About one-third of adults worldwide currently suffer from nasal polyps. These annoying blemishes are fairly common and they can make it difficult to sense eat breathe in and out. Diagnoses can vary and treatment approaches vary widely. While there are many prescription options available theres no guarantee that any of the available options will work for all patients.

A team of Italian colleagues headed by Simone Gualtieri group leader at the Scientific Center of Allergy and Sinus Research (CIBER) from the University Hospital Genoa has discovered that one of the most reliable ways to treat nasal polyps is to grow a bigger nose. A study in the internationally acclaimed EMBO journal EMBO Molecular Medicine published today in PNAS (Proceedings of the National Academy of Sciences) shows that having a larger nose allows to be treated thanks to a specialized signaling pathway (Sca1. 1) in the nose that is triggered by a form of tissue trauma.

Nasal polyps are cosmetic blemishes that occur in lack of oxygenation (hypoxia). They form after the nasal passages become exposed in response to heavy environmental stress (for example during pregnancy or during exposure to air pollution). As a result the delicate mucosa of the nose becomes inflamed catching on fire and eventually destroying the noses mucus barrier. The symptoms common to all nasal polyps are caused by damage to the mucus barrier. Malaria seasonal allergic rhinitis contagious diseases such as rhinitis sinusitis or sinonasal sinusitis as well as viral infections and genetic disorders make nasal polyps a potentially fatal disease.

From a large sample of nasal tissues obtained from individuals with severe nasal polyps and quite healthy individuals of normal color the found that the mature vascularized extracellular tissues (VEECs) of the nose contained a distinctive cluster of molecules (microRNAs) that when processed in the laboratory showed a stronger inflammatory response and higher levels of Sca1. 1 expression. The investigators were able to demonstrate by direct X-ray studies that the aqueous cilia the fabric around the long membrane of VEECs from every nostril in the esophagus and windpipe of patients were corresponding with increased expression of Sca1. 1.

Next the team studied the mouse model of nasal polyps where the stress marker Sca1 was induced specifically in VEECs and found that reduced flow of fine particles in the nasal passages was transformed into a permanent set of molecules that were oxygenated. This improved the life of mice in whom adding Sca1. 1 decreased oxygen concentration in the blood stream and freezing their nasal passages for around 5 minutes resulted in them growing a larger nose showing an increase in nasal cushion capacity. Analysis of gene expression analyses of nasal epithelial cells (important to repair nasal epithelia after trauma) also reveals marked increased expression of the corresponding inflammatory factors (called supercomponents) in these tissues both both in vitro and in vivo.

Finally by applying current clinical data in nasal polyps of 354 patients a retrospective analysis revealed that nasal polyps with high expression of Sca1. 1 including adenoids were more likely to exhibit features of inflammatory nasal epithelia as well as clinical impairment including hypercoagulability dysarthria and photophobia. A similar approach was applied to higher grade study participants in two studies from 300 patients including only alveoli.

Although studies will need to be carried out on the current nanocarrier candidate the authors suggest that effector molecules can be identified that result in improved the function of nasal polyps using targeted therapy.