Endotyping chronic rhinosinusitis based on olfactory cleft mucus biomarkers

Area of Science:

• Immunology
• Otolaryngology
• Data Science

Background:

• Chronic rhinosinusitis (CRS) is a treatable cause of olfactory dysfunction.
• However, research on endotypes specific to olfactory loss in CRS is limited.
• This study addresses the need to characterize CRS endotypes related to smell impairment.

Purpose of the Study:

• To explore inflammatory endotypes in CRS using unsupervised cluster analysis.
• To analyze olfactory cleft (OC) biomarkers in a phenotype-free manner.
• To identify distinct inflammatory signatures within CRS.

Main Methods:

• Prospective recruitment of CRS patients and controls.
• Collection of psychophysical olfactory testing, Questionnaire of Olfactory Dysfunction (QOD-NS), and OC endoscopy data.
• Analysis of 26 OC biomarkers using principal component and cluster analysis.

Main Results:

• Six principal components explained 69.50% of biomarker variance, revealing inflammatory signatures (Type 2, Th17, growth factor, neutrophil chemoattractant).
• Ten distinct clusters were identified, significantly differing in control, CRS with nasal polyps, and CRS without nasal polyps frequencies.
• Olfactory measures, including testing, QOD-NS, and endoscopy, showed significant differences across clusters.

Conclusions:

• Clustering OC biomarkers effectively organizes CRS patients into clinically relevant endotypes.
• This method distinguishes between CRS patients and healthy controls.
• Further validation studies are needed to refine these olfactory endotypes.