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Jin J, Guo B, Zhang W, Chen JJ, Deng YQ, Xiang R, Tan L, Liu PQ, Zheng L, Chen Z, Tao ZZ, Xu Y. Predictive Value of Eosinophil Cationic Protein in Nasal Secretions in Eosinophilic Chronic Rhinosinusitis. Laryngoscope 2023; 133:3304-3312. [PMID: 37255052 DOI: 10.1002/lary.30692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/31/2023] [Accepted: 03/22/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To investigate the value of secretions Eosinophilic cationic protein (ECP) detection in the diagnosis of endotypes of Chronic rhinosinusitis (CRS) and its correlation with clinical symptoms, so as to provide guidance for the clinical application of EOS and ECP detection in secretions. METHODS Patients' nasal secretions and polyps (or middle turbinate for control) were collected and their EOS% and ECP levels were measured. Correlation analysis was performed for EOS% and ECP levels in secretions and tissues, respectively. The correlation between secretions EOS% and ECP and clinical symptom scores (symptomatic visual analog scale (VAS) scores, Lanza-kennedy scores from nasal endoscopy and Lund-Mackay scores from sinus CT) was further analyzed. Receiver operating characteristic curves were used to assess the predictive potential of EOS% and ECP in nasal secretions. RESULTS Eosinophilic chronic rhinosinusitis (ECRS) patients had higher concentrations of ECP in nasal secretions than healthy subjects and NECRS (non-eosinophilic CRS) (p < 0.0001;0.0001); EOS% in nasal secretions was higher in ECRS than healthy subjects (p = 0.0055), but the differences between ECRS and NECRS were not statistically significant (p = 0.0999). Correlation analysis showed that tissue EOS% was correlated with ECP concentration and EOS% in nasal secretions (R = 0.5943;0.2815). There was a correlation between EOS% in secretions with a total LM score (R = 0.3131); ECP concentration in secretions with a total LK score (R = 0.3792). To diagnose ECRS, the highest area under the curve (0.8230) was determined for ECP in secretions; the highest area under the curve (0.6635) was determined for EOS% in secretions. CONCLUSION Measurement of ECP in nasal secretions is useful for non-invasive diagnosis of ECRS. LEVEL OF EVIDENCE 3 Laryngoscope, 133:3304-3312, 2023.
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Affiliation(s)
- Jing Jin
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bei Guo
- Department of Otolaryngology, Central Hospital of Wuhan, Wuhan, China
| | - Wei Zhang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jian-Jun Chen
- Department of Otolaryngology-Head and Neck Surgery, Union Hospital of Tongji Medical Collge, Wuhan, China
| | - Yu-Qing Deng
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Rong Xiang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lu Tan
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Pei-Qiang Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Zheng
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhe Chen
- Department of Otolaryngology Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ze-Zhang Tao
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
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靳 晶, 许 昱. [Research progress of biomarkers in nasal secretions in endotypes diagnosis and clinical application of chronic rhinosinusitis]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:888-892. [PMID: 36347587 PMCID: PMC10127556 DOI: 10.13201/j.issn.2096-7993.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Indexed: 06/16/2023]
Abstract
With the development of studies on the endotypes of chronic rhinosinusitis (CRS) and the biomarkers of nasal secretions, the studies of CRS endotypes based on nasal secretion have become more abundant. This paper summarizes the endotypes classification of CRS, the collection methods of nasal secretion and the nasal secretion biomarkers related to the endotypes of CRS, in order to provide a reference for establishing the corresponding endotypes of CRS based on the nasal secretion biomarkers.
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Affiliation(s)
- 晶 靳
- 武汉大学人民医院耳鼻咽喉头颈外科(武汉,430060)Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - 昱 许
- 武汉大学人民医院耳鼻咽喉头颈外科(武汉,430060)Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China
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Parra-Ferro M, Justice JM, Lobo BC, Munger SD, Schlosser RJ, Mulligan JK. Utilization of Nasal Mucus to Investigate the Pathophysiology of Chronic Rhinosinusitis. Am J Rhinol Allergy 2022; 36:872-883. [PMID: 35848564 DOI: 10.1177/19458924221111830] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Nasal mucus is proving to be a useful means by which to study the pathogenesis of chronic rhinosinusitis (CRS). Given the increase in publications examining nasal mucus and the lack of a review on this topic, we will focus on this noninvasive approach to studying CRS. Particular attention will be drawn towards inflammatory cytokines and biomarkers and their influence on disease severity. METHODS A literature review of papers published in English pertaining to nasal mucus was performed using the PubMed database. The search utilized combinations of the following keywords: sinusitis, polyps, sample collection, nasal mucus, or nasal secretion. Studies solely on acute or bacterial sinusitis, allergic rhinitis, or cystic fibrosis were not included. RESULTS A wide variety of materials and methods have been used to collect nasal mucus. Numerous assay types have been performed with the most common being ELISA, cytometric bead array, and proteomics. Most studies have focused on examining the levels of Th1/Th2 cytokines along with chemokines associated with type 2 immunity. Other factors identified include growth factors, senescence-associated proteins, complement, and antimicrobial defenses have also been identified. Nasal mucus cytokines have proven useful in cluster analysis and predicting postoperative improvement in Sino-nasal Outcome Test (SNOT-22) scores. One limitation of the use of nasal mucus is that some studies have suggested that nasal mucus does not always reflect the tissue microenvironment. CONCLUSIONS Nasal mucus represents a critical tool by which to examine the sinonasal microenvironment in a noninvasive manner. Unlike studies of tissue, it can be utilized in both surgically and medically managed patients and avoids the trauma of biopsies. However, studies are still needed to determine the most effective method for nasal mucus collection. Studies should also take care to confirm that nasal mucus markers do, in fact, reflect the levels of the product studied in the tissue.
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Affiliation(s)
- Mauricio Parra-Ferro
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida
| | - Jeb M Justice
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida.,Center for Smell and Taste, 3463University of Florida, Gainesville, Florida
| | - Brian C Lobo
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida
| | - Steven D Munger
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida.,Department of Pharmacology and Therapeutics, 440202University of Florida College of Medicine, Gainesville, Florida.,Center for Smell and Taste, 3463University of Florida, Gainesville, Florida.,Training Program in Chemosensory Science, 3463University of Florida, Gainesville, Florida.,Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, 3463University of Florida College of Medicine, Gainesville, Florida
| | - Rodney J Schlosser
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer K Mulligan
- Center for Smell and Taste, 3463University of Florida, Gainesville, Florida.,Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, 3463University of Florida, Gainesville, Florida
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Huriyati E, Darwin E, Yanwirasti Y, Wahid I. Association of Inflammation Mediator in Mucosal and Tissue of Chronic Rhinosinusitis with Recurrent Nasal Polyp. Open Access Maced J Med Sci 2019; 7:1635-1640. [PMID: 31210814 PMCID: PMC6560307 DOI: 10.3889/oamjms.2019.327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Chronic rhinosinusitis with polyps (CRSwNP) have a high risk of recurrence and patients often experience repeated surgery. There are several types of inflammatory patterns in CRSwNP, such as Th2 inflammation (eosinophilic) and Th1/Th17 inflammation (neutrophilic). AIM This study aims to determine the expression of IL-5, IL-8, IL-17A and TGF-β in recurrent CRSwNP using the most convenient and non-invasive examination tool such as brushing the mucosal polyp and find out its correlation with polyp tissues. MATERIAL AND METHODS A cross-sectional comparative study was carried out on 15 samples of mucosal brushing and polyp tissue. Expressions of IL-5, IL-8, IL-17A and TGF-β on mucosa were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) examination and tissues using Immunohistochemical (IHC) examination. RESULT The result showed that Only IL-5 has a significant relationship between mucosa and tissue with moderate positive correlation (p < 0.05; r = 0.527). CONCLUSION This study concluded that mucosa brushing could be used as a simple and non-invasive examination to observe the expression of IL-5 in recurrent CRSwNP. IL-5 is one of the cytokines that mark the Th2 (eosinophilic) inflammatory pattern where eosinophilic polyps are closely related to recurrence.
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Affiliation(s)
- Effy Huriyati
- Postgraduate Biomedical Science, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - Eryati Darwin
- Department of Histology, Faculty of Medicine, Andalas University, Padang Indonesia
| | | | - Irza Wahid
- Department of Internal Medicine, Faculty of Medicine, Andalas University, General Hospital of Dr M. Djamil, Padang, Indonesia
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Warman M, Granot E, Halperin D. Improvement in allergic and nonallergic rhinitis: A secondary benefit of adenoidectomy in children. EAR, NOSE & THROAT JOURNAL 2016; 94:220;222;224-7. [PMID: 26053979 DOI: 10.1177/014556131509400607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Chronic rhinitis (CR) is a common disorder in children. Allergic rhinitis (AR) is a risk factor for CR, and children with AR tend to suffer more from hypertrophic adenoids than do patients with nonallergic rhinitis (NAR). Few studies have addressed the issue of alleviating symptoms of pediatric CR or AR following adenoidectomy alone. We conducted a retrospective chart review to determine whether CR in children improves after adenoidectomy and whether children with AR will benefit more than those with NAR. Charts of 47 children who had undergone adenoidectomy for nasal obstruction and chronic middle ear effusion were reviewed. AR and NAR subgroups were classified based on symptoms, signs, blood IgE, and nasal smear (allergic criteria). Hypertrophic adenoids were graded using the adenoid-to-nasopharyngeal ratio (ANr >0.8). A questionnaire was used to assess the change in chronic rhinitis postoperatively. Improvement in CR was reported in 37 of 47 (79%) children. Patients with AR improved to a higher extent than those with NAR (12 of 14 [86%] vs. 25 of 33 [76%], respectively), but the difference was not statistically significant. A total of 41 lateral postoperative nasopharyngeal x-rays were obtained. The x-rays revealed that 20 of 26 (77%) of patients with ANr >0.8 had complete and 4 of 26 (15%) had partial resolution of symptoms of CR for a total resolution rate of 92%, compared to only a 53% resolution in the ANr <0.8 subgroup (6 of 15 and 2 of 15 patients, respectively [p <0.05]). The correlation between adenoid size and resolution of CR was not related to any of the AR/NAR subgroups. We conclude that symptoms of CR may improve after adenoidectomy in children who are experiencing nasal obstruction and chronic otitis media with effusion. Clinical improvement did not differ between AR and NAR patients, and was more prominent in children with hypertrophic adenoids (ANr >0.8).
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Affiliation(s)
- Meir Warman
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, POB 1, Rehovot 76100, Israel.
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Xu J, Han R, Kim DW, Mo JH, Jin Y, Rha KS, Kim YM. Role of Interleukin-10 on Nasal Polypogenesis in Patients with Chronic Rhinosinusitis with Nasal Polyps. PLoS One 2016; 11:e0161013. [PMID: 27584662 PMCID: PMC5008817 DOI: 10.1371/journal.pone.0161013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 07/28/2016] [Indexed: 01/28/2023] Open
Abstract
Background and Objectives Interleukin 10 (IL-10) is a potent anti-inflammatory cytokine. The dysregulation of IL-10 is associated with an enhanced immunopathologic response to infection, as well as with an increased risk for developing numerous autoimmune diseases. In this study, we investigated IL-10 expression in chronic rhinosinusitis with nasal polyps (CRSwNP) and assessed the possible role of IL-10 in the pathogenesis of CRSwNP. Materials and Methods Thirty-five patients with CRSwNP, 12 patients with chronic rhinosinusitis without NP (CRSsNP) and 10 control subjects were enrolled in this study. NP tissues and uncinated tissues (UT) were collected for analysis. Dispersed NP cells (DNPCs) were cultured in the presence or absence of IL-25 and IL-10, and a flow cytometric assay was performed to identify the constitutive cell populations of the DNPCs. Murine NP (n = 18) models were used for the in vivo experiments. Real-time PCR, immunohistochemistry, western blotting analysis and ELISA were performed to measure the expression levels of the selected inflammatory cytokines and inflammation-associated molecules. Results The mRNA expression levels of IL-10, IL-5, IL-17A, IL-25 and interferon gamma (IFN-γ) were significantly higher in the NP tissues than in the UT tissues. Strong positive correlations were observed between IL-10 and a variety of inflammatory cytokines (IL-5, IL-17A, IL-25, IFN-γ) and inflammation-associated molecules (B-cell activating factor; BAFF, CD19). Other than the IL-25 to IL-10 ratio, the expression ratios of the other measured inflammatory cytokines to IL-10 were significantly lower in the CRSwNP group than in the CRSsNP or control groups. Administrating IL-25 into the cultured DNPCs significantly increased the production of IL-10, but administrating IL-10 had no effect on the production of IL-25. Conclusion Increased expression of IL-10, IL-10 related inflammatory cytokine, and IL-10 related B cell activation indicated that IL-10, a potent anti-inflammatory cytokine, has a pivotal role in the pathogenesis of CRSwNPs.
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Affiliation(s)
- Jun Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Ruining Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Dae Woo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ji-Hun Mo
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Chonan, Korea
| | - Yongde Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Ki-Sang Rha
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Yong Min Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
- * E-mail:
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Bisgin A, Eyigor H, Osma U, Yilmaz MD, Yalcin AD. Serum soluble tumour necrosis factor related apoptosis-inducing ligand level and peripheral eosinophil count in patients with nasal polyposis. J Laryngol Otol 2015; 129:250-3. [PMID: 25655059 DOI: 10.1017/s0022215114003442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Nasal polyposis is one of the most common inflammatory pathologies of the nasal cavity. Eosinophilic inflammation plays an important role in the pathogenesis. This study aimed to investigate soluble tumour necrosis factor related apoptosis-inducing ligand levels and eosinophil count in nasal polyposis patients. METHODS The study was performed on 24 adult nasal polyposis patients and 24 age-matched healthy individuals. The patients had not received any medical or surgical treatment. Pre-operative computed tomography scans were assessed using the Lund-MacKay grading system, and soluble tumour necrosis factor related apoptosis-inducing ligand levels were measured with a sandwich enzyme-linked immunosorbent assay. RESULTS Compared with controls, eosinophil levels in nasal polyposis patients were increased (p = 0.024), but there was no significant difference in soluble tumour necrosis factor related apoptosis-inducing ligand levels (p = 0.529). The Lund-MacKay mean grading was 12.43 ± 6.9. There was no correlation between soluble tumour necrosis factor related apoptosis-inducing ligand level and Lund-MacKay grading and eosinophil count. CONCLUSION There was no relationship between soluble tumour necrosis factor related apoptosis-inducing ligand level and blood eosinophil or clinical markers; however, soluble tumour necrosis factor related apoptosis-inducing ligand level remains of interest for future studies.
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Affiliation(s)
- A Bisgin
- Medical Genetics Department of Balcali Clinics and Hospitals,Faculty of Medicine,Cukurova University,Adana,Turkey
| | - H Eyigor
- Department of Otorhinolaryngology,Antalya Training and Research Hospital,Turkey
| | - U Osma
- Department of Otorhinolaryngology,Antalya Training and Research Hospital,Turkey
| | - M D Yilmaz
- Department of Otorhinolaryngology,Antalya Training and Research Hospital,Turkey
| | - A D Yalcin
- Department of Internal Medicine,Allergy and Clinical Immunology Unit,Antalya Training and Research Hospital,Turkey
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Paramasivan S, Jones D, Baker L, Hanton L, Robinson S, Wormald PJ, Tan L. The Use of Chitosan–Dextran Gel Shows Anti-Inflammatory, Antibiofilm, and Antiproliferative Properties in Fibroblast Cell Culture. Am J Rhinol Allergy 2014; 28:361-5. [DOI: 10.2500/ajra.2014.28.4069] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Chitosan-dextran gel has been used as an antihemostatic agent and antiadhesive agent after endoscopic sinus surgery. Because Staphylococcus aureus biofilms have been implicated in recalcitrant chronic rhinosinusitis, this study aimed to further investigate the (i) anti-inflammatory, (ii) bacterial biofilm inhibition, (iii) antiproliferative effects, and (iv) wound-healing properties of chitosan and chitosan-dextran gel. Methods Fibroblasts were isolated from human nasal tissue and were used to determine the effects of chitosan and chitosan-dextran gel on (i) cell proliferation, (ii) wound healing, (iii) inflammation in fibroblast cultures challenged with superantigens S. aureus enterotoxin B (SEB) and toxic shock syndrome toxin (TSST), and (iv) on S. aureus biofilms. Results Chitosan was highly effective at reducing IL-8 expression after TSST and SEB challenge. Chitosan was also effective at reducing IL-8 expression of nonchallenged fibroblasts showing its anti-inflammatory effects on fibroblasts in a diseased state. Chitosan-dextran gel showed strong antibiofilm properties at 50% (v/v) concentration in vitro. Dextran, on its own, showed antibiofilm properties at 1.25% (w/v) concentration. Chitosan, on its own, reduced proliferation of fibroblasts to 82% of control proliferation and chitosan-dextran gel reduced proliferation of the fibroblasts to 0.04% of control proliferation. Relative to the no treatment controls, chitosan-dextran gel significantly delayed the wound-healing rate over the first 48 hours of the experiment. Conclusion Chitosan-dextran gel reduced fibroblast proliferation and wound-healing time, showing a possible mechanism of reducing adhesions in the postsurgical period. Chitosan reduced IL-8 levels, showing its anti-inflammatory properties. Chitosan-dextran gel and dextran treatment showed antibiofilm properties in our model.
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Affiliation(s)
- Sathish Paramasivan
- Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
| | - Damien Jones
- Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
| | - Leonie Baker
- Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
| | - Lyall Hanton
- Department of Polymer and Supra-molecular Chemistry, University of Otago, Dunedin, New Zealand
| | - Simon Robinson
- Department of Polymer and Supra-molecular Chemistry, University of Otago, Dunedin, New Zealand
| | - Peter J. Wormald
- Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
| | - Lorwai Tan
- Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
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Oyer SL, Mulligan JK, Psaltis AJ, Henriquez OA, Schlosser RJ. Cytokine correlation between sinus tissue and nasal secretions among chronic rhinosinusitis and controls. Laryngoscope 2013; 123:E72-8. [PMID: 23852962 DOI: 10.1002/lary.24305] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/24/2013] [Accepted: 06/24/2013] [Indexed: 01/11/2023]
Abstract
OBJECTIVES/HYPOTHESIS Compare cytokine levels in sinus tissue to sinus secretions from controls and chronic rhinosinusitis patients. STUDY DESIGN In vitro. METHODS Polyurethane foam sponges were placed into middle meati of patients with chronic rhinosinusitis without nasal polyps (CRSsNP), with polyps (CRSwNP), and controls. Sinus biopsies were then taken from the same location. Protein levels of tumor necrosis factor-alpha (TNF-α), interferon-γ (IFN-γ), and interleukins (IL) 2, 4, 6, 8, 10, and 17A were measured via cytometric bead assay for each sample. Protein values from sinus tissue and secretions were compared with Pearson's correlation between samples as well as one-way ANOVA with posthoc t test between groups. RESULTS Samples from 43 patients in total were examined. Mucus was measured from 10 controls, 11 CRSsNP and 10 CRSwNP, and sinus tissue was measured from 10 controls, 15 CRSsNP and 10 CRSwNP. IL-8 and IFN-γ levels were outside of the detectable range of the assay. Levels of secreted IL-2, 4, 6, 10, and 17A correlated with tissue levels (P < 0.05 for all, r > 0.49) while TNF-α did not (P = 0.71). CRSsNP had elevated mucus levels of IL-2, 4, 6, 10, and 17A compared to controls. CRSwNP had elevated mucus levels of IL-4, 6, 10, 17A, and TNF-α compared to controls. CONCLUSIONS Cytokine levels in sinus secretions correlate with levels in sinus tissue and are elevated in CRS versus control based on Th1/Th2 skewing.
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Affiliation(s)
- Samuel L Oyer
- Division of Rhinology&Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Effect of long-term, low-dose clarithromycin on T helper 2 cytokines, eosinophilic cationic protein and the 'regulated on activation, normal T cell expressed and secreted' chemokine in the nasal secretions of patients with nasal polyposis. The Journal of Laryngology & Otology 2012; 126:495-502. [PMID: 22559798 DOI: 10.1017/s0022215112000485] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the effects of macrolides on the cytokines and chemokines that modulate the function of eosinophils in nasal polyposis. METHODS Twenty-two non-allergic and 18 allergic patients with nasal polyps were administered clarithromycin 500 mg/day (single oral dose) for eight weeks. We measured the nasal secretion levels of the T helper 2 (also known as Th2) cytokines interleukin 4, 5 and 6, the 'regulated on activation, normal T cell expressed and secreted' (also known as RANTES) chemokine, and the eosinophilic cationic protein, before and after treatment. RESULTS After clarithromycin treatment, we found reduced levels of the 'regulated on activation, normal T cell expressed and secreted' chemokine in samples from both non-allergic and allergic patients (p < 0.05). Clarithromycin treatment decreased the levels of eosinophilic cationic protein only in non-allergic patients (p < 0.05), and decreased the level of interleukin 6 only in allergic patients (p < 0.05). Decreased levels of the 'regulated on activation, normal T cell expressed and secreted' chemokine were associated with a reduction in polyp size both in non-allergic and allergic patients. CONCLUSION Clarithromycin has a strong anti-inflammatory effect in nasal polyposis, but has different immunomodulatory effects in allergic and non-allergic nasal polyposis patients.
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Abstract
Eosinophilic Inflammation in Allergic Rhinitis and Nasal PolyposisOn histopathological examination, nasal polyps and nasal mucosa in allergic rhinitis show different forms of pseudostratified respiratory epithelium, whereas the dominant characteristic of lamina propria is an eosinophilic infiltration. The aim of this study was to compare interleukin (IL)-5 and eosinophilic cationic protein (ECP) levels in the nasal fluid of 42 patients: 12 with allergic rhinitis and nasal septal deviation, 17 non-atopic patients with nasal polyposis, and 13 atopic nasal polyp patients were enrolled in this cross-sectional study. Nasal secretion samples were collected a few days before surgery. The levels of IL-5 were measured using flow cytometry and the ECP using a commercial ELISA kit. In addition, we counted eosinophils in hematoxylin-and-eosin-stained sections of all nasal polyp and all nasal mucosa samples taken from the inferior nasal turbinates during septoplasty. A significantly higher concentration of IL-5 was found in the nasal fluid of atopic patients with nasal polyposis than in non-atopic nasal polyp patients (p=0.025) and patients with allergic rhinitis (p=0.05). ECP was higher in atopic nasal polyp patients than in patients with allergic rhinitis (p<0.0001) and than in non-atopic nasal polyp patients (p<0.0001). Polyp eosinophils were higher in atopic' than in non-atopic patients (p<0.0001) and higher than in the mucosa of patients with allergic rhinitis (p<0.0001). These however had significantly more mucosal eosinophils than was found in the polyps of non-atopic patients' (p=0.025). ECP levels in nasal fluid and eosinophil counts in tissue specimens correlated well in all three groups of patients. Our study has shown that atopic nasal polyp patients have a higher level of eosinophilic inflammation than non-atopic patients with nasal polyps and patients with allergic rhinitis.
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