An Overview of the Application of Systems Biology in an Understanding of Chronic Rhinosinusitis (CRS) Development

Abstract

Chronic rhinosinusitis (CRS) is an inflammatory disease of the paranasal sinuses. It is defined as the presence of a minimum of two out of four main symptoms such as hyposmia, facial pain, nasal blockage, and discharge, which last for 8–12 weeks. CRS significantly impairs a patient’s quality of life. It needs special treatment mainly focusing on preventing local infection/inflammation with corticosteroid sprays or improving sinus drainage using nasal saline irrigation. When other treatments fail, endoscopic sinus surgery is considered an effective option. According to the state-of-the-art knowledge of CRS, there is more evidence suggesting that it is more of an inflammatory disease than an infectious one. This condition is also treated as a multifactorial inflammatory disorder as it may be triggered by various factors, such as bacterial or fungal infections, airborne irritants, defects in innate immunity, or the presence of concomitant diseases. Due to the incomplete understanding of the pathological processes of CRS, there is a continuous search for new indicators that are directly related to the pathogenesis of this disease—e.g., in the field of systems biology. The studies adopting systems biology search for possible factors responsible for the disease at genetic, transcriptomic, proteomic, and metabolomic levels. The analyses of the changes in the genome, transcriptome, proteome, and metabolome may reveal the dysfunctional pathways of inflammatory regulation and provide a clear insight into the pathogenesis of this disease. Therefore, in the present paper, we have summarized the state-of-the-art knowledge of the application of systems biology in the pathology and development of CRS.

Pathomechanisms of AERD—Recent Advances

“…In the future, systems biology methods could give us more insight on the cellular level changes in this disease. Already now, the pathways behind CRS and asthma have been investigated with different omics approaches (genomics, transcriptomics, proteomics and metabolomics) [reviewed in (56,57)]. The findings have made biomarker analysis and pointof-care technology development realistic, thus allowing more precise and quicker diagnoses and personalized treatment to be available in the future clinical practice.…”

Endotypes of chronic rhinosinusitis: Relationships to disease phenotypes, pathogenesis, clinical findings, and treatment approaches

“…Modern techniques including genomics (transcriptomics), proteomics, and metabolomics provide comprehensive and un-biased approaches to study biological systems, identify previously unrecognized mechanistic pathways in health and disease, and establish endotypes within a disease. [83][84][85] Systems biology has provided a more holistic understanding of diseases and endotypes. [83][84][85] Proteomic analysis of nasal mucus and mucosa in CRS suggested a trend of increased presence of immunological, metabolic, tissue remodeling, and apoptotic pathways in CRS.…”

“…Proteomic analysis of nasal mucus and mucosa in CRS suggested a trend of increased presence of immunological, metabolic, tissue remodeling, and apoptotic pathways in CRS 86,87 . Metabolomics analysis of low molecular weight compounds (up to 1,500 Da) has been performed in CRS 85 . Fazlollahi et al 88 found that fatty acids (palmitic, oleic, stearic, and lauric) were highly elevated in CRSwNP compared to CRSsNP and control tissues.…”

Endotypes of Chronic Rhinosinusitis; relationships to disease phenotypes, pathogenesis, clinical findings and treatment approaches.

“…Modern techniques including genomics (transcriptomics), proteomics and metabolomics provide comprehensive and un-biased approaches to study biological systems, identify previously un-recognized mechanistic pathways in health and disease, and establish endotypes within a disease [81][82][83] . Systems biology has provided a more holistic understanding of diseases and endotypes [81][82][83] . Proteomic analysis of nasal mucus and mucosa in CRS suggested a trend of increased presence of immunological, metabolic, tissue remodeling and apoptotic pathways in CRS 84,85 .…”

“…Proteomic analysis of nasal mucus and mucosa in CRS suggested a trend of increased presence of immunological, metabolic, tissue remodeling and apoptotic pathways in CRS 84,85 . Metabolomics analysis of low molecular weight compounds (up to 1,500 Da) has been performed in CRS 83 . Fazlollahi et al found that fatty acids (palmitic, oleic, stearic, and lauric) were highly elevated in CRSwNP compared to CRSsNP and control tissues 86 .…”