Genomics, proteomics and metabolomics
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 disease81-83. Systems biology has provided a more holistic
understanding of diseases and endotypes 81-83.
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. 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. Miyata
found impaired synthesis of cyclooxygenase- and lipoxygenase-derived
mediators (including prostaglandin D2[PGD2], PGE2, thromboxane
B2, 15-hydroxyeicosatetraenoic acid and lipoxin
A4) and selective upregulation of leukotriene D4 in
nasal polyp-derived eosinophils compared to healthy peripheral blood
eosinophils 87. Future proteome and metabolome studies
will require larger sample size and higher reproducibility to identify
endotypes. In contrast, transcriptome analysis by microarray and
RNA-Sequencing has been successfully used to characterize not only
phenotype-specific (e.g. CRSsNP and CRSwNP) but also endotype-specific
(e.g. eosinophilic and non-eosinophilic) gene expression profiles in
CRS.