Correlation Between Bone Morphogenic Protein-2 (Bmp-2) Levels With Global Osteitis Scoring Scale (Goss) and Endotype Biomarkers in Chronic Rhinosinusitis
Main Article Content
Abstract
Introduction: Chronic rhinosinusitis (CRS) is a nasal and sinus inflammation. It's divided into primary and secondary types, distinguishable by biomarkers. In general, endotypes in primary CRS classified into type 2 and non-type 2 (combination of type 1 and type 3) based on specific inflammatory mediators, immune cells, and physiological functions. Paranasal sinus osteitis, a bone change due to inflammation, occurs in primary CRS marked with the damage of lamellar bone structure and new bone formation. Bone morphogenetic protein 2 (BMP-2) is a potential biomarker for bone formation in CRS. Osteitis severity is measured by the Global Osteitis Scoring Scale (GOSS). This study aims to analyze the correlation between BMP-2, GOSS, and inflammation subtypes in primary CRS. Methods: An analytic, cross-sectional study was conducted on 33 primary CRS patients. BMP-2 and endotype biomarkers were measured in uncinate process tissue using ELISA. Normal BMP-2 and endotype biomarkers levels were determined from non-CRS nasal tissue. Osteitis was evaluated using CT scans and GOSS. Results: BMP-2 level has no significant difference in endotype 2 and non-type 2 CRS. BMP-2 level had a significant correlation with IL-5 (endotype 2) (p value = 0.00) and OSM (non-type 2) (p value = 0.00). BMP-2 did not correlate with GOSS values in endotype 2 or non-type 2. Conclusion: Type 2 CRS had slightly higher BMP-2 levels, correlating more with IL-5 and OSM. However, BMP-2 did not correlate with osteitis severity (GOSS), suggesting a minor role in CRS osteitis.
Downloads
Article Details
References
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Official Journal of the European and International Rhinologic Societies and of the Confederation of European ORL-HNS. 2020;Suppl 29:1–464. doi: 10.4193/Rhin20.600
Maharani I, Wijaya JH. Chronic Rhinosinusitis Epidemiology Study in Those Who Need a Surgical Intervention at Saiful Anwar General Hospital Ward January 1st, 2018 – December 31th 2021. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2023;24(24):1–6. Doi: 10.21608/ejentas.2023.189806.1605
Grayson JW, Hopkins C, Mori E, Senior B, Harvey RJ. Contemporary Classification of Chronic Rhinosinusitis beyond Polyps vs No Polyps: A Review. Vol. 146, JAMA Otolaryngology - Head and Neck Surgery. American Medical Association; 2020. p. 831–8. Doi: 10.1001/jamaoto.2020.1453
Bachert C, Tomassen P. Endotype-driven approach for chronic rhinosinusitis. Implementing Precision Medicine in Best Practices of Chronic Airway Diseases. Elsevier Inc.; 2018. 51–57 p.
Kato A, Peters AT, Stevens WW, Schleimer RP, Tan BK, Kern RC. Endotypes of chronic rhinosinusitis: Relationships to disease phenotypes, pathogenesis, clinical findings, and treatment approaches. Vol. 77, Allergy: European Journal of Allergy and Clinical Immunology. John Wiley and Sons Inc; 2022. p. 812–26. Doi: 10.1111/all.15074
Leung N, Mawby TAR, Turner H, Qureishi A. Osteitis and chronic rhinosinusitis: a review of the current literature. European Archives of Oto-Rhino-Laryngology. 2016;273(10):2917–23. Doi: 10.1007/s00405-015-3817-0
Khalmuratova R, Shin HW. Crosstalk between mucosal inflammation and bone metabolism in chronic rhinosinusitis. Clin Exp Otorhinolaryngol. 2021;14(1):43–9. Doi: 10.21053/ceo.2020.00416
Snidvongs K, Sacks R, Harvey RJ. Osteitis in Chronic Rhinosinusitis. Curr Allergy Asthma Rep. 2019;19(5).
Khalmuratova R, Shin HW, Kim DW, Park JW. Interleukin (IL)-13 and IL-17A contribute to neo-osteogenesis in chronic rhinosinusitis by inducing RUNX2. EBioMedicine. 2019;46:330–41. Doi: 10.1016/j.ebiom.2019.07.035
Kim JY, Lim S, Lim HS, Kim YS, Eun KM, Khalmuratova R, et al. Bone morphogenetic protein-2 as a novel biomarker for refractory chronic rhinosinusitis with nasal polyps. Journal of Allergy and Clinical Immunology. 2021;148(2):461-472.e13. doi: 10.1016/j.jaci.2021.02.027
Tsuda T, Takeda K, Terada R, Tanaka S, Waki S, Akama T, et al. Osteitis in Eosinophilic Chronic Rhinosinusitis. Ear Nose Throat J. 2022;0(0):1–8. Doi: 10.1177/01455613221083793
Wang M, Zhou B, Li Y, Cui S, Huang Q. Radical versus Functional Endoscopic Sinus Surgery for Osteitis in Chronic Rhinosinusitis. Orl. 2021;83(4):234–41. Doi: 10.1159/000513528
Georgalas C, Videler W, Freling N, Fokkens W. Global Osteitis Scoring Scale and chronic rhinosinusitis: A marker of revision surgery. Clinical Otolaryngology. 2010;35(6):455–61. Doi: 10.1111/j.1749-4486.2010.02218.x
Aparna S, George S. The Impact of Osteitis on Quality of Life in Patients with Chronic Rhinosinusitis. Indian Journal of Otolaryngology and Head and Neck Surgery. 2023;75:1056–61. Doi: 10.1007/s12070-023-03617-4
Cao PP, Wang ZC, Schleimer RP, Liu Z. Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes. Annals of Allergy, Asthma and Immunology. 2019;122(1):33–40. Doi: 10.1016/j.anai.2018.10.014
Española S, Clínica DI, Wen W, Zhu S, Ma R, Wang L, et al. Allergologia et immunopathologia and TNF- α in refractory chronic rhinosinusitis : A retrospective study. 2022;50(2):137–42. Doi: https://doi.org/10.15586/aei.v50i4.527
Carsuzaa F, Béquignon É, Bainaud M, Jégou JF, Dufour X, Lecron JC, et al. Oncostatin M Counteracts the Fibrotic Effects of TGF‐β1 and IL‐4 on Nasal‐Polyp‐Derived Fibroblasts: A Control of Fibrosis in Chronic Rhinosinusitis with Nasal Polyps? Int J Mol Sci. 2022;23(11):1–9. Doi: 10.3390/ijms23116308