Decreased SPLUNC1 expression is associated with Pseudomonas infection in surgically treated chronic rhinosinusitis patients who may require repeated sinus surgery.
OBJECTIVE
Chronic rhinosinusitis colonized with Pseudomonas aruginosa is difficult to treat and is related to biofilm formation. Repeated sinus surgery is often required for these patients. Short palate, lung, and nasal epithelial clone 1 (SPLUNC1) is an epithelium-secreted protein that is involved in innate immunity and has anti-Pseudomonas and antibiofilm functions. This study examined if SPLUNC1 expression was related to sinusitis with bacterial culture positive for Pseudomonas and the possibility of using SPLUNC1 to predict treatment outcomes for sinusitis.


METHODS
Nonrandomized retrospective study.


METHODS
This was a retrospective study of patients at a tertiary referral center. Pseudomonas aruginosa infection was compared to clinical variables such as SPLUNC1 mRNA expression levels, immunohistochemical (IHC) stain intensity, Lund-Mackay sinus computed tomography scores, rapid recurrent sinusitis, requirement for repeat sinus surgery, Phadiatop test results, age, gender, nasal polyp(s), and patients' presence/absence of diabetes mellitus. Comparisons between groups were performed using the χ(2) test or Fisher exact test when one confronter was <5. The statistical analyses were carried out with SPSS version 13.


RESULTS
P. aeruginosa sinus infections were associated with lower sinus mucosa SPLUNC1 expression (P = .0018), weaker SPLUNC1 IHC staining intensity (P = .011), and poor postoperative outcome (i.e., need repeated sinus surgery) (P < .001). Other factors were not associated with Pseudomonas sinus infection.


CONCLUSIONS
Sinusitis with positive P. aeruginosa bacterial culture is associated with decreased SPLUNC1 sinus mucosa expression. Repeated sinus surgeries are more frequently needed for these patients.
Department of Otolaryngology, China Medical University and Hospital, Taichung, Taiwan.
Yung-An
YA
Tsou
Chuan-Mu
CM
Chen
Tzu-Chieh
TC
Lin
Fang-Wei
FW
Hu
Chin-Jann
CJ
Tai
Hui-Chen
HC
Chen
Te-Huei
TH
Yeh
Horng-Jyh
HJ
Harn
Ming-Hsui
MH
Tsai
Chia-Ing
CI
Jan
D002908:Chronic Disease; D006023:Glycoproteins / Q000096:biosynthesis*; D006801:Humans; D010256:Paranasal Sinuses; D010750:Phosphoproteins / Q000096:biosynthesis*; D011552:Pseudomonas Infections / Q000378:metabolism / Q000382:microbiology* / Q000601:surgery; D011550:Pseudomonas aeruginosa; D012086:Reoperation; D012189:Retrospective Studies; D012220:Rhinitis / Q000378:metabolism* / Q000382:microbiology / Q000601:surgery; D012852:Sinusitis / Q000378:metabolism* / Q000382:microbiology / Q000601:surgery; D016896:Treatment Outcome
C485599:BPIFA1 protein, human; D006023:Glycoproteins; D010750:Phosphoproteins