FRIDAY, Oct. 8, 2004 (HealthDayNews) -- A new study contends sinusitis seems to have genetic underpinnings, and the finding might one day lead to new treatments for the condition that clogs the nasal passages of some 37 million Americans each year.
After a three-year analysis, Johns Hopkins scientists came to the conclusion that sinus disease may be caused by genes that produce too much or too little of certain proteins; one gene shows particular promise as a possible treatment.
The report appears in the Oct. 8 online issue of the Journal of Allergy and Clinical Immunology.
Among patients with chronic sinusitis, almost 20 percent develop nasal polyps. Sinus disease can result in swelling of the tissues in the sinus cavity, which can cause the loss of the sense of smell and a slowing down of air circulation and drainage, which can create a breeding ground for infections. Treatments include medications and surgery.
However, after surgery, the polyps often grow back and symptoms return. If medications are discontinued, the same thing can happen.
According to the Agency for Health Care Research and Quality, Americans spend almost $6 billion a year on treatments for sinus disease.
The new findings give clues to which genes may play a role in controlling this illness, the researchers said.
"We found many genes that differed between diseased tissue and normal tissue," said study author Dr. Jean Kim, an assistant professor of medicine at Johns Hopkins University School of Medicine. "Many genes were up-regulated and many were down-regulated."
"Up-regulated" means these genes produced a higher-than-normal amount of the gene's specific proteins, and "down-regulated" means they produced a lower-than-normal amount of the gene's specific proteins, Kim explained.
In their study, Kim and her colleagues looked at healthy and diseased sinus tissue from 14 patients. Altogether, they looked at 10,000 genes.
Kim's team found that, when compared with healthy tissue, 192 genes were up-regulated in diseased tissue and 156 were down-regulated. Why certain genes do that in sinus disease is not known, Kim said.
"The most interesting finding was that the most down-regulated gene was the protein CC10," Kim said. "This protein is present in respiratory tissues and is necessary for neonatal lung development."
In addition, CC10 is being used now to help neonatal lung development in premature babies, Kim noted. "Perhaps if we were to replace the level of CC10, we could have a good treatment for sinus disease," she said.
Replacing the levels of CC10 in diseased tissue is the next step in the team's research, Kim added.
Dr. John M. DelGaudio, an assistant professor of otolaryngology-head and neck surgery at Emory University, said, "Since there are multiple possible causes for nasal polyps, and the pathogenesis of nasal polyps is not fully understood, the immediate impact of this information is minimal."
DelGaudio is not convinced this finding will produce new treatments for sinus diseases. "However, it does provide a stepping stone for further evaluation of nasal polyps, possibly looking for the expression of genes involved in inflammation," he said.
More information
The National Institute of Allergy and Infectious Diseases can tell you more about sinusitis.
