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- Title
Secreted P-glycoprotein is a noninvasive biomarker of chronic rhinosinusitis.
- Authors
Nocera, Angela L.; Meurer, Ana T.; Miyake, Marcel M.; Sadow, Peter M.; Han, Xue; Bleier, Benjamin S.
- Abstract
<bold>Objective: </bold>The discovery of noninvasive biomarkers of chronic rhinosinusitis (CRS) is critical to enable our ability to provide prognostic information and targeted medical therapy. Epithelial P-glycoprotein (P-gp) is overexpressed in CRS and exists in an extracellular, secreted form. The objective of this study was to determine whether secreted P-gp concentrations are elevated in CRS and can be used to predict disease severity.<bold>Methods: </bold>Institutional review board-approved study examining mucus concentrations of P-gp in 36 patients (10 control, 16 CRS without nasal polyps [CRSsNP], and 10 CRS with nasal polyps [CRSwNP]). P-gp concentrations were determined by enzyme-linked immunosorbent assay and normalized to total protein (TP). Clinical indices of disease severity, including the Sino-Nasal Outcomes Test (SNOT-22) and Lund-Mackay score, were collected for all patients.<bold>Results: </bold>Secreted P-gp concentration was significantly higher in CRS versus control patients (mean ± standard deviation; 247.8 ± 224.8 vs. 102.4 ± 81.7 pcg P-gp/μg TP, P = 0.022). A threshold value of 250 pcg/μg TP was used to differentiate low versus high secretors. High P-gp secretors with CRS (sNP and wNP, n = 9) demonstrated significantly higher SNOT-22 and Lund-Mackay scores (57.1 ± 7.9 and 13.9 ± 7.3) versus low secretors (38.3 ± 23.9 and 6.8 ± 7.3; P = 0.030 and P = 0.013, respectively) and had a significantly higher proportion of CRSwNP (66.7%) versus the low secretors (23.5%, n = 17, P = 0.046).<bold>Conclusion: </bold>P-gp secretion levels are significantly elevated in patients with CRS. High P-gp secretion is associated with a higher incidence of CRSwNP and confers worse subjective and objective measures of disease severity. The presence of elevated P-gp secretion may therefore represent a novel noninvasive biomarker of CRS and could be used to predict patients who may benefit from P-gp inhibitory therapeutic strategies.<bold>Level Of Evidence: </bold>NA Laryngoscope, 127:E1-E4, 2017.
- Subjects
SINUSITIS; P-glycoprotein; NASAL polyps; GLANDS; MEDICAL care; CHRONIC diseases; ENZYME-linked immunosorbent assay; GLYCOPROTEINS; NASAL mucosa; RHINITIS; SEVERITY of illness index
- Publication
Laryngoscope, 2017, Vol 127, Issue 1, pE1
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.26249