Gene expression evaluation in patients affected by inflammatory diseases of paranasal sinuses. Valutazione dell’espressione genica in pazienti affetti da patologia infiammatoria dei seni paranasali.

Below the clinical observation level of chronic rhinosinusitis (CRS) there are several consistent pathophysiological mechanisms different from each other and important in the presentation of the underlying inflammation: so we could say that there are inflammatory endotypes (ET) of CRS. These ET are subtypes of disease defined functionally and pathologically by a molecular mechanism. Each ET might be identified by specific biomarkers (BM) which originate from the encoding of specific genes. Analysis of gene expression is the first signal of biologic modifications and leads to the identification of Expression BM. In our study we compared the expression of selected genes between healthy patients and patients affected by CRS with nasal polyps without hypereosinophilia and/or other comorbidities. These candidate genes were selected from literature because of their demonstrated hyper/hypo-expression at level of pathological polypoid tissue, sure that replication studies are very important for the progress of science. In our study for the first time in the same population many genes involved in the pathogenesis of the disease were analysed at the same time and we obtained statistically significant result in 5 genes out of 9 analysed; 4 of these corroborate literature results. These 5 genes are the ones towards which future researches could address further efforts. Collaboration between ENT and Biologist is essential both for patients endotyping and in elaborating new treatments. Using well-defined ET in clinical studies might allow to identify patient groups that best benefit from existing as well as new treatments and this could result in personalized multidisciplinary treatments and in a substantial improvement in future patient care.