Deprived TLR9 Expression in Apparently Healthy Nasal Mucosa Might Trigger Polyp-Growth in Chronic Rhinosinusitis Patients

Background

The origin of nasal polyps in chronic rhinosinusitis is unknown, but the role of viral infections in polyp growth is clinically well established. Toll-like receptors (TLRs) have recently emerged as key players in our local airway defense against microbes. Among these, TLR9 has gained special interest in viral diseases. Many studies on chronic rhinosinusitis with nasal polyps (CRSwNP) compare polyp tissue with nasal mucosa from polyp-free individuals. Knowledge about changes in the turbinate tissue bordering the polyp tissue is limited.

Objectives

To analyse the role of TLR9 mediated microbial defense in tissue bordering the polyp.

Methods

Nasal polyps and turbinate tissue from 11 patients with CRSwNP and turbinate tissue from 11 healthy controls in total were used. Five biopsies from either group were analysed immediately with flow cytometry regarding receptor expression and 6 biopsies were used for in vitro stimulation with a TLR9 agonist, CpG. Cytokine release was analysed using Luminex. Eight patients with CRSwNP in total were intranasally challenged with CpG/placebo 24 hours before surgery and the biopsies were collected and analysed as above.

Results

TLR9 expression was detected on turbinate epithelial cells from healthy controls and polyp epithelial cells from patients, whereas TLR9 was absent in turbinate epithelial cells from patients. CpG stimulation increased the percentage cells expressing TLR9 and decreased percentage cells expressing VEGFR2 in turbinate tissue from patients. After CpG stimulation the elevated levels of IL-6, G-CSF and MIP-1β in the turbinate tissue from patients were reduced towards the levels demonstrated in healthy controls.

Conclusion

Defects in the TLR9 mediated microbial defense in the mucosa adjacent to the anatomic origin of the polyp might explain virus induced polyp growth. CpG stimulation decreased VEGFR2, suggesting a role for CpG in polyp formation. The focus on turbinate tissue in patients with CRSwNP opens new perspectives in CRSwNP-research.     

鼻息肉患者前列腺素E2受体的表达及意义

摘要 目的：研究EP受体在慢性鼻-鼻窦炎伴鼻息肉（chronic rhinosinusitis with nasal polyps, CRSwNP）中的表达及意义。方法：收集20例嗜酸粒细胞性CRSwNP(eosinophilic CRSwNP,ECRSwNP )、20例非嗜酸粒细胞性CRSwNP（noneosinophilic CRSwNP,non-ECRSwNP)患者息肉和14例正常对照组鼻腔钩突黏膜。免疫组织化学和Western blot技术检测各组鼻组织中四种EP受体亚型蛋白的表达;对连续切片行免疫组化染色,检测EP受体与活化的嗜酸粒细胞之间的关系;用Real-time PCR检测各组EP受体和IL-5/IL-13 mRNA的表达水平。结果：EP受体主要表达于鼻黏膜上皮、腺体和上皮下炎症细胞,EP1受体选择性表达于上皮下炎症细胞。与对照组和non-ECRSwNP相比较,ECRSwNP组中EP1 mRNA和蛋白表达均上调,而三组间EP2、EP3和EP4受体的表达无明显差异。连续切片免疫组化染色示,EP1阳性的嗜酸粒细胞占EP1阳性总细胞数的50%。息肉组织EP1 mRNA与IL-5（r=0.55; P <0.001）、IL-13（r=0.69; P<0.001）mRNA的表达水平呈正相关。结论：ECRSwNP中EP1的表达上调与大量的嗜酸粒细胞等浸润有关。EP1受体可能通过趋化和活化嗜酸粒细胞参与ECRSwNP组织炎症的发生和发展。     

慢性鼻窦炎伴鼻息肉患者血清OPN、BAFF、25-（OH）D3的变化及对息肉组织分型的鉴别价值探讨

摘要 目的：探讨慢性鼻窦炎伴鼻息肉（CRSwNP）患者血清骨桥蛋白（OPN）、B细胞活化因子（BAFF）、25羟基维生素D3[25-（OH）D3]水平及其对息肉组织分型的鉴别价值。方法：选取2019年6月-2021年6月于延安大学附属医院治疗的87例CRSwNP患者为CRSwNP组,根据息肉组织嗜酸粒细胞浸润程度将其分为嗜酸性CRSwNP患者（ECRSwNP组,n=41）和非嗜酸性CRSwNP患者（nECRSwNP组,n=46）。选取同期于延安大学附属医院治疗的慢性鼻窦炎不伴鼻息肉患者（CRSsNP组,n=60）和健康体检者（对照组,n=60）。比较CRSwNP组、CRSsNP组和对照组患者血清OPN、BAFF、25-（OH）D3水平。采用多因素Logistic回归分析ECRSwNP发生的影响因素,采用受试者工作特征（ROC）曲线评估各指标对CRSwNP息肉组织分型的鉴别价值。结果：CRSwNP组、CRSsNP组血清OPN、BAFF水平高于对照组,25-（OH）D3水平低于对照组,且CRSwNP组血清OPN、BAFF水平高于CRSsNP组,25-（OH）D3水平低于CRSsNP组（P<0.05）。ECRSwNP组变应性鼻炎史、哮喘病史患者占比、外周血嗜酸粒细胞数量及比例、血清总IgE浓度、血清OPN及BAFF水平高于nECRSwNP组（P<0.05）,而血清25-（OH）D3水平低于nECRSwNP组（P<0.05）。多因素Logistic回归分析显示：外周血嗜酸粒细胞数量及比例、血清总IgE浓度、血清OPN及BAFF水平升高是ECRSwNP发生的危险因素（P<0.05）,25-（OH）D3水平升高是ECRSwNP的保护因素（P<0.05）。血清OPN、BAFF、25-（OH）D3对CRSwNP息肉组织分型单独检测的ROC曲线下面积（AUC）分别为：0.789、0.800、0.817,联合检测鉴别CRSwNP患者息肉组织分型的AUC为0.900,灵敏度、特异度分别为0.860、0.827,联合检测鉴别价值更高（P＜0.05）。结论：血清OPN、BAFF和25-（OH）D3水平在不同息肉组织分型中具有差异性,CRSwNP患者血清OPN和BAFF水平升高是ECRSwNP发生的危险因素,25-（OH）D3水平升高是保护因素,联合检测辅助临床鉴别CRSwNP息肉组织类型的价值更高。     

Non-Eosinophilic Nasal Polyps Shows Increased Epithelial Proliferation and Localized Disease Pattern in the Early Stage

BackgroundNon-eosinophilic nasal polyps (NPs) show less inflammatory changes and are less commonly associated with lower airway inflammatory disorders such as asthma, compared with eosinophilic NPs. However, the development of non-eosinophilic NPs which is a predominant subtype in Asian population still remains unclear.MethodsA total of 81 patients (45 with non-eosinophilic NPs and 36 with eosinophilic NPs) were enrolled. Clinical information and computed tomography (CT), endoscopic, and histological findings were investigated. Tissue samples were analyzed for total IgE levels and for mRNA expression levels of interleukin (IL)-4, IL–5, IL–13, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-17A, IL–22, IL-23p19, transforming growth factor (TGF)-β1, TGF-β2, TGF-β3, and periostin. Immunostaining assessment of Ki–67 as a proliferation marker was performed.ResultsWe found that epithelial in-growing patterns such as pseudocysts were more frequently observed in histological and endoscopic evaluations of non-eosinophilic NPs, which was linked to increase epithelial staining of Ki–67, a proliferating marker. Eosinophilic NPs were characterized by high infiltration of inflammatory cells, compared with non-eosinophilic NPs. To investigate the developmental course of each subtype, CT was analyzed according to CT scores and subtypes. Non-eosinophilic NPs showed more localized pattern and maxillary sinus involvement, but lesser olfactory involvement in early stage whereas eosinophilic NPs were characterized by diffuse ethmoidal and olfactory involvement. In addition, high ethmoidal/maxillary (E/M) CT scores, indicating ethmoidal dominant involvement, were one of surrogate markers for eosinophilic NP. E/M CT scores was positively correlated with levels of T_H2 inflammatory markers, including IL–4, IL–5, periostin mRNA expression and total IgE levels in NPs, whereas levels of the T_H1 cytokine, IFN- γ were inversely correlated. Moreover, if the combinatorial algorithm meet the three of the four markers, including IL–5 (<2.379), periostin (<3.889), IFN-γ (>0.316), and E/M ratio (<2.167), non-eosinophilic CRSwNP are diagnosed with a sensitivity of 84.4% and a specificity of 84.8%.ConclusionHistologic, immunologic and clinical data suggest that non-eosinophilic NPs showed enhanced epithelial alteration and more localized maxillary involvement. Combination of cutoff value on IL–5, periostin, IFN-γ, and E/M scores may be one of surrogate markers for non-eosinophil NP subtype.     

Interleukin-13 Inhibits Lipopolysaccharide-Induced BPIFA1 Expression in Nasal Epithelial Cells

Short palate, lung, and nasal epithelium clone 1 (SPLUNC1) protein is expressed in human nasopharyngeal and respiratory epithelium and has demonstrated antimicrobial activity. SPLUNC1 is now referred to as bactericidal/permeability-increasing fold containing family A, member 1 (BPIFA1). Reduced BPIFA1 expression is associated with bacterial colonization in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Interleukin 13 (IL-13), predominately secreted by T helper 2 (T_H2) cells, has been found to contribute to airway allergies and suppress BPIFA1 expression in nasal epithelial cells. However, the molecular mechanism of IL-13 perturbation of bacterial infection and BPIFA1 expression in host airways remains unclear. In this study, we found that lipopolysaccharide (LPS)-induced BPIFA1 expression in nasal epithelial cells was mediated through the JNK/c-Jun signaling pathway and AP-1 activation. We further demonstrated that IL-13 downregulated the LPS-induced activation of phosphorylated JNK and c-Jun, followed by attenuation of BPIFA1 expression. Moreover, the immunohistochemical analysis showed that IL-13 prominently suppressed BPIFA1 expression in eosinophilic CRSwNP patients with bacterial infection. Taken together, these results suggest that IL-13 plays a critical role in attenuation of bacteria-induced BPIFA1 expression that may result in eosinophilic CRSwNP.     

The Induction of IL-33 in the Sinus Epithelium and Its Influence on T-Helper Cell Responses

BackgroundChronic rhinosinusitis (CRS) is characterized by epithelial activation and chronic T-cell infiltration in sinonasal mucosa and nasal polyps. IL-33 is a new cytokine of the IL-1 cytokine family that has a pro-inflammatory and Th2 type cytokine induction property. The role of IL-33 in the pathomechanisms of CRS and its interaction with other T cell subsets remain to be fully understood.MethodsThe main trigger for IL-33 mRNA expression in primary human sinonasal epithelial cells was determined in multiple cytokine and T-cell stimulated cultures. The effects of IL-33 on naïve, Th0 and memory T-cells was studied by PCR, ELISA and flow cytometry. Biopsies from sinus tissue were analyzed by PCR and immunofluorescence for the presence of different cytokines and receptors with a special focus on IL-33.ResultsIL-33 was mainly induced by IFN-γ in primary sinonasal epithelial cells, and induced a typical CRSwNP Th2 favoring cytokine profile upon co-culture with T-helper cell subsets. IL-33 and its receptor ST2 were highly expressed in the inflamed epithelial tissue of CRS patients. While IL-33 was significantly up-regulated in the epithelium for CRSsNP, its receptor was higher expressed in sinus tissue from CRSwNP.ConclusionsThe present study delineates the influence of IL-33 in upper airway epithelium and a potential role of IL-33 in chronic inflammation of CRSwNP by enhancing Th2 type cytokine production, which could both contribute to a further increase of an established Th2 profile in CRSwNP.     

Effect of Lipopolysaccharide on Glucocorticoid Receptor Function in Control Nasal Mucosa Fibroblasts and in Fibroblasts from Patients with Chronic Rhinosinusitis with Nasal Polyps and Asthma

BackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the upper airways frequently associated with asthma. Bacterial infection is a feature of CRSwNP that can aggravate the disease and the response to glucocorticoid treatment.ObjectiveWe examined whether the bacterial product lipopolysaccharide (LPS) reduces glucocorticoid receptor (GR) function in control nasal mucosa (NM) fibroblasts and in nasal polyp (NP) fibroblasts from patients with CRSwNP and asthma.MethodsNP (n = 12) and NM fibroblasts (n = 10) were in vitro pre-incubated with LPS (24 hours) prior to the addition of dexamethasone. Cytokine/chemokine secretion was measured by ELISA and Cytometric Bead Array. GRα, GRβ, mitogen-activated protein-kinase phosphatase-1 (MKP-1) and glucocorticoid-induced leucine zipper (GILZ) expression was measured by RT-PCR and immunoblotting, GRα nuclear translocation by immunocytochemistry, and GRβ localization by immunoblotting. The role of MKP-1 and GILZ on dexamethasone-mediated cytokine inhibition was analyzed by small interfering RNA silencing.ResultsPre-incubation of nasal fibroblasts with LPS enhanced the secretion of IL-6, CXCL8, RANTES, and GM-CSF induced by FBS. FBS-induced CXCL8 secretion was higher in NP than in NM fibroblasts. LPS effects on IL-6 and CXCL8 were mediated via activation of p38α/β MAPK and IKK/NF-κB pathways. Additionally, LPS pre-incubation: 1) reduced dexamethasone’s capacity to inhibit FBS-induced IL-6, CXCL8 and RANTES, 2) reduced dexamethasone-induced GRα nuclear translocation (only in NM fibroblasts), 3) did not alter GRα/GRβ expression, 4) decreased GILZ expression, and 5) did not affect dexamethasone’s capacity to induce MKP-1 and GILZ expression. MKP-1 knockdown reduced dexamethasone’s capacity to suppress FBS-induced CXCL8 release.ConclusionThe bacterial product LPS negatively affects GR function in control NM and NP fibroblasts by interfering with the capacity of the activated receptor to inhibit the production of pro-inflammatory mediators. This study contributes to the understanding of how bacterial infection of the upper airways may limit the efficacy of glucocorticoid treatment.     

Differential Expression and Release of Activin A and Follistatin in Chronic Rhinosinusitis with and without Nasal Polyps

Background

Chronic rhinosinusitis with (CRSwNP) and without nasal polyps (CRSsNP) should be regarded as distinct clinical entities based on differential inflammatory mediator and remodeling profiles. Activin A, a member of the TGF-β superfamily, plays an important role in inflammation and remodeling in the lower airways, although its expression and release in the upper airways remain undescribed.

Objective

To investigate the expression of activin A and its inhibitor follistatin in nasal tissue samples from CRSsNP and CRSwNP patients, and to monitor the spontaneous release of these molecules in a human mucosal model.

Methods

Protein levels were determined using ELISA for activin A, follistatin, TGF-β1 and indicator proteins (IL-5, ECP, IFNγ) in 13 CRSsNP, 23 CRSwNP, and 10 control samples. The spontaneous release rate and the release ratios of activin A, follistatin and TGF-β1 were determined in 9 CRSsNP and 7 CRSwNP tissue fragments cultured ex-vivo. The induction of activin A and TGF-β1 by one another was studied in 7 CRSsNP tissue fragments cultured ex-vivo.

Results

Significantly higher concentrations of activin A, follistatin, TGF-β1, and IFNγ were observed in CRSsNP compared with CRSwNP samples, whereas the concentrations of IL-5 and ECP were significantly lower. Follistatin was positively and linearly correlated with activin A in CRSsNP and CRSwNP. Activin A, follistatin and TGF-β1 were all spontaneously released by the samples, although the relative ratios released by tissue fragments from CRSsNP and CRSwNP samples were significantly different, with a higher follistatin/activin A-ratio and a follistatin/TGFß1-ratio (with less overall TGF-β1) in CRSwNP than in CRSsNP. Furthermore, TGF-β1 enhanced activin A secretion in CRSsNP tissue fragments cultured ex-vivo.

Conclusion

The differences in tissue concentrations and spontaneous release rates for activin A and follistatin in different CRS samples support the hypothesis that CRSsNP and CRSwNP are two distinct disease entities with respect to remodeling patterns.     

Hematic infiltrates and the expression of HLA-DR antigens in naso-sinusoidal polyps of the fibrous type

In this study fibrous nasal polyps, obtained from four patients, were analyzed by means of immunocytochemical methods for the presence of interstitial hematic cell infiltrate and HLA-DR molecule expression. This histologic type accounted for 36.4% of nasal polyps studied. Our results demonstrated that cells belonging to monocyte-macrophage lineage were mainly detected within fibrous and edematous zones (greater than 50%), whereas T cells were found within the subepithelial peripheral connective tissue (greater than 60%). Surface and gland epithelial cells appeared to be more intensely stained for HLA-DR molecules than nasal epithelium of normal subjects, thus indicating that the intensity of HLA-DR molecule expression correlated with the presence of a hematic cell infiltrate. Nasal polyps are a frequent pathology whose etiology has not yet been completely clarified. The present study provides additional information about the fibrous polyp structure and can support some speculations on the nasal polyp etiology.     

Decreased expression of VE-cadherin and claudin-5 and increased phosphorylation of VE-cadherin in vascular endothelium in nasal polyps

VE-cadherin and claudin-5 are major components of adherens and tight junctions of vascular endothelial cells and a decrease in their expression and an increase in the tyrosine-phosphorylation of VE-cadherin are associated with an increase in endothelial paracellular permeability. To clarify the mechanism underlying the development of edema in nasal polyps, we studied these molecules in polyp microvessels. Normal inferior turbinate mucosal tissues and nasal polyps from patients treated with or without glucocorticoid were stained for VE-cadherin or claudin-5 and CD31 by a double-immunofluorescence method and the immunofluorescence intensities were graded 1–3 with increasing intensity. To correct for differences in fluorescence intensity attributable to a different endothelial area being exposed in a section or to the thickness of a section, the relative immunofluorescence intensity was estimated by dividing the grade of VE-cadherin or claudin-5 by that of CD31 in each microvessel. Tyrosine-phosphorylation of VE-cadherin was examined by Western blot analysis. The relative intensities of VE-cadherin and claudin-5 in the CD31-positive microvessels significantly decreased in the following order; inferior turbinate mucosa, treated polyps and untreated polyps. The ratio of tyrosine-phosphorylated VE-cadherin to VE-cadherin was significantly higher in untreated polyps than in the inferior turbinate mucosa and treated polyps, between which no significant difference in the ratio was seen. Thus, in nasal polyps, the barrier function of endothelial adherens and tight junctions is weakened, although glucocorticoid treatment improves this weakened barrier function.     

中鼻甲手术治疗鼻窦炎的临床疗效

为了研究中鼻甲手术处理对治疗患者鼻窦炎的临床疗效,本研究选取2013年3月至2018年3月在我院进行鼻内镜手术的患者400例,根据术中对中鼻甲处理情况分为观察组和对照组,每组200例,观察组行中鼻甲成形术,对照组行中鼻甲切除术;观察2组患者治疗一年后的疗效、Lund-Kennedy评分、主观症状VAS评分、嗅觉变化及并发症。研究显示,观察组的治疗有效率(90.50%)与对照组(88.50%)无显著差异(p=0.514)。两组患者治疗1年后的Lund-Kennedy总评分均显著降低,并且观察组的Lund-Kennedy总评分显著低于对照组(2.24 vs.2.75,p<0.05)。对于Lund-Kennedy评分的各个单项评分,治疗后观察组的息肉、瘢痕和结痂显著低于对照组(p<0.05)。治疗1年后观察组的鼻塞评分显著低于对照组(2.22 vs.3.43,p<0.05),而两组的脓涕评分差异无统计学意义(2.25 vs.2.76,p>0.05)。治疗1年后,两组嗅觉功能评分均显著降低,但两组评分之间差异无统计学意义(1.78 vs.1.81,p>0.05)。两组患者的并发症发生率无统计学差异(p>0.05)。本研究表明,中鼻甲是否切除不影响患者的治疗效果和嗅觉功能,然而,与中鼻甲切除术相比,中鼻甲成形术后患者具有较少的息肉、瘢痕、结痂、鼻腔干燥现象,并且可显著改善鼻塞主观症状。     

Involvement of B2 Receptor in Bradykinin-Induced Proliferation and Proinflammatory Effects in Human Nasal Mucosa-Derived Fibroblasts Isolated from Chronic Rhinosinusitis Patients

Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the sinonasal mucosa either accompanied by polyp formation (CRSwNP) or without polyps (CRSsNP). CRSsNP accounts for the majority of CRS cases and is characterized by fibrosis and neutrophilic inflammation. However, the pathogenesis of CRS, especially CRSsNP, remains unclear. Immunohistochemistry of CRSsNP specimens in the present study showed that the submucosa, perivascular areas, and the mucous glands were abundant in fibroblasts. Therefore, we investigated the effects bradykinin (BK), an autacoid known to participate in inflammation, on human CRSsNP nasal mucosa-derived fibroblasts (NMDFs). BK increased CXCL1 and -8 secretion and mRNA expression with EC₅₀ ranging from 0.15~0.35 μM. Moreover, BK enhanced cell proliferation and upregulated the expressions of proinflammatory molecules, including cell adhesion molecules (CAMs) and cyclooxygenase (COX)-1 and -2. These functionally caused an increase in monocyte adhesion to fibroblast monolayer. Using pharmacological intervention and BKR siRNA knockdown, we demonstrated that the BK-induced CXCL chemokine release, cell proliferation and COX and CAM expressions were mainly through the B2 receptor (B2R). Accordingly, the B2R was preferentially expressed in the NMDFs than B1R. The B2R was highly expressed in the CRSsNP than the control specimens, while the B1R and kininogen (KNG)/BK expression slightly increased in the CRSsNP mucosa. Collectively, we report here for the first time that fibroblasts, KNG/BK, and BKRs are overexpressed in CRSsNP mucosa and BK upregulates chemokine expression, proliferation, and proinflammatory molecule expression in NMDFs via B2R activation, which lead to a functional increase in monocyte-fibroblast interaction. Our findings reveal a critical role of fibroblast, KNG/BK, and BKRs in the development of CRSsNP.     

Lysophosphatidic acid stimulates inflammatory cascade in airway epithelial cells

Nasal polyps are benign outgrowths originating from the anterior ethmoid and maxillary sinuses. The events leading to polyp formation are unknown but evidence points to damage of the mucousal epithelium. Lysophosphatidic acid (LPA) is a water-soluble phospholipid that has been implicated in the development of allergic inflammation. We hypothesized LPA may be an important mediator in the initiation and maintenance of the inflammatory milieu of the polyp. Data was compared from unstimulated lung epithelial and when possible nasal polyp-derived epithelial cells with LPA stimulated cells. LPA receptors 1 and 2 were constitutively expressed on lung and nasal polyp-derived epithelial cells and receptor mRNA expression was decreased upon stimulation with IL-13 and IFN-gamma. When cells were treated with LPA, cellular proliferation was stimulated 2.2 fold. Supernatants from LPA stimulated cells displayed decreases in the levels of VEGF, GM-CSF, and TNF-alpha at 24h which returned to normal or increased at 48h. Our results suggest epithelial cells undergo rapid proliferation in response to LPA resulting in a transient decrease in inflammatory cytokines followed by an upregulation of these cytokines that could lead to increased inflammation.     

变应性鼻炎鼻黏膜组织重塑的研究及转化生长因子β1 在鼻黏膜中 的表达*

目的:探讨变应性鼻炎(allergic rhinitis AR)鼻黏膜组织是否存在重塑并检测与组织重塑密切相关的转化生长因子β1(TGF-β1)在AR患者鼻黏膜组织中的表达及意义。方法:取健康自愿者、轻度间歇性AR患者、重度持续性AR患者的中鼻甲黏膜组织各10例。苏木素伊红(HE)染色法观察嗜酸细胞浸润并测定上皮损伤情况;阿辛蓝-过碘酸-希夫(AB-PAS)染色法计数杯状细胞数;三色胶原(MT)染色测定细胞外基质沉积面积百分比。酶联免疫吸附试验(ELISA)测定组织中TGF-β1的表达。结果:①对照组无明显嗜酸细胞浸润,两鼻炎组较多嗜酸细胞浸润(P<0.01),②轻度AR组中仅上皮细胞损伤1级比对照组明显(P<0.01),重度AR组上皮损伤1、2、3级均比对照组明显(P<0.01),③两鼻炎组杯状细胞数明显多于对照组(P值均<0.01),④与对照组相比,轻度AR组胶原沉积面积增多,但无统计学意义(P>0.05),重度AR组明显增多(P<0.01),⑤TGF-β1在两鼻炎组黏膜中的表达均比对照组显著增高(P<0.01);重度AR组TGF-β1的表达均比轻度AR组增高,具有统计学意义(P<0.05)。结论:AR的鼻黏膜组织发生了重塑,表现为:上皮细胞损伤,杯状细胞化生,细胞外基质沉积,重度AR患者的鼻黏膜重塑更强,更广泛。TGF-β1积极参与了AR鼻黏膜组织的重塑过程。     

MBP-Positive and CD11c-Positive Cells Are Associated with Different Phenotypes of Korean Patients with Non-Asthmatic Chronic Rhinosinusitis

Background

Asthmatic nasal polyps primarily exhibit eosinophilic infiltration. However, the identities of the immune cells that infiltrate non-asthmatic nasal polyps remain unclear. Thus, we thought to investigate the distribution of innate immune cells and its clinical relevance in non-asthmatic chronic rhinosinusitis (CRS) in Korea.

Methods

Tissues from uncinate process (UP) were obtained from controls (n = 18) and CRS without nasal polyps (CRSsNP, n = 45). Nasal polyps (NP) and UP were obtained from CRS with nasal polyps (CRSwNP, n = 56). The innate immune cells was evaluated by immunohistochemistry such as, eosinophil major basic protein (MBP), tryptase, CD68, CD163, CD11c, 2D7, human neutrophil elastase (HNE) and its distribution was analyzed according to clinical parameters.

Results

In comparisons between UP from each group, CRSwNP had a higher number of MPB⁺, CD68⁺, and CD11c⁺ cells relative to CRSsNP. Comparisons between UP and NP from CRSwNP indicated that NP have a higher infiltrate of MBP⁺, CD163⁺, CD11c⁺, 2D7⁺ and HNE⁺ cells, whereas fewer CD68⁺ cells were found in NP. In addition, MBP⁺ and CD11c⁺ cells were increased from UP of CRSsNP, to UP of CRSwNP, and to NP of CRSwNP. Moreover, in UP from CRSwNP, the number of MBP⁺ and CD11c⁺ cells positively correlated with CT scores. In the analysis of CRSwNP phenotype, allergic eosinophilic polyps had a higher number of MBP⁺, tryptase⁺, CD11c⁺, 2D7⁺ cells than others, whereas allergic non-eosinophilic polyps showed mainly infiltration of HNE⁺ and 2D7⁺ cells.

Conclusions

The infiltration of MBP⁺ and CD11c⁺ innate immune cells show a significant association with phenotype and disease extent of CRS and allergic status also may influences cellular phenotype in non-asthmatic CRSwNP in Korea.     

Proteomic Analysis of Nasal Epithelial Cells from Cystic Fibrosis Patients

The pathophysiology of cystic fibrosis (CF) lung disease remains incompletely understood. New explanations for the pathogenesis of CF lung disease may be discovered by studying the patterns of protein expression in cultured human nasal epithelial cells (HNEC). To that aim, we compared the level of protein expressions in primary cultures of HNEC from nasal polyps secondary to CF (CFNP, n = 4), primary nasal polyps (NP, n = 8) and control mucosa (CTRL, n = 4) using isobaric tag for relative and absolute quantification (iTRAQ) labeling coupled with liquid chromatography (LC)-MS-MS. The analysis of the data revealed 42 deregulated protein expressions in CFNP compared to NP and CTRL, suggesting that these alterations are related to CF. Overall, AmiGo analysis highlighted six major pathways important for cell functions that seem to be impaired: metabolism, G protein process, inflammation and oxidative stress response, protein folding, proteolysis and structural proteins. Among them, glucose and fatty acid metabolic pathways could be impaired in CF with nine deregulated proteins. Our proteomic study provides a reproducible set of differentially expressed proteins in airway epithelial cells from CF patients and reveals many novel deregulated proteins that could lead to further studies aiming to clarify the involvement of such proteins in CF pathophysiology.