Detecting a Bacterial Process in Chronic Rhinosinusitis

Abstract

The present invention provides a method for identifying bacterial induced rhinosinusitis. The method comprises obtaining a nasal or paranasal mucus sample and detecting the presence of neutrophil degranulation in the mucus sample. Degranulation of neutrophils can be determined by morphological analysis of the cells in the mucus or by detection of released (i.e., “free”) granule content markers such as neutrophil elastase or myeloperoxidase. Based on an accurate determination of the cause of sinusitis as described herein, an appropriate treatment can be instituted.

1 . A method for detecting bacterial sinusitis in an individual comprising the steps of:
 a) collecting nasal or paranasal mucus from an individual;   b) selectively detecting the presence of a free neutrophil granule content marker in the mucus sample;   wherein the presence of the free neutrophil granule marker in the mucus compared to a normal control is indicative of a bacterial sinusitis in the individual.   
   
   
       2 . The method of  claim 1 , wherein collected mucus sample is centrifuged to obtain a supernatant and the free neutrophil granule content marker is detected in the supernatant. 
   
   
       3 . The method of  claim 2 , wherein the mucus sample is processed without homogenization. 
   
   
       4 . The method of  claim 1 , wherein the neutrophil granule content marker is neutrophil elastase (NE). 
   
   
       5 . The method of  claim 4 , wherein the NE is detected using an antibody or an antigen binding fragment thereof specific for NE. 
   
   
       6 . The method of  claim 1 , wherein the neutrophil granule content marker is myeloperoxidase (MPO). 
   
   
       7 . The method of  claim 5 , wherein the MPO is detected by using an antibody or an antigen binding fragment thereof specific for MPO. 
   
   
       8 . The method of  claim 1  further comprising the step of detecting selectively the presence of eosinophil degranulation in the mucus sample. 
   
   
       9 . The method of  claim 8 , wherein the eosinophil degranulation is detected by identifying the presence of free major basic protein. 
   
   
       10 . A method for detecting bacterial sinusitis comprising the steps of:
 a) collecting nasal or paranasal mucus from an individual, wherein the mucus comprises intact leukocyte cells in a liquid medium;   b) without homogenization of the samples, separating the intact leukocyte cells from the liquid medium;   c) detecting the presence of a neutrophil granule content marker in the liquid medium;   wherein the presence of neutrophil granule content marker in the liquid medium is indicative of bacterial sinusitis.   
   
   
       11 . The method of  claim 10 , wherein the neutrophil granule content marker is neutrophil elastase 
   
   
       12 . The method of  claim 13 , wherein the neutrophil granule content marker is myeloperoxidase. 
   
   
       13 . The method of  claim 10 , wherein the separation in step b) is done by centrifugation. 
   
   
       14 . A method for detecting bacterial sinusitis by identifying the presence of neutrophil degranulation comprising the steps of:
 a) collecting nasal or paranasal mucus from an individual;   b) processing the collected mucus such that if intact leukocytes are present in the collected mucus, there is no significant breakup of said intact leukocytes during processing; and   c) analyzing the processed mucus sample for the presence of neutrophil degranulation,
 wherein the presence of neutrophil degranulation is indicative of bacterial sinusitis. 
   
   
   
       15 . The method of  claim 14 , wherein the presence of neutrophil degranulation is determined by morphological analysis of the mucus sample. 
   
   
       16 . The method of  claim 14 , wherein steps a) and b) are carried out without homogenization or sonication of the mucus sample. 
   
   
       17 . The method of  claim 14 , wherein the neutrophil degranulation is identified by detecting the presence of a neutrophil granule content marker. 
   
   
       18 . The method of  claim 17 , wherein the neutrophil granule content marker is neutrophil elastase. 
   
   
       19 . The method of  claim 17 , wherein the neutrophil granule content marker is myeloperoxidase. 
   
   
       20 . The method of  claim 14 , further comprising the step of analyzing for eosinophil degranulation in the mucus sample.