CD3+CD4-CD8- mucosal T cells are associated with uncontrolled chronic rhinosinusitis with nasal polyps

Transcriptomic Differentiation of Phenotypes in Chronic Rhinosinusitis and Its Implications for Understanding the Underlying Mechanisms

Chronic rhinosinusitis (CRS) is a multifaceted disease with variable clinical courses and outcomes. We aimed to determine CRS-associated nasal-tissue transcriptome in clinically well-characterized and phenotyped individuals, to gain a novel insight into the biological pathways of the disease. RNA-sequencing of tissue samples of patients with CRS with polyps (CRSwNP), without polyps (CRSsNP), and controls were performed. Characterization of differently expressed genes (DEGs) and functional and pathway analysis was undertaken. We identified 782 common CRS-associated nasal-tissue DEGs, while 375 and 328 DEGs were CRSwNP- and CRSsNP-specific, respectively. Common key DEGs were found to be involved in dendritic cell maturation, the neuroinflammation pathway, and the inhibition of the matrix metalloproteinases. Distinct CRSwNP-specific DEGs were involved in NF-kβ canonical pathways, Toll-like receptor signaling, HIF1α regulation, and the Th2 pathway. CRSsNP involved the NFAT pathway and changes in the calcium pathway. Our findings offer new insights into the common and distinct molecular mechanisms underlying CRSwNP and CRSsNP, providing further understanding of the complex pathophysiology of the CRS, with future research directions for novel treatment strategies.

High-Frequency Nanosecond Bleomycin Electrochemotherapy and its Effects on Changes in the Immune System and Survival

In this work, a time-dependent and time-independent study on bleomycin-based high-frequency nsECT (3.5 kV/cm × 200 pulses) for the elimination of LLC1 tumours in C57BL/6J mice is performed. We show the efficiency of nsECT (200 ns and 700 ns delivered at 1 kHz and 1 MHz) for the elimination of tumours in mice and increase of their survival. The dynamics of the immunomodulatory effects were observed after electrochemotherapy by investigating immune cell populations and antitumour antibodies at different timepoints after the treatment. ECT treatment resulted in an increased percentage of CD4⁺ T, splenic memory B and tumour-associated dendritic cell subsets. Moreover, increased levels of antitumour IgG antibodies after ECT treatment were detected. Based on the time-dependent study results, nsECT treatment upregulated PD 1 expression on splenic CD4⁺ Tr1 cells, increased the expansion of splenic CD8⁺ T, CD4⁺CD8⁺ T, plasma cells and the proportion of tumour-associated pro inflammatory macrophages. The Lin^- population of immune cells that was increased in the spleens and tumour after nsECT was identified. It was shown that nsECT prolonged survival of the treated mice and induced significant changes in the immune system, which shows a promising alliance of nanosecond electrochemotherapy and immunotherapy.

Effect of Xinyi Biyan Pill in Adjuvant Treatment of Patients with Chronic Rhinosinusitis and Its Influence on Serum Inflammatory Factors and Immune Function

OBJECTIVE

To explore the effect of Xinyi Biyan Pill in adjuvant treatment of patients with chronic rhinosinusitis (CRS) and its influence on serum inflammatory factors and immune function.

METHODS

From January 2017 to April 2020, 112 CRS patients admitted to this hospital were randomly divided into the control group (n = 52) and the study group (n = 60). The control group was treated with endoscopic sinus surgery (ESS), after the operation, levofloxacin capsules were taken orally, budesonide nasal spray was given, and the nasal cavity was flushed with normal saline; on the basis of that mentioned above, the study group was treated with Xinyi Biyan Pill orally after the surgery. The clinical efficacy and the symptom relief time of nasal congestion and runny nose, hyposmia, mucosal edema, and vesicles disappearance of the two groups after treatment were observed; the serum inflammatory factors' (C-reactive protein (CRP), interleukin-6 (IL-6), and interleukin-8 (IL-8)) and immune function indexes' (total immunoglobulin E (TIgE), eosinophil cationic protein (ECP), CD3+, CD4+, and CD4+/CD8+) expression levels before and after treatment in the two groups were detected; the recurrence of CRS after 1 year of treatment in the two groups was recorded.

RESULT

After treatment, the total clinical effective rate of the study group (92.98%) was significantly higher than that of the control group (78.00%) (P < 0.05). After treatment, the symptom relief time of nasal congestion and runny nose, hyposmia, mucosal edema, and vesicle disappearance in the study group was shorter than that in the control group (P < 0.05). After treatment, the expression levels of serum CRP, IL-6, and IL-8 in the two groups were significantly lower than those before treatment, and the study group was significantly lower than the control group (P < 0.05). After treatment, the expression levels of serum TIgE and ECP of the two groups were significantly lower than those before treatment, the expression levels of serum CD3+, CD4+, and CD4+/CD8+ of the two groups were significantly higher than those before treatment, and the study group had significant changes compared with the control group (P < 0.05). After 1 year of treatment, the recurrence rate of CRS in the study group (1.79%) was significantly lower than that in the control group (12.00%) (P < 0.05).

CONCLUSION

Xinyi Biyan Pill has a significant clinical effect in adjuvant treatment of CRS patients. It can effectively reduce the expression level of serum inflammatory factors, improve the body's immune function, and prevent short-term recurrence. It is worthy of clinical promotion.

Transcription factors gene expression in chronic rhinosinusitis with and without nasal polyps

Background Chronic rhinosinusitis (CRS) current therapeutic approaches still fail in some patients with severe persistent symptoms and recurrences after surgery. We aimed to evaluate the master transcription factors gene expression levels of T cell subtypes in chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP) that could represent new, up-stream targets for topical DNAzyme treatment. Patients and methods Twenty-two newly diagnosed CRS patients (14 CRSwNP and 8 CRSsNP) were prospectively biopsied and examined histopathologically. Gene expression levels of T-box transcription factor (T-bet, TBX21), GATA binding protein 3 (GATA3), Retinoic acid-related orphan receptor C (RORC) and Forkhead box P3 (FOXP3) were analyzed by real-time quantitative polymerase chain reaction (RT-qPCR). Results Eosinophilic CRSwNP was characterized by higher level of GATA3 gene expression compared to noneosinophilic CRSwNP, whereas there was no difference in T-bet, RORC and FOXP3 between eosinophilic and noneosinophilic CRSwNP. In CRSsNP, we found simultaneous upregulation of T-bet, GATA3 and RORC gene expression levels in comparison to CRSwNP; meanwhile, there was no difference in FOXP3 gene expression between CRSwNP and CRSsNP. Conclusions In eosinophilic CRSwNP, we confirmed the type 2 inflammation by elevated GATA3 gene expression level. In CRSsNP, we unexpectedly found simultaneous upregulation of T-bet and GATA3 that is currently unexplained; however, it might originate from activated CD8+ cells, abundant in nasal mucosa of CRSsNP patients. The elevated RORC in CRSsNP could be part of homeostatic nasal immune response that might be better preserved in CRSsNP patients compared to CRSwNP patients. Further data on transcription factors expression rates in CRS phenotypes are needed.