucus. Numerous assay types have been performed with the most common being ELISA, cytometric bead array, and proteomics. Most studies have focused on examining the levels of Th1/Th2 cytokines along with chemokines associated with type 2 immunity. Other factors identified include growth factors, senescence-associated proteins, complement, and antimicrobial defenses have also been identified. Nasal mucus cytokines have proven useful in cluster analysis and predicting postoperative improvement in Sino-nasal Outcome Test (SNOT-22) scores. One limitation of the use of nasal mucus is that some studies have suggested that nasal mucus does not always reflect the tissue microenvironment.

Conclusions: Nasal mucus represents a critical tool by which to examine the sinonasal microenvironment in a noninvasive manner. Unlike studies of tissue, it can be utilized in both surgically and medically managed patients and avoids the trauma of biopsies. However, studies are still needed to determine the most effective method for nasal mucus collection. Studies should also take care to confirm that nasal mucus markers do, in fact, reflect the levels of the product studied in the tissue.

Keywords: chemokine; complement; cytokine; cytometric bead array; nasal mucus; nasal polyp; nasal secretion; olfaction; sinusitis; type 2 inflammation.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA-compliant literature review diagram.
See this image and copyright information in PMC

References

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