Multiple gene expression profiling suggests epithelial dysfunction in polypoid chronic rhinosinusitis

Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disorder resulting from a complex gene-environment interaction. Although
its aetiology remains elusive, numerous studies reported gene expression alterations of factors apparently implicated in all
aspects of the inflammatory response. However, most investigations are limited, unconfirmed analyses of a single gene. Moreover,
studies concerning multiple gene expression analyses, usually on inflammatory mediators (e.g. cytokines), show contrasting outcomes
in part due to use of heterogeneous samples or methodologies with limited power. In this scenario, our goal was to simultaneously
evaluate the expression of a panel of selected genes (AQP5, MUC5AC, CAV1, LTF, COX2, PGDS, TNFα, TGFβ1, MGB1) potentially
involved in CRS inflammatory mechanisms. While most of the samples collected were excluded from the analysis because of poor
quality RNA, we were able to demonstrate statistically significant downregulation of the AQP5, CAV1, LTF, MGB1 genes in a specific
subset of polypoid CRS (patients without typical comorbidities), which might suggest relevant underlying epithelial dysfunction. Further
studies are needed to enrich our knowledge on the pathogenesis of CRS. Forthcoming approaches might utilise next-generation
RNA sequencing and comprehensive bioinformatics analyses to better characterise the transcriptome profiles of CRS endotypes.