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News Americas

A recent study has suggested that people who are genetically more sensitive to certain bitter tastes may have better surgical outcomes after sinus surgery. (Photograph: ARENA Creative/Shutterstock)
0 Comments Jan 7, 2016 | News Americas

Bitter taste sensitivity may predict surgical outcome in sinusitis patients

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PHILADELPHIA, USA: New research from the Monell Chemical Senses Center and the Perelman School of Medicine at the University of Pennsylvania in Philadelphia suggests that physicians may soon be able to use a simple taste test to predict the outcome of sinus surgery. The research team has identified a genetic biomarker—a bitter taste receptor—that forecast better postsurgical results in certain chronic rhinosinusitis patients.

Chronic rhinosinusitis (CRS) affects more than 35 million Americans and accounts for one in five adult antibiotic prescriptions annually. Each year, over half a million CRS sufferers do not respond to antibiotics or other medications and choose to undergo sinus surgery.

“Sinus surgery is a very commonly performed surgery because it helps the vast majority of sinusitis sufferers, but we still don’t understand why some people get modest improvement, while others get exceptional improvement in their symptoms,” said the study’s lead author, Dr. Nithin D. Adappa, Assistant Professor of Otorhinolaryngology (Head and Neck Surgery) at the Perelman School of Medicine. “If we could predict the level of improvement for each individual, based on an inborn genetic difference, it would contribute to setting realistic expectations for our patients, which is an important factor in counseling them about surgery.”

The genetic biomarker that the researchers examined is the bitter taste receptor T2R38. The research team had previously demonstrated that T2R38 is also found in the upper airways, where it defends against bacterial infection. “This study arises from our earlier work that suggested that people with certain inborn differences in their genetic code for T2R38 might be better at fighting off certain types of respiratory infections,” said study author Dr. Noam Cohen, Associate Professor of Otorhinolaryngology (Head and Neck Surgery) at the medical school. “Therefore we wondered if this specific genetic difference, in being able to combat infection, correlated with the degree of improvement following surgery. In fact, this is precisely what we found.”

The current study followed 123 CRS patients who had not responded to conventional medical treatment and had chosen to undergo functional endoscopic sinus surgery. The presence of the biomarker T2R38 was determined genetically through standard DNA sequencing. Moreover, the patients were asked to taste a specific bitter chemical compound called phenylthiocarbamide (PTC) and report their sensations. Patients who had the biomarker found the PTC solution highly bitter and unpleasant. In contrast, patients without the genetic variant that generates the T2R38 receptor often could not distinguish PTC from water.

The researchers assessed patient improvement one, three and six months after surgery using the Sino-Nasal Outcome Test, a scale commonly used to measure nasal and general health symptoms and related quality of life. The patients who were most sensitive to PTC—and therefore to bitter taste—reported breathing more easily through their nose, having fewer subsequent infections, and sleeping more soundly six months after surgery than those patients who were less sensitive, the team reported.

“The same bitter receptor that responds to a bitter taste compound in the mouth also responds to chemicals secreted by bacteria in the airways. This immune boost may help the more bitter-sensitive people to recover and feel better post-surgery,” explained study author Dr. Danielle Reed, a behavioral geneticist at Monell.

“The next step is to ask other otolaryngologists to correlate surgical outcomes to DNA sequencing of T2R38 and/or bitter taste tests to confirm our findings and determine if this effect occurs in people in various geographic regions, as well as patients of other racial and ethnic groups, since our patients were mostly Americans of European descent,” Adappa concluded.

The study, titled “TAS2R38 genotype predicts surgical outcome in nonpolypoid chronic rhinosinusitis,” was published online ahead of print on Nov. 12, 2015, in International Forum of Allergy & Rhinology.

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