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Demir MG, Aydın S, Oğuztüzün S, Başak K, Bozer BM, Kılıç M. Expression Levels of Glutathione S-Transferase and Cytochrome P450 Isoenzymes in Nasal Polyp Tissue. Indian J Otolaryngol Head Neck Surg 2023; 75:178-182. [PMID: 37007881 PMCID: PMC10050304 DOI: 10.1007/s12070-022-03353-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Nasal polyps are benign sinonasal masses composed of eosinophils and extracellular edema. Pathogenesis of the polyp formation is unclear but several studies strongly suggest a correlation with infection, inflammation and allergy conditions. Our aim is to investigate the potential link between allergy and nasal polyp in tissue level. Nasal polyp group included 60 patients whose diagnosis was confirmed with biopsy and the control group included 38 healthy patients. Tissue sample of the control group was taken from inferior turbinate mucosa under local anesthesia and nasal polyp tissue was collected from functional endoscopic sinus surgery. The glutathione S-transferase (GST) and cytochrome P450 (CYP) isoenzyme expressions of the tissue samples were investigated under light microscopy and graded by a senior pathologist. GSTP1 protein expression was significantly higher in tissue samples from nasal polyp group compared to that of control group (p < 0.05). However, CYP1A1, GSTM1 and GSTA1 isoenzymes were not different between the two groups (p > 0.05). We have found that GSTP1 isoenzyme was elevated in nasal polyp tissue compared to the control. The increase in protein expression of GSTP1 might have occured as a tissue response to the increased oxidative stress thus suggesting a role of GSTP1 in polyp formation.
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Affiliation(s)
- Mehmet Gökhan Demir
- Department of Oral and Maxillofacial Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Sedat Aydın
- Department of Oral and Maxillofacial Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Serpil Oğuztüzün
- Biology Department, Faculty of Arts and Sciences, Kırıkkale University, Kirikkale, Turkey
| | - Kayhan Başak
- Pathology Department, Kartal Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Büşra M. Bozer
- Biology Department, Faculty of Arts and Sciences, Kırıkkale University, Kirikkale, Turkey
| | - Murat Kılıç
- Biology Department, Faculty of Arts and Sciences, Kırıkkale University, Kirikkale, Turkey
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2
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Sierra-Vargas MP, Montero-Vargas JM, Debray-García Y, Vizuet-de-Rueda JC, Loaeza-Román A, Terán LM. Oxidative Stress and Air Pollution: Its Impact on Chronic Respiratory Diseases. Int J Mol Sci 2023; 24:853. [PMID: 36614301 PMCID: PMC9821141 DOI: 10.3390/ijms24010853] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/05/2023] Open
Abstract
Redox regulation participates in the control of various aspects of metabolism. Reactive oxygen and nitrogen species participate in many reactions under physiological conditions. When these species overcome the antioxidant defense system, a distressed status emerges, increasing biomolecular damage and leading to functional alterations. Air pollution is one of the exogenous sources of reactive oxygen and nitrogen species. Ambient airborne particulate matter (PM) is important because of its complex composition, which includes transition metals and organic compounds. Once in contact with the lungs' epithelium, PM components initiate the synthesis of inflammatory mediators, macrophage activation, modulation of gene expression, and the activation of transcription factors, which are all related to the physiopathology of chronic respiratory diseases, including cancer. Even though the pathophysiological pathways that give rise to the development of distress and biological damage are not fully understood, scientific evidence indicates that redox-dependent signaling pathways are involved. This article presents an overview of the redox interaction of air pollution inside the human body and the courses related to chronic respiratory diseases.
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Affiliation(s)
- Martha Patricia Sierra-Vargas
- Departmento de Investigación en Toxicología y Medicina Ambiental, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (INER), Ciudad de México 14080, Mexico
| | - Josaphat Miguel Montero-Vargas
- Departmento de Investigación en Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (INER), Ciudad de México 14080, Mexico
| | - Yazmín Debray-García
- Departmento de Investigación en Toxicología y Medicina Ambiental, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (INER), Ciudad de México 14080, Mexico
| | - Juan Carlos Vizuet-de-Rueda
- Departmento de Investigación en Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (INER), Ciudad de México 14080, Mexico
| | - Alejandra Loaeza-Román
- Departmento de Investigación en Toxicología y Medicina Ambiental, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (INER), Ciudad de México 14080, Mexico
| | - Luis M. Terán
- Departmento de Investigación en Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (INER), Ciudad de México 14080, Mexico
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3
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Zorlu ME, Uygur KK, Yılmaz NS, Demirel ÖÖ, Aydil U, Kızıl Y, Uslu S. Evaluation of Advanced Oxidation Protein Products (AOPP) and Superoxide Dismutase (SOD) Tissue Levels in Patients with Nasal Polyps. Indian J Otolaryngol Head Neck Surg 2022; 74:4824-4830. [PMID: 36742727 PMCID: PMC9895680 DOI: 10.1007/s12070-022-03124-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/10/2022] [Indexed: 02/07/2023] Open
Abstract
The aim of this study is to eveluate levels of advanced oxidation protein products (AOPP) which are thought to increase in the polyp tissue and superoxide dismutase (SOD), an antioxidant enzyme, with using specthrophotometry in polyp tissue and healthy mucosa. 30 nasal polyp patients without inflammatory disease except for nasal polyposis were included in the study. The control group consisted of 18 patients who did not have allergy, asthma, inflammatory and granulomatous disease and planned surgery due to septum deviation and concha hypertrophy. AOPP and SOD tissue levels were measured by spectrophotometry in polyp tissue specimens taken from patients with nasal polyps and concha samples taken from patients in the control group. The mean AOPP tissue level of patients in the nasal polyposis group was statistically significantly higher than the control group. (p < 0.05). The mean SOD activity level was significantly lower in the nasal polyposis group than the control group. (p < 0.05) As a result of this study, high AOPP levels in polyp tissue and low SOD levels in polyp tissue compared to healthy nasal mucosa, oxidative stress plays an important role in nasal polyp development.
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Affiliation(s)
- Mehmet Ekrem Zorlu
- Department of Otolaryngology and Head and Neck Surgery, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Saim Cikrikci Street, Karabaglar, Izmir Izmir, Turkey
- Department of Otorhinolaryngology and Head and Neck Surgery, Gazi University School of Medicine, 06500 Beşevler, Ankara, Turkey
| | - K. Kemal Uygur
- Department of Otorhinolaryngology and Head and Neck Surgery, Gazi University School of Medicine, 06500 Beşevler, Ankara, Turkey
| | - Niyazi Samet Yılmaz
- Department of Biochemistry, Polatlı Duatepe State Hospital, Ankara, Turkey
- Department of Biochemistry, Gazi University School of Medicine, Beşevler, Ankara Turkey
| | - Özlem Özbaş Demirel
- Department of Biochemistry, Ankara Training and Research Hospital, Ankara, Turkey
| | - Utku Aydil
- Department of Otorhinolaryngology and Head and Neck Surgery, Gazi University School of Medicine, 06500 Beşevler, Ankara, Turkey
| | - Yusuf Kızıl
- Department of Otorhinolaryngology and Head and Neck Surgery, Gazi University School of Medicine, 06500 Beşevler, Ankara, Turkey
| | - Sabri Uslu
- Department of Otorhinolaryngology and Head and Neck Surgery, Gazi University School of Medicine, 06500 Beşevler, Ankara, Turkey
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4
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Comparison of tissue level of selenium and zinc in patients with nasal polyposis and healthy people. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Jiao J, Wang C, Zhang L. Epithelial physical barrier defects in chronic rhinosinusitis. Expert Rev Clin Immunol 2019; 15:679-688. [PMID: 30925220 DOI: 10.1080/1744666x.2019.1601556] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Chronic rhinosinusitis (CRS) is a common upper airway disease with a prevalence of greater than 10% of the general population. Although the pathogenesis of CRS remains poorly understood, there is growing evidence indicating that epithelial physical barrier defects play an important role in CRS pathogenesis. Areas covered: Epithelial physical barriers are maintained by various intercellular junctions, especially tight junctions (TJs). Recent studies suggest that the expression of TJ molecules and epithelial barrier function in human nasal epithelium are modulated by various internal and external factors. This review summarizes recent advances regarding the structure, function, and regulating mechanisms of the epithelial physical barrier in the context of CRS. Expert opinion: Available data indicate that epithelial physical barrier defects in CRS can result from inhaled allergens, microbial or virus infections, cytokines, hypoxia, or zinc deficiency, among other causes. Several genes/molecules, such as SPINK5, S100A7, S100A8/9, PCDH1, NDRG1, SPRR, and p63 are involved in modulating the physical barrier function in the context of CRS. The exact mechanisms and molecular pathways that lead to these barrier defects, however, require additional study. Additional work is necessary to further explore the epithelial physical barrier function in normal and pathologic sinonasal mucosa.
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Affiliation(s)
- Jian Jiao
- a Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing , China.,b Beijing Key Laboratory of Nasal Diseases , Beijing Institute of Otolaryngology , Beijing , China
| | - Chengshuo Wang
- a Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing , China.,b Beijing Key Laboratory of Nasal Diseases , Beijing Institute of Otolaryngology , Beijing , China
| | - Luo Zhang
- a Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing , China.,b Beijing Key Laboratory of Nasal Diseases , Beijing Institute of Otolaryngology , Beijing , China
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Alekseenko SI, Skalny AV, Ajsuvakova OP, Skalnaya MG, Notova SV, Tinkov AA. Mucociliary transport as a link between chronic rhinosinusitis and trace element dysbalance. Med Hypotheses 2019; 127:5-10. [PMID: 31088648 DOI: 10.1016/j.mehy.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/01/2019] [Accepted: 03/20/2019] [Indexed: 12/21/2022]
Abstract
Chronis rhinosinusitis is considered as a widespread public health issue with a prevalence of 10%. The disease significantly reduces quality of life and increases the risk of cardiovascular diseases as well as certain forms of cancer. Alteration of mucociliary clearance frequently observed in the patients and plays a significant role in disease pathogenesis. Certain studies have demonstrated that patients with chronic rhinosinusitis are characterized by significant reduction of essential trace elements and toxic metal overload. However, the particular mechanisms of the role of trace element dysbalance in chronic rhinosinusitis are unclear. We hypothesize that exposure to toxic trace elements (arsenic, nickel, cadmium) damages ciliary mucosal epithelium thus affecting mucociliary transport. In turn, altered mucociliary transport results in reduced removal of the inhaled metal-containing particles from nasal mucosa leading to their absorption and further aggravation of toxicity. Essential trace elements (zinc, selenium) play a significant role in regulation of mucociliary transport and immunity, thus their deficiency (either dietary or due to antagonism with toxic metals) may be associated with impaired functions and increased toxic metal toxicity. Therefore, a vicious circle involving metal accumulation and toxicity, essential element deficiency, impairment of mucociliary transport and metal particle removal, resulting in further accumulation of metals and aggravation of toxic effects is formed. The present hypothesis is supported by the findings on the impact of trace elements especially zinc and arsenic on mucociliary clearance, the role of mucociliary transport in heavy metal particles elimination from the airways, trace element dysbalance in chronic rhinosinusitis, as well as toxic and essential metal antagonism. The data from hypothesis testing and its verification may be used for development of therapeutic approach for management of chronic rhinosinusitis. Particularly, the use of essential elements (zinc, selenium) may reduce toxic metal toxicity thus destroying the vicious circle of heavy metal exposure, toxicity, alteration of mucociliary clearance, and aggravation of chronic rhinosinusitis. Essential element supplementation may be considered as a tool for management of chronic refractory rhinosinusitis. In addition, analysis of essential and toxic trace element status may provide an additional diagnostic approach to risk assessment of chronic rhinosinusitis in highly polluted environments.
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Affiliation(s)
- Svetlana I Alekseenko
- K. A. Raukhfuss Children's Municipal Multidisciplinary Clinical Center of High Medical Technologies, St. Petersburg, Russia; Mechnikov North-West State Medical University, St Petersburg, Russia
| | - Anatoly V Skalny
- Yaroslavl State University, Yaroslavl, Russia; Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Olga P Ajsuvakova
- Yaroslavl State University, Yaroslavl, Russia; Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Margarita G Skalnaya
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Svetlana V Notova
- Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia; Orenburg State University, Orenburg, Russia
| | - Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, Russia; Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
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7
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Murphy J, Ramezanpour M, Roscioli E, Psaltis AJ, Wormald P, Vreugde S. Mucosal zinc deficiency in chronic rhinosinusitis with nasal polyposis contributes to barrier disruption and decreases ZO-1. Allergy 2018; 73:2095-2097. [PMID: 29935023 DOI: 10.1111/all.13532] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Jae Murphy
- Department of Surgery‐Otolaryngology, Head and Neck Surgery The University of Adelaide Adelaide SA Australia
| | - Mahnaz Ramezanpour
- Department of Surgery‐Otolaryngology, Head and Neck Surgery The University of Adelaide Adelaide SA Australia
| | - Eugene Roscioli
- Department of Surgery‐Otolaryngology, Head and Neck Surgery The University of Adelaide Adelaide SA Australia
| | - Alkis James Psaltis
- Department of Surgery‐Otolaryngology, Head and Neck Surgery The University of Adelaide Adelaide SA Australia
| | - Peter‐John Wormald
- Department of Surgery‐Otolaryngology, Head and Neck Surgery The University of Adelaide Adelaide SA Australia
| | - Sarah Vreugde
- Department of Surgery‐Otolaryngology, Head and Neck Surgery The University of Adelaide Adelaide SA Australia
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Ren MQ, Zhou YT, Chen HX, Li TY, Vajandar SK, Osipowicz T, Watt F, Li CW. Quantitative analysis of multiple elements in healthy and remodeled epithelium from human upper airway mucosa using nuclear microscopy. Allergy 2018; 73:724-727. [PMID: 29023780 DOI: 10.1111/all.13329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 01/19/2023]
Abstract
Elements are vital in airway mucosal physiology and pathology, but their distribution and levels in the mucosa remain unclear. This study uses the state-of-the-art nuclear microscopy facility to map and quantify multiple elements in the histology sections of nasal mucosa from patients with nasal polyps or inverted papilloma. Our results demonstrate that P and Ca are the most abundant elements in mucosa and their distinct difference between epithelial and subepithelial regions; more importantly, our results reveal decreased amounts of Cu and Zn in the remodeled epithelium as compared to the normal epithelium. These findings suggest that Cu and Zn may be beneficial targets to regulate aberrant epithelial remodeling in airway inflammation.
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Affiliation(s)
- M.-Q. Ren
- Centre for Ion Beam Applications; Department of Physics; National University of Singapore; Singapore Singapore
| | - Y.-T. Zhou
- Department of Otolaryngology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - H.-X. Chen
- Department of Otolaryngology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - T.-Y. Li
- Department of Otolaryngology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - S. K. Vajandar
- Centre for Ion Beam Applications; Department of Physics; National University of Singapore; Singapore Singapore
| | - T. Osipowicz
- Centre for Ion Beam Applications; Department of Physics; National University of Singapore; Singapore Singapore
| | - F. Watt
- Centre for Ion Beam Applications; Department of Physics; National University of Singapore; Singapore Singapore
| | - C.-W. Li
- Department of Otolaryngology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
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Asara Y, Melis A, De Luca LM, Bozzo C, Castiglia P, Chessa G, Piras P, Karligkiotis A, Bandiera P, Malaguarnera M, Marchal JA, Madeddu R. Influence of metals on rhinosinusal polyposis in Sardinian population (Italy). ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:21726-21732. [PMID: 27522207 DOI: 10.1007/s11356-016-7406-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/04/2016] [Indexed: 06/06/2023]
Abstract
Metals have strong toxic effects in humans and can act as immunoregulatory factors. The purpose of our study was to determine whether the concentrations of metals are associated with the clinical course of nasal polyposis (NP). We measured the concentrations of 10 metals and non-metal (Zn, Mn, Se, Fe, Cr, Ni, Pb, Al, Cd, and Cu) in 58 patients with NP, and 29 controls with a healthy nasal mucosa. We used electron microscopy to compare the ultrastructural features of the nasal mucosa between NP patients and healthy controls. Concentrations of metals in nasal polyps and healthy mucosa were determined by mass spectrometry. Transmission electron microscopic (TEM) and scanning electron microscopic (SEM) images of the nasal mucosa were obtained. The mean tissue concentrations of all 10 metals and non-metal were significantly lower in NP patients than in healthy controls (P < 0.05).TEM and SEM revealed changes in the mucosal ultrastructure in NP with progressive fibrosis, devascularisation, and inflammation. Tissue concentrations of metals were lower in NP patients than in healthy controls, and this was particularly evident in massive polyposis.
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Affiliation(s)
- Yolande Asara
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy
- INBB-National Institute of Biostructures and Biosystems, Sassari, Italy
| | - Andrea Melis
- Division of Otorhinolaryngology, Department of Surgery, Microsurgery and Medical Sciences, University of Sassari, Sassari, Italy
| | - Laura Maria De Luca
- Division of Otorhinolaryngology, Department of Surgery, Microsurgery and Medical Sciences, University of Sassari, Sassari, Italy
| | - Corrado Bozzo
- Division of Otorhinolaryngology, "P. Dettori" Hospital, Tempio Pausania, Italy
| | - Paolo Castiglia
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Giannina Chessa
- IZS-Istituto Zooprofilattico Sperimentale della Sardegna, Sassari, Italy
| | - Patrizia Piras
- IZS-Istituto Zooprofilattico Sperimentale della Sardegna, Sassari, Italy
| | - Apostolos Karligkiotis
- Division of Otorhinolaryngology, Department of Surgery, Microsurgery and Medical Sciences, University of Sassari, Sassari, Italy
| | - Pasquale Bandiera
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Michele Malaguarnera
- Department of Medical and Pediatric Science, Research Centre "The Great Senescence", University of Catania, Catania, Italy
| | - Juan Antonio Marchal
- Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Roberto Madeddu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy.
- INBB-National Institute of Biostructures and Biosystems, Sassari, Italy.
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Khlifi R, Olmedo P, Gil F, Chakroun A, Hammami B, Hamza-Chaffai A. Heavy metals in normal mucosa and nasal polyp tissues from Tunisian patients. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:463-471. [PMID: 25081002 DOI: 10.1007/s11356-014-3251-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 06/23/2014] [Indexed: 06/03/2023]
Abstract
Despite growing evidence that bacteria, fungi, allergens, and superantigens play a prominent role in the pathophysiology of nasal polyps (NP), the exact cause of polyposis is still unknown. The etiology of NP is considered multifactorial. Until now, there is no information on the presence of heavy metals, such as cadmium (Cd), chromium (Cr), nickel (Ni), and arsenic (As) or of their role, in the pathogenesis of NP disease. In this study, concentrations of these four metals in tissue of NP were determined using Atomic Absorption Spectrometry. The Ni, Cr, and As levels in NP tissues were 2.1-, 3.2-, and 8.0-fold higher than those of normal mucosa (p < 0.05), respectively. A strong effect of cumulative smoking as expressed in the number of pack per year (PY), Ni, As, and Cd levels in NP tissue samples of patients ever-smokers (1-20 and >20 PY) are significantly higher than those of non-smokers (p = 0.006, 0.002, and < 0.001, respectively). The highest As concentrations among patients lived at polluted areas (1-25 and > 25 years) were observed in both nasal mucosa and NP tissues. The Ni and As in both nasal mucosa and NP tissues of patients occupationally exposed were significantly higher than non-exposed group. Cr and As levels were found to be associated with NP stage classification (p < 0.05). This is the first report to describe an association between concentrations of metals (Cr, As, and Ni) in human NP tissues and the risk of NP disease. Tissue metal levels have increased due to smoking, environmental, and occupational exposure. Therefore, heavy metal exposure may increase the risk of NP in the Tunisian population. The considerable risk in the category of highest cumulative exposure argues for an association between heavy metals exposure and nasal polyposis risk. Future investigations with larger samples should better elucidate this association.
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Affiliation(s)
- Rim Khlifi
- Unit of Marine and Environmental Toxicology, UR 09-03, Sfax University, IPEIS, BP 1172, 3018, Sfax, Tunisia,
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