TAS2R38 genotype predicts surgical outcome in nonpolypoid chronic rhinosinusitis.
TAS2R38 genotype predicts surgical outcome in nonpolypoid chronic rhinosinusitis.
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DOI：
10.1002/alr.21666
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发表时间：
2016-01
影响因子：
6.4
通讯作者：
Cohen NA
中科院分区：
文献类型：
--
作者：
Adappa ND;Farquhar D;Palmer JN;Kennedy DW;Doghramji L;Morris SA;Owens D;Mansfield C;Lysenko A;Lee RJ;Cowart BJ;Reed DR;Cohen NA
在美国，每年有超过55万例慢性鼻窦炎(CRS)患者接受鼻窦手术。虽然鼻窦手术的结果差异很大，但还没有已知的遗传因素被发现可以预测手术结果。苦味受体T2R38最近被证明调节上呼吸道的先天防御，并可能影响患者对治疗的反应。我们的目标是确定TAS2R38基因是否可以预测鼻窦手术后CRS患者的预后。一项对接受鼻窦手术的患者进行的前瞻性研究，通过22个项目的鼻腔结果测试(SNOT-22)评估术后结果。对2例患者进行了TAS2R38基因分型。初步分析123例CRS患者，82例有鼻息肉(CRSwNP)，41例无鼻息肉(CRSsNP)。急诊室手术6个月后，SNOT-22总体改善25±23分。在没有息肉的患者中，TAS2R38型与手术结果显著相关；功能性受体纯合子的平均改善为38±21，而非功能性受体的杂合子或纯合子的平均改善为12±22(p=0.006)。这一结果得到了多变量回归的证实，该回归包括了更多具有1个月和3个月评分的患者(n=207)。在接受鼻窦手术治疗CRS的患者中，我们发现了一种基因多态性，它可以预测非息肉型CRS患者术后6个月生活质量改善的变异性。这是第一个被证实可以预测特定CRS患者手术结果的基因多态。
Over 550,000 sinus surgeries are performed annually in the United States on patients with chronic rhinosinusitis (CRS). Although the results of sinus surgery vary widely, no known genetic factor has been identified to predict surgical outcomes. The bitter taste receptor T2R38 has recently been demonstrated to regulate upper airway innate defense and may affect patient responses to therapy. Our goal was to determine whether TAS2R38 genetics predicts outcomes in CRS patients following sinus surgery. A prospective study of patients undergoing sinus surgery evaluating postoperative outcomes through the 22-item Sino-Nasal Outcome Test (SNOT-22). Patients were genotyped for TAS2R38. A total of 123 patients with CRS were initially analyzed; 82 patients showed nasal polyps (CRSwNP) and 41 patients were without nasal polyps (CRSsNP). Six months a er surgery, the overall SNOT-22 improvement was 25 ± 23 points. The TAS2R38 genotype was found to significantly correlate with surgical outcomes in patients without polyps; homozygotes for the functional receptor had a mean improvement of 38 ± 21, whereas heterozygotes or homozygotes for the nonfunctional receptor had a mean improvement of 12 ± 22 (p = 0.006). This result was confirmed with a multivariate regression that incorporated further patients with 1-month and 3-month scores (n = 207). In patients undergoing sinus surgery for CRS, we have identified a genetic polymorphism that predicts variability in quality of life improvement following surgery at 6 months in nonpolypoid CRS. This is the first genetic polymorphism identified that has demonstrated to predict surgical outcome for a select group of CRS patients.