Phenotypic and Genotypic Evaluation of the Bitter Taste Receptor T2R38 in Chronic Rhinosinusitis

<b>Introduction:</b> Chronic rhinosinusitis (CRS) is a multifactorial disease in which genetic predisposition plays a significant role. The bitter taste receptor T2R38, expressed in nasal and sinus mucosa, supports innate immunity. Single nucleotide polymorphisms (SNPs) in the <i>TAS2R38</i> gene affect individuals' ability to perceive its agonist - phenylthiocarbamide (PTC) - as bitter. Carriers of non-functional variants often experience more severe CRS.<b>Aim:</b> To evaluate the accuracy of the PTC taste strip test in determining the T2R38 phenotype and its correlation with genotype confirmed by molecular analysis. We also assessed associations between T2R38 polymorphisms, surgical outcomes, and COVID-19 incidence.<b>Material and methods:</b> A total of 50 patients with CRS and 37 controls underwent a PTC taste strip test and completed a clinical questionnaire. <i>TAS2R38</i> genotyping was performed using DNA extracted from peripheral blood and mucosal samples.<b>Results:</b> The functional PAV variant strongly correlated with the ability to perceive PTC as bitter. Identified genotypes included <i>PAV/PAV, PAV/AVI, AVI/AVI</i>, and rarer forms (<i>AAV/AVI, PAV/AAV</i>). The <i>AVI/AVI</i> genotype was associated with more severe CRS on CT scans. No significant association was found between genotype and surgical outcomes or COVID-19 incidence.<b>Discussion:</b> Phenotypic taste testing may help identify individuals with impaired T2R38 function and poorer innate immune responses, allowing for more tailored treatment.<b>Conclusions:</b> The PTC taste strip test is a simple, non-invasive tool that correlates well with <i>TAS2R38</i> genotype and may support clinical decision-making in CRS.