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慢性鼻-鼻窦炎中的味觉感受器:有何证据?系统评价。

Taste receptors in chronic rhinosinusitus, what is the evidence? A systematic review.

机构信息

University of Maryland School of Medicine, Baltimore, MD.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

出版信息

Int Forum Allergy Rhinol. 2022 Jul;12(7):917-934. doi: 10.1002/alr.22938. Epub 2022 Jan 5.

Abstract

BACKGROUND

Bitter and sweet taste receptors (T2Rs and T1Rs), respectively, are involved in the innate immune response of the sinonasal cavity and associated with chronic rhinosinusitis (CRS). Growing evidence suggests extraoral TRs as relevant biomarkers, but the current understanding is incomplete. This systematic review synthesizes current evidence of extraoral taste receptors in CRS.

METHODS

PubMed, Embase, Cochrane, Web of Science, and Scopus were reviewed in accordance with Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines and included studies of genotypic and phenotypic T2R/T1R status in CRS patients.

RESULTS

Twenty-two studies with 3845 patients were included. Seventeen studies evaluated genotype and 10 evaluated taste phenotypes. Four of 6 studies examining the haplotype distribution of the T2R, TAS2R38, demonstrated increased AVI/AVI haplotype ("nontaster") frequency in CRS. Meanwhile, 2 studies demonstrated decreased bitter sensitivity in CRS with nasal polyposis (CRSwNP), whereas 3 other studies reported decreased bitter sensitivity only in CRS without nasal polyposis (CRSsNP). Findings regarding sweet sensitivity were mixed. Three studies with cystic fibrosis patients (n = 1393) were included. Studies investigating the association between clinical outcomes and TAS2R38 alleles were limited, but the nonfunctional combination of AVI/AVI was associated with increased utilization of sinus surgery and, in CRSsNP patients, with poorer improvement of symptoms postoperatively.

CONCLUSION

Both genotypic and phenotypic assessments of T2Rs suggest a potential association with CRS, particularly CRSsNP. However, limited evidence and mixed conclusions cloud the role of T2Rs in CRS. Future investigations should aim to increase diverse populations, broaden institutional diversity, examine T1Rs, and utilize uniform assessments.

摘要

背景

苦味和甜味受体(T2R 和 T1R)分别参与鼻-鼻窦腔的先天免疫反应,并与慢性鼻-鼻窦炎(CRS)相关。越来越多的证据表明,口腔外的 TR 是相关的生物标志物,但目前的认识并不完整。本系统评价综合了目前关于 CRS 中口腔外味觉受体的证据。

方法

根据系统评价和荟萃分析的首选报告项目,对 PubMed、Embase、Cochrane、Web of Science 和 Scopus 进行了综述,并纳入了 CRS 患者的 T2R/T1R 基因型和表型状态的研究。

结果

纳入了 22 项研究,共 3845 例患者。17 项研究评估了基因型,10 项研究评估了味觉表型。6 项研究中,有 4 项研究显示 T2R、TAS2R38 单倍型分布的 AVI/AVI 单倍型(“非味觉者”)频率在 CRS 中增加。同时,有 2 项研究显示 CRSwNP 中苦味敏感性降低,而另外 3 项研究仅显示 CRSsNP 中苦味敏感性降低。关于甜味敏感性的研究结果不一。纳入了 3 项囊性纤维化患者(n=1393)的研究。研究 TAS2R38 等位基因与临床结局之间关系的研究有限,但 AVI/AVI 的非功能组合与鼻窦手术使用率增加有关,在 CRSsNP 患者中,与术后症状改善较差有关。

结论

T2R 的基因型和表型评估均表明其与 CRS 尤其是 CRSsNP 有潜在关联。然而,有限的证据和不一致的结论使 T2R 在 CRS 中的作用仍不清楚。未来的研究应旨在增加多样化的人群、扩大机构多样性、研究 T1R,并利用统一的评估方法。

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