Epigenetic Modulation Drives Chronic Type 2 Chronic Rhinosinusitis With Nasal Polyposis: Identifying Markers, Pathogens and Mechanisms

Status: Recruiting
Location: See location...
Intervention Type: Procedure
Study Type: Observational
SUMMARY

Background/rationale While multiple disorders feature a Type 2 (T2) inflammation, triggers for T2 remains unknown. In Chronic Rhinosinusitis with Nasal Polyposis CRSwNP), a classic Type 2 disorder, dysfunction of the epithelial barrier is suggested by loss of epithelial cell differentiation, impaired response to wounding, and impairment of innate defense mechanisms. After unsuccessful attempts to describe T2 disorders solely by host genetic or environmental factors, the role of epigenetics in the modification of innate immune response and epithelial integrity appears an important unexplored mechanism for a novel appreciation of T2 disease. In addition, the investigators explore the possibility that these changes may be induced by viral pathogens. This concept has been supported by the recent observation that SARS-CoV-2 viral reduction measures resulted in a reduction of the frequency of respiratory viruses and a concomitant reduction in chronic airway disease, suggesting a role for viruses in T2 disease. Hypothesis The investigators believe T2 chronic rhinosinusitis (CRSwNP) involves epigenetic mechanisms where external factors, possibly viruses, contribute to disease via epigenetic manipulation and/or chronic viral infection. Objectives The investigators aim to identify epigenetic signatures associated with T2 CRS and explore the contribution of viruses. Method A robust methylation profiling with extensive coverage will be used for epigenome-wide association studies in T2 CRS patients assessing healthy subjects, CRS patients in remission, and diseased patients undergoing surgery. Moreover, advanced transcriptomic and metagenomic methods will identify gene expression profiles and viruses. This proposal also includes a cross-sectional study of patients undergoing surgery to assess transcriptomic patterns and epigenetics at the single-cell level. Expected outcome The investigators expect to identify epigenetic biomarkers and implicate several pathogenic viruses to open new targets for novel therapies.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: t
View:

• T2 CRSwNP patients with favorable evolution

• T2 CRSwNP patients undergoing ESS

• Healthy volonteers with no nasal symptoms and documented normal sense of smell

Locations
Other Locations
Canada
CHUM
RECRUITING
Montreal
Contact Information
Primary
Martin Y. Desrosiers, MD
desrosiers_martin@hotmail.com
514-890-8000
Backup
Leandra Mfuna Endam, MSc
leandra.mfuna-endam.chum@ssss.gouv.qc.ca
514-890-8000
Time Frame
Start Date: 2023-05-18
Estimated Completion Date: 2025-12-30
Participants
Target number of participants: 60
Treatments
Primary epithelial cells
Population: The investigators will use frozen dissociated cells from our biobank in earliest possible format (P0 or P1) to preserve original viruses and epigenetic marks. Polyp samples from T2 CRSwNP will be selected according to clinical phenotype together with blood test and histology.
Patients in remission of CRSwNP
Population: Perfect sinus cavity outcome after ESS under continued intranasal corticosteroids (INCS) or dupilumab.
Effect of sinus surgery on the sinus virome
Population: Patients undergoing ESS for CRSwNP, including at least 30% of subjects with aspirin sensitivity.
Healthy volonteers
Population: Participants with no sino-nasal symptoms and normal sense of smell as assessed by UPSIT-40 testing.
Sponsors
Leads: Centre hospitalier de l'Université de Montréal (CHUM)

This content was sourced from clinicaltrials.gov