Our Summary

This research paper investigates why nasal polyps (small, benign growths in the nose) often grow back after being surgically removed, especially in patients with a chronic condition called rhinosinusitis with nasal polyps (CRSwNP). The researchers focused on a molecule called CRTH2, which is found on a type of immune cell involved in allergic reactions.

The study included 41 CRSwNP patients and 17 control participants. The researchers extracted genetic material (mRNA) from nasal tissues and measured the expression of CRTH2. They also used a technique called immunofluorescence staining to confirm the distribution and expression of the CRTH2 protein.

The results showed that the nasal polyps had more CRTH2 than the control samples, especially the polyps that grew back after surgery. The amount of CRTH2 was also related to the number of a specific type of white blood cell (eosinophils) that are involved in inflammation and allergic reactions. Additionally, higher levels of CRTH2 were associated with worse outcomes after surgery.

Interestingly, the overexpression of CRTH2 was independent of whether the patient also had asthma. The study concluded that high levels of CRTH2 are linked to more severe inflammation and a higher chance of nasal polyps growing back after surgery, regardless of whether the patient also has asthma. Thus, CRTH2 could be a useful marker to predict the recurrence of nasal polyps.

FAQs

  1. Why do nasal polyps often grow back after surgical removal?
  2. What is the role of the molecule CRTH2 in the recurrence of nasal polyps?
  3. Can high levels of CRTH2 predict the recurrence of nasal polyps after surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about nasal polyp removal is to discuss the possibility of using targeted therapies that specifically target molecules like CRTH2 to help prevent the recurrence of nasal polyps after surgery. This personalized approach may help improve outcomes and reduce the need for additional surgeries in the future.

Suitable For

Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) who have high levels of CRTH2 may be recommended for nasal polyp removal surgery. These patients may have more severe inflammation and a higher chance of polyps growing back after surgery. Additionally, patients with high levels of eosinophils, a type of white blood cell involved in inflammation and allergic reactions, may also be recommended for nasal polyp removal surgery. This research suggests that CRTH2 could be a useful marker to predict the recurrence of nasal polyps and guide treatment decisions for patients with CRSwNP.

Timeline

Before nasal polyp removal:

  1. Patient experiences symptoms of nasal congestion, runny nose, postnasal drip, reduced sense of smell, and facial pain or pressure.
  2. Patient may undergo diagnostic tests such as nasal endoscopy or imaging studies to confirm the presence of nasal polyps.
  3. Patient may try conservative treatments such as nasal corticosteroids, antihistamines, or nasal saline irrigation to manage symptoms.

After nasal polyp removal:

  1. Patient undergoes nasal polyp removal surgery, which may be performed endoscopically or through traditional surgery.
  2. Patient may experience some discomfort, swelling, and nasal congestion in the immediate postoperative period.
  3. Patient may need to follow postoperative care instructions such as using nasal sprays, avoiding strenuous activities, and attending follow-up appointments.
  4. Patient may experience improvement in symptoms such as better nasal breathing, reduced nasal congestion, improved sense of smell, and decreased facial pain or pressure.
  5. Patient may need to continue with long-term management strategies to prevent nasal polyp recurrence, such as regular follow-up appointments, nasal corticosteroids, and allergen avoidance.

What to Ask Your Doctor

Some questions a patient should ask their doctor about nasal polyp removal include:

  1. What is the likelihood of my nasal polyps growing back after surgery?
  2. Are there any factors that may increase the risk of my nasal polyps recurring?
  3. Can you explain the role of CRTH2 in nasal polyp growth and recurrence?
  4. How will you monitor my CRTH2 levels before and after surgery?
  5. Are there any specific treatments or medications that target CRTH2 to prevent nasal polyp recurrence?
  6. What are the potential complications or side effects associated with nasal polyp removal surgery?
  7. How long is the recovery period after nasal polyp removal surgery?
  8. Are there any lifestyle changes or precautions I should take to reduce the risk of my nasal polyps returning?
  9. How often should I follow up with you after the surgery to monitor for any signs of nasal polyp recurrence?
  10. Can you provide me with any additional resources or information about nasal polyps and their treatment options?

Reference

Authors: Chen W, He S, Xie X, Yang X, Duan C, Ye P, Li X, Lawrence MG, Borish L, Feng X. Journal: Front Immunol. 2022 Nov 18;13:1046426. doi: 10.3389/fimmu.2022.1046426. eCollection 2022. PMID: 36466917