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Decreased SPLUNC1 expression is associated with Pseudomonas infection in surgically treated chronic rhinosinusitis
Yung-An Tsou1, Chuan-Mu Chen, Tzu-Chieh Lin
1Department of Otolaryngology, China Medical University and Hospital, Taichung, Taiwan.
Objectives/Hypothesis:
Chronic rhinosinusitis colonized with Pseudomonas aruginosa is difficult to treat and is related to biofilm formation. Repeated sinus surgery is often required for these patients. Short palate, lung, and nasal epithelial clone 1 (SPLUNC1) is an epithelium-secreted protein that is involved in innate immunity and has anti-Pseudomonas and antibiofilm functions. This study examined if SPLUNC1 expression was related to sinusitis with bacterial culture positive for Pseudomonas and the possibility of using SPLUNC1 to predict treatment outcomes for sinusitis.
Study Design:
Nonrandomized retrospective study.
Methods:
This was a retrospective study of patients at a tertiary referral center. Pseudomonas aruginosa infection was compared to clinical variables such as SPLUNC1 mRNA expression levels, immunohistochemical (IHC) stain intensity, Lund-Mackay sinus computed tomography scores, rapid recurrent sinusitis, requirement for repeat sinus surgery, Phadiatop test results, age, gender, nasal polyp(s), and patients' presence/absence of diabetes mellitus. Comparisons between groups were performed using the χ(2) test or Fisher exact test when one confronter was <5. The statistical analyses were carried out with SPSS version 13.
Results:
P. aeruginosa sinus infections were associated with lower sinus mucosa SPLUNC1 expression (P = .0018), weaker SPLUNC1 IHC staining intensity (P = .011), and poor postoperative outcome (i.e., need repeated sinus surgery) (P < .001). Other factors were not associated with Pseudomonas sinus infection.
Conclusions:
Sinusitis with positive P. aeruginosa bacterial culture is associated with decreased SPLUNC1 sinus mucosa expression. Repeated sinus surgeries are more frequently needed for these patients.
Insights
Chronic rhinosinusitis with Pseudomonas aeruginosa is hard to treat. Lower expression of Short Palate, Lung, and Nasal Epithelial Clone 1 (SPLUNC1) correlates with Pseudomonas infections and the need for repeat sinus surgery.
Area of Science:
- Immunology
- Otolaryngology
- Microbiology
Background:
- Chronic rhinosinusitis (CRS) with Pseudomonas aeruginosa is challenging to treat, often linked to biofilm formation and requiring repeat surgeries.
- Short Palate, Lung, and Nasal Epithelial Clone 1 (SPLUNC1) is an innate immune protein with known anti-Pseudomonas and antibiofilm properties.
Purpose of the Study:
- To investigate the relationship between SPLUNC1 expression and Pseudomonas-positive CRS.
- To determine if SPLUNC1 can predict treatment outcomes in patients with sinusitis.
Main Methods:
- A nonrandomized retrospective study was conducted at a tertiary referral center.
- Compared Pseudomonas aeruginosa infection with clinical variables including SPLUNC1 mRNA and IHC expression, CT scores, recurrent sinusitis, need for repeat surgery, and patient demographics.
- Statistical analyses included chi-squared and Fisher exact tests using SPSS version 13.
Main Results:
- Lower sinus mucosa SPLUNC1 expression and weaker IHC staining intensity were significantly associated with P. aeruginosa infections (P = .0018 and P = .011, respectively).
- Decreased SPLUNC1 expression correlated with poor postoperative outcomes, specifically the need for repeated sinus surgery (P < .001).
- No other clinical factors were associated with Pseudomonas sinus infection.
Conclusions:
- Positive P. aeruginosa bacterial culture in sinusitis is linked to reduced SPLUNC1 expression in sinus mucosa.
- Patients with Pseudomonas-positive sinusitis and decreased SPLUNC1 expression are more likely to require repeat sinus surgeries.
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