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Mar 27, 2014
 |  BC Innovations  |  Cover Story

A bitter taste for sinus infections

Modulating taste receptors in upper airways might provide a new way to treat chronic rhinosinusitis, according to a study from the University of Pennsylvania that shows bitter taste agonists stimulate the release of antimicrobial peptides in the sinuses.1 Taste receptor-targeted therapies could reduce patient dependence on antibiotics, but pinpointing the right taste receptor for an individual's infection might be the biggest challenge.

The UPenn team is now optimizing delivery of taste receptor ligands to the nasal cavity for a planned clinical study in rhinosinusitis and is developing a taste test-based diagnostic to link receptor polymorphisms to specific infections.

Antibiotics combined with steroids are standard treatment in chronic rhinosinusitis, a disease involving persistent infection or inflammation of the nasal sinus cavities. However, the drugs fail to control the infection in a substantial number of patients, and antibiotic overuse contributes to the emergence of resistant bacterial strains.

In patients who do not respond to standard therapy, surgery is used to open the nasal passages. However, some patients also fail to respond to surgery.

To find alternatives to antibiotics, researchers are trying to harness the innate immune system to overcome airway infections. Recently, bitter taste receptors in airway epithelia have emerged as important players in the innate host defense.2

In 2012, Noam Cohen and his team found that Gram-negative bacteria in the upper airways can stimulate the bitter taste receptor type 2 member 38 (TAS2R38), thus triggering secretion of bactericidal levels of nitric oxide.3

His team also found that patients with an inactivating TAS2R38 polymorphism had an increased risk of developing chronic sinusitis from Pseudomonas aeruginosaand other Gram-negativeinfections.3

Now, Cohen and colleagues have identified a pathway linking taste receptor stimulation to bactericidal activity and have discovered effects of bitter and sweet taste receptors that could be exploited therapeutically.

Cohen is an associate professor of otorhinolaryngology: head and neck surgery at the Philadelphia VA Medical Center and director of rhinology research and chair of the Otorhinolaryngology Resident Research Community at the Perelman School of Medicine at the University of Pennsylvania. The team also included researchers from The Children's Hospital of Philadelphia and Monell Chemical Senses Center.

Bitter receptors,...

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