by Ellen Goldbaum, University of Buffalo
June 6, 2013 (TSR) – A new test will allow doctors to diagnose chronic rhinosinusitis, one of the most common chronic diseases in the United States.
“This is a game-changer,” says Jens U. Ponikau, clinical assistant professor of otolaryngology at the University at Buffalo, who co-led the clinical trials on the new test. “It provides physicians with a way to precisely identify what kind of inflammation is present in the nose and can help guide their treatment approach.”
More than 30 million people in the US suffer from the condition. There are no approved drugs or treatments that target chronic rhinosinusitis, mainly, Ponikau says, because physicians have not had sufficient insight into what causes it.
“The symptoms for chronic rhinosinusitis include long-term nasal congestion, thick mucus, headache, loss of sense of smell, and opportunistic bacterial infections, most of which are similar to other common conditions,” Ponikau says. “So is it a year-round allergy, a deviated septum, the common cold, some recurrent bacterial infection, or chronic sinusitis? Until now, there were few ways to tell.”
Some patients have even undergone endoscopic surgery in hopes of getting some relief, but often the disease comes back after surgery, he says.
While working at the Mayo Clinic, Ponikau and David A. Sherris, professor and chair of the otolaryngology department at Buffalo, made the discovery that chronic rhinosinusitis (CRS) is an immunologic condition in which rare white blood cells called eosinophils travel through the nasal skin into the mucus, where they release a toxic protein called major basic protein, damaging tissue and causing symptoms.
“The major basic protein is specific only to chronic rhinosinusitis and does not appear in acute sinusitis, allergy, or the common cold,” explains Ponikau, “but we and researchers at other centers around the world had to confirm this.”
“Patients afflicted with CRS show a specific kind of airway inflammation, which is usually not caused by bacterial infection,” says Lakshmanan Suresh, clinical associate professor in the oral diagnostic sciences department and vice president of R&D and clinical services at Diagnostics of Amherst, NY, which is launching the test nationwide. “Our CRS test shows inflammation elicited due to fungus and is helpful in identifying patients where antibiotic therapy may not be helpful.”
The test can be performed in a physician’s office. A sample of nasal mucus is taken from a patient and is then sent to Immco Diagnostics for analysis, which will typically take a few days.