Taste receptors in CRS, what is the evidence?: a systematic review

Background

Bitter (T2Rs) and sweet (T1Rs) taste receptors are involved in the innate immune response of the sinonasal cavity and associated with chronic rhinosinusitis (CRS). Growing evidence suggests extraoral taste receptors as relevant biomarkers, but current understanding is incomplete. This systematic review synthesizes current evidence of extraoral taste receptors in CRS.

Methods

PubMed, Embase, Cochrane, Web of Science, and Scopus were reviewed in accordance with Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines and included studies of genotypic and phenotypic T2R/T1R receptor status in CRS patients.

Results

Twenty-two studies with 3,845 patients were included. Seventeen studies evaluated genotype and 10 evaluated taste phenotypes. Four of six studies examining the haplotype distribution of the T2R, TAS2R38, demonstrated increased AVI/AVI haplotype (“non-taster”) frequency in CRS. Meanwhile, two studies demonstrated decreased bitter sensitivity in CRS with nasal polyposis (CRSwNP) while three other studies reported decreased bitter sensitivity only in CRS without nasal polyposis (CRSsNP). Findings regarding sweet sensitivity were mixed. Three studies with cystic fibrosis patients (n=1,393) were included. Studies investigating the association between clinical outcomes and TAS2R38 alleles were limited, but the nonfunctional combination of AVI/AVI was associated with increased utilization of sinus surgery and, in CRSsNP patients, with poorer improvement of symptoms postoperatively.

Conclusions

Both genotypic and phenotypic assessments of T2Rs suggest a potential association with CRS, particularly CRSsNP. However, limited evidence and mixed conclusions cloud the role of T2Rs in CRS. Future investigations should aim to increase diverse populations, broaden institutional diversity, examine T1Rs, and utilize uniform assessments.

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