Neutrophil Extracellular Traps as a Biomarker in Refractory Non-Type 2 CRSwNP

Area of Science:

• Otorhinolaryngology
• Immunology
• Genomics

Background:

• Chronic rhinosinusitis (CRS) has type 2 (T2) and non-T2 inflammatory subtypes.
• T2 CRS often presents as CRS with nasal polyps (CRSwNP) and asthma.
• Refractory non-T2 CRSwNP, prevalent in Asia, lacks clear mechanistic understanding.

Purpose of the Study:

• To identify biomarkers for refractory non-T2 CRSwNP.
• To investigate the molecular mechanisms underlying non-T2 CRSwNP refractoriness using RNA sequencing.

Main Methods:

• RNA sequencing of nasal polyps (NPs) and ethmoidal mucosa (EM) from CRS patients and controls.
• Analysis of differentially expressed genes (DEGs) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways.
• Immunofluorescence staining and enzyme-linked immunosorbent assay to validate findings.

Main Results:

• Significant DEGs were identified between T2 and non-T2 CRS tissues and controls.
• KEGG analysis revealed enrichment of neutrophil extracellular trap (NET) formation in non-T2-NP and non-T2-EM.
• NETs were elevated in non-T2-NPs and significantly correlated with disease refractoriness.

Conclusions:

• Neutrophil extracellular traps (NETs) are implicated in the refractoriness of non-T2 CRSwNP.
• NETs represent a potential therapeutic target for refractory non-T2 CRSwNP.
• Understanding these molecular pathways can guide treatment strategies for severe CRS.