The fibrinolysis pathway has been previously observed in the etiopathogenesis of CRSwNP.
The researchers did this study to explore the protein derangements of selected protease inhibitors of the serpin superfamily in CRSwNP and correlate the protease inhibitor derangements of the fibrinolysis pathway tissue with exosomal samples to evaluate the potential of an exosomal noninvasive “liquid biopsy” for CRSwNP.
Institutional review board-approved study in which matched tissue and mucus exosomal proteins were compared between control and CRSwNP patients using Western Blot analysis and IHC. Researchers performed a transcriptome analysis of the same proteins using whole transcriptome sequencing.
The transcriptomic data set showed multiple differentially expressed genes, including SerpinB2, SerpinE1, SerpinF2, and SerpinG1. Western Blot and IHC analysis showed the Serpin protease inhibitors’ overexpression in tissue, indicating the fibrinolysis cascade’s downregulation. The mucus exosomal serpin proteins exhibited similar findings.
The study concluded that the fibrinolysis pathway protease inhibitors, especially SerpinB2, SerpinF2, and SerpinG1, are positively deranged in patients with CRSwNP. These findings suggest the downregulation of the fibrinolysis pathway via proteolytic cascade imbalance leading to excessive polyp fibrin deposition. Further research is required.
Reference: https://journals.sagepub.com/doi/full/10.1177/1945892419831108
