Comparison of Nasal Mucus Metabolites in Chronic Rhinosinusitis With and Without Polyps and Healthy Controls

To identify differences in nasal mucus metabolites from patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP) and healthy controls.

Cross-sectional.

Single institution tertiary care facility.

Patients were assigned to groups based on the appearance of normal mucosa (control [n = 5]), diseased mucosa ([CRSsNP] [n = 6]), or polypoid mucosa ([CRSwNP] [n = 4]), respectively. Mucus was collected on swabs. Nasal mucus metabolites were quantified via untargeted metabolomics using liquid chromatography-mass spectrometry (LC-MS) for detection of all metabolites observable with the method. Metabolites in biochemical pathways implicated in sinonasal disease were further selected for analysis.

In the glycerophospholipid pathway, glycerophosphocholine and glycerol-3-phosphate were significantly elevated in controls (C) compared to the CRSwNP and CRSsNP groups (false discovery rate [FDR] = 0.03, C vs CRSwNP fold change [FC] = 3.83, C vs CRSsNP FC = 3.92 and FDR = 0.02, C vs CRSwNP FC = 3.05, C vs CRSsNP FC = 3.50, respectively). In the sphingolipid pathway, C24-OH sulfatide and dihydroceramide were significantly elevated in CRSwNP compared to CRSsNP and control mucus (FDR = 0.01, CRSwNP vs C FC = 146.75, CRSsNP vs C FC = 45.55, CRSwNP vs CRSsNP FC = 3.22 and FDR = 0.05, CRSwNP vs C FC = 4.40, CRSwNP vs CRSsNP FC = 2.72, respectively).

Glycerophosphocholine and sphingolipid nasal mucus metabolites differed between patients with subtypes of CRS and controls. Nasal mucus metabolites may aid in differentiating subtypes of sinusitis.