Nasal Fluid Proteins Linked to Respiratory Symptom Burden

NASAL FLUID protein levels were associated with symptom burden in people with heterogeneous respiratory conditions, according to an exploratory study by researchers in Australia. 

Patient reported outcome measures are widely used to assess symptoms in respiratory disease, but the relationship between symptom severity and underlying mucosal biology remains incompletely understood. Researchers conducted an exploratory study to investigate whether nasal fluid could provide a non-invasive way of assessing airway inflammation and its relationship with symptoms. 

Nasal fluid samples were collected from 30 participants with heterogeneous respiratory conditions. Protein concentrations of 40 analytes were measured using a multiplex immunoassay. Symptom burden was assessed using the 22-item Sino-Nasal Outcome Test (SNOT-22), with associations between protein concentrations and symptom scores analysed using Spearman correlation. 

TRAIL and CXCL10 Associated with Symptoms 

The mean SNOT-22 score among participants was 39.1 (range, 3-89). Two proteins, TRAIL and CXCL10, demonstrated positive correlations with SNOT-22 scores. 

The correlation coefficient for TRAIL was 0.563 (P=0.001), while the correlation coefficient for CXCL10 was 0.520 (P=0.005). These findings indicated that higher levels of these proteins were associated with greater reported symptom burden within the study population. 

The analysis also showed substantial variation in nasal fluid protein expression between individuals. This variability was observed even among participants who had similar SNOT-22 scores, highlighting differences in biological profiles that may not be apparent from symptom assessments alone. 

Potential Role for Nasal Fluid Profiling 

The findings suggested that nasal fluid could provide a useful, non-invasive approach for investigating biological variation alongside patient reported symptoms in respiratory disease. 

However, the study was exploratory and included a relatively small, heterogeneous group of 30 participants. The findings therefore did not establish causation between nasal fluid proteins and symptom severity. 

The researchers suggested that nasal fluid profiling could be investigated further in larger studies incorporating complementary clinical and physiological measures. Such multimodal approaches could help clarify the relationship between airway biology and patient reported symptom burden and assess whether nasal fluid biomarkers have a future role in respiratory disease assessment.  

Reference 

Lupancu T et al. Exploring associations between nasal fluid inflammatory proteins and patient-reported symptom burden in respiratory disease. Front Allergy.2026;7:1902168. 

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