Proteomics blood testing to distinguish chronic rhinosinusitis subtypes.
OBJECTIVE
To evaluate the potential of surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) proteomic profiling of serum samples to distinguish chronic rhinosinusitis subtypes.


METHODS
Translational study of serum samples from prospectively enrolled patients undergoing sinus surgery.


METHODS
Patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis were prospectively enrolled in an ongoing, institutional review board approved proteomics study. SELDI-TOF-MS was performed on 42 serum samples in patients with chronic rhinosinusitis with nasal polyposis (15 patients diagnosed with allergic fungal rhinosinusitis, 10 patients with Samter's triad, and 17 with chronic rhinosinusitis with nasal polyposis). Classification tree analysis on protein spectra developed from peaks detected in the 0 to 100 kD range was performed to identify disease subtypes.


RESULTS
SELDI-TOF-MS correctly identified patients with allergic fungal rhinosinusitis from serum samples with 84% sensitivity and 90% specificity, and correctly identified patients with Samter's triad with 88% sensitivity and 88% specificity in two subtype comparison groups. SELDI-TOF-MS correctly identified patients with allergic fungal rhinosinusitis with 76% sensitivity and 82% specificity, and correctly identified patients with Samter's triad with 80% sensitivity and 90% specificity in three subtype comparison groups.


CONCLUSIONS
The study provides molecular evidence that allergic fungal rhinosinusitis is a discrete subtype of chronic rhinosinusitis. SELDI-TOF-MS is a promising technology that could lead to the development of a rapid blood test, to identify severe chronic rhinosinusitis subtypes. Further investigation into the utility of this technology is warranted.
Das
Subinoy
S
Department of Otolaryngology, Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA. subinoy.das@osumc.edu
Maeso
Patricia A
PA
Becker
Adam M
AM
Prosser
John D
JD
Adam
Bao-Ling
BL
Kountakis
Stilianos E
SE
D001241:Aspirin; D001249:Asthma / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000175:diagnosis; D005658:Fungi / Q000276:immunology; D006801:Humans; D009298:Nasal Polyps / Q000097:blood / Q000175:diagnosis; D011237:Predictive Value of Tests; D040901:Proteomics; D012017:Referral and Consultation; D012130:Respiratory Hypersensitivity / Q000175:diagnosis; D012220:Rhinitis / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D012221:Rhinitis, Allergic, Perennial / Q000097:blood / Q000175:diagnosis; D012852:Sinusitis / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
D015415:Biomarkers; D001241:Aspirin