Parra-Ferro Mauricio, Justice Jeb M, Lobo Brian C, Munger Steven D, Schlosser Rodney J, Mulligan Jennifer K
Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida.
Center for Smell and Taste, 3463University of Florida, Gainesville, Florida.
Am J Rhinol Allergy. 2022 Nov;36(6):872-883. doi: 10.1177/19458924221111830. Epub 2022 Jul 17.
Nasal mucus is proving to be a useful means by which to study the pathogenesis of chronic rhinosinusitis (CRS). Given the increase in publications examining nasal mucus and the lack of a review on this topic, we will focus on this noninvasive approach to studying CRS. Particular attention will be drawn towards inflammatory cytokines and biomarkers and their influence on disease severity.
A literature review of papers published in English pertaining to nasal mucus was performed using the PubMed database. The search utilized combinations of the following keywords: sinusitis, polyps, sample collection, nasal mucus, or nasal secretion. Studies solely on acute or bacterial sinusitis, allergic rhinitis, or cystic fibrosis were not included.
A wide variety of materials and methods have been used to collect nasal mucus. Numerous assay types have been performed with the most common being ELISA, cytometric bead array, and proteomics. Most studies have focused on examining the levels of Th1/Th2 cytokines along with chemokines associated with type 2 immunity. Other factors identified include growth factors, senescence-associated proteins, complement, and antimicrobial defenses have also been identified. Nasal mucus cytokines have proven useful in cluster analysis and predicting postoperative improvement in Sino-nasal Outcome Test (SNOT-22) scores. One limitation of the use of nasal mucus is that some studies have suggested that nasal mucus does not always reflect the tissue microenvironment.
Nasal mucus represents a critical tool by which to examine the sinonasal microenvironment in a noninvasive manner. Unlike studies of tissue, it can be utilized in both surgically and medically managed patients and avoids the trauma of biopsies. However, studies are still needed to determine the most effective method for nasal mucus collection. Studies should also take care to confirm that nasal mucus markers do, in fact, reflect the levels of the product studied in the tissue.
鼻黏液正被证明是研究慢性鼻-鼻窦炎（CRS）发病机制的一种有用手段。鉴于研究鼻黏液的出版物不断增加，且缺乏关于该主题的综述，我们将聚焦于这种研究CRS的非侵入性方法。将特别关注炎性细胞因子和生物标志物及其对疾病严重程度的影响。
使用PubMed数据库对以英文发表的有关鼻黏液的论文进行文献综述。搜索使用了以下关键词的组合：鼻窦炎、息肉、样本采集、鼻黏液或鼻分泌物。仅关于急性或细菌性鼻窦炎、过敏性鼻炎或囊性纤维化的研究不包括在内。
已使用多种材料和方法来收集鼻黏液。进行了大量的检测类型，最常见的是酶联免疫吸附测定（ELISA）、细胞计数珠阵列和蛋白质组学。大多数研究集中于检测Th1/Th2细胞因子水平以及与2型免疫相关的趋化因子。还确定了其他因素，包括生长因子、衰老相关蛋白、补体和抗菌防御。鼻黏液细胞因子已被证明在聚类分析和预测鼻窦结局测试（SNOT-22）评分的术后改善方面有用。使用鼻黏液的一个局限性是，一些研究表明鼻黏液并不总是反映组织微环境。
鼻黏液是一种以非侵入性方式检查鼻窦微环境的关键工具。与组织研究不同，它可用于手术和药物治疗的患者，且避免了活检的创伤。然而，仍需要研究来确定收集鼻黏液的最有效方法。研究还应注意确认鼻黏液标志物确实反映了组织中所研究产物的水平。
