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Harcourt-Smith EA, Krstic ET, Soekov-Pearce BJ, Colella AD, Chegeni N, Chataway TK, Woods CM, Aliakbari K, Carney AS. The Nasal Innate Immune Proteome After Saline Irrigation: A Pilot Study in Healthy Individuals. Am J Rhinol Allergy 2023:19458924231159176. [PMID: 36847244 DOI: 10.1177/19458924231159176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Previous research has shown diminished nasal immune function following nasal saline irrigation (NSI), returning to baseline at 6 hours. The aim of this study was to examine the immune nasal proteome before and after 14 days of nasal irrigation. METHODS Seventeen healthy volunteers received either isotonic (IsoSal) or low salt (LowNa) NSI. Nasal secretions were collected before and 30 min after NSI at baseline and again after 14 days. Specimens were analyzed using mass spectrometry to detect proteins of relevance to nasal immune function. RESULTS One thousand eight hundred and sixty-five proteins were identified with significant changes in 71 proteins, of which 23 were identified as part of the innate immune system. Baseline analysis demonstrated an increase of 9 innate proteins after NSI, most after IsoSal. After 14 days, a greater increase in innate peptides was present, with most now in the LowNa group. When NSI solutions were compared, a significant increase in 4 innate proteins, including a 211% in lysozyme, was detected in the LowNa group. CONCLUSION LowNa NSI demonstrates evidence of improving the innate immune secretions, especially lysozyme, in healthy volunteers.
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Affiliation(s)
| | - Emerson T Krstic
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | | | - Alex D Colella
- Proteomics Facility, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Nusha Chegeni
- Proteomics Facility, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Timothy K Chataway
- Proteomics Facility, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Charmaine M Woods
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Kamelya Aliakbari
- Proteomics Facility, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - A Simon Carney
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
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Pedan H, Janosova V, Hajtman A, Calkovsky V. Non-Reflex Defense Mechanisms of Upper Airway Mucosa: Possible Clinical Application. Physiol Res 2021; 69:S55-S67. [PMID: 32228012 DOI: 10.33549/physiolres.934404] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The sinonasal mucosa has an essential role in defense mechanisms of the upper respiratory tract. The innate immune system presents the primary defense against noxious microorganisms followed by induction of the adaptive immune mechanisms as a consequence of the presence of pathogens. This well-known activation of adaptive immune system in response to presence of the antigen on mucosal surfaces is now broadly applicated in vaccinology research. Prevention of infectious diseases belongs to substantial challenges in maintaining the population health. Non-invasive, easily applicable mucosal vaccination purposes various research opportunities that could be usable in daily practice. However, the existence of multiple limitations such as rapid clearance of vaccine from nasal mucosa by means of mucociliary transport represents a great challenge in development of safe and efficient vaccines. Here we give an updated view on nasal functions with focus on nasal mucosal immunity and its potential application in vaccination in nearly future.
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Affiliation(s)
- H Pedan
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and Martin University Hospital, Martin, Slovak
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Characterization of mRNA Profiles of Exosomes from Diverse Forms of M2 Macrophages. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1585306. [PMID: 33299857 PMCID: PMC7704128 DOI: 10.1155/2020/1585306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/18/2022]
Abstract
Exosomes transmit certain amounts of molecules to specific recipient cells for intercellular communication. Among these molecules, messenger RNAs (mRNAs) may be delivered and translated into proteins in the recipient cells, and these mRNAs are thought to be critical mediators of exosomal functions. There are three subtypes of M2 macrophages (M2Ф), M2aФ, M2bФ, and M2cФ, which have different specific functional programs. The aim of the present study was to screen the mRNA profiles in the exosomes of these macrophage subtypes and to analyze the transcriptomic profile features associated with their specific functions. The mRNA contents of the exosomes isolated from the culture supernatants of the M2Ф subtypes were analyzed and compared using the Illumina HiSeq platform. The results indicated that the exosomes contained particular mRNAs from their source cells and were messengers of cellular functions. Bioinformatics analysis suggested that the exosomal mRNAs from M2bФs are enriched in the Toll-like receptor (TLR), tumor necrosis factor (TNF), NOD-like receptor (NLR), and NF-kappa B (NF-κB) signaling pathways. The mRNA profile of exosomes from M2bФ was distinctly different from that of exosomes from M2aФ and M2cФ and was consistent with the M2bФ cytological characteristic of maintaining a high level of proinflammatory cytokine and regulatory factor production. Therefore, the mRNA profiles revealed several characteristics of the exosomes from diverse forms of M2Ф. Further functional investigations based on these results may advance the understanding of the physiological roles of exosome-transferred mRNAs in MФ functions.
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Hayes SM, Biggs TC, Goldie SP, Harries PG, Walls AF, Allan RN, Pender SLF, Salib RJ. Staphylococcus aureus internalization in mast cells in nasal polyps: Characterization of interactions and potential mechanisms. J Allergy Clin Immunol 2019; 145:147-159. [PMID: 31254531 DOI: 10.1016/j.jaci.2019.06.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/30/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) with nasal polyps is a common chronic condition. The exact cause of nasal polyps remains unknown. Recently, we made the novel observation of intracellular localization of Staphylococcus aureus within mast cells in nasal polyps. OBJECTIVE This follow-up study aimed to further characterize interactions between S aureus and mast cells in this setting and elucidate potential internalization mechanisms with particular emphasis on the role of staphylococcal enterotoxin B (SEB). METHODS A prospective study was performed using an explant tissue model with ex vivo inferior turbinate mucosa obtained from patients with chronic rhinosinusitis with nasal polyps (n = 7) and patients without CRS (n = 5). Immunohistochemistry was used to characterize S aureus uptake into mast cells and investigate the effects of SEB on this process. An in vitro cell-culture model was used to investigate mast cell-S aureus interactions by using a combination of fluorescent in situ hybridization, confocal laser scanning microscopy, scanning electron microscopy, transmission electron microscopy, and proliferation assays. RESULTS S aureus was captured by extracellular traps and entered mast cells through phagocytosis. Proliferating intracellular S aureus led to the expansion and eventual rupture of mast cells, resulting in release of viable S aureus into the extracellular space. The presence of SEB appeared to promote internalization of S aureus into mast cells. CONCLUSION This study provides new insights into the interactions between S aureus and mast cells, including the internalization process, and demonstrates a prominent role for SEB in promoting uptake of the bacteria into these cells.
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Affiliation(s)
- Stephen M Hayes
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Southampton NIHR Respiratory Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Department of Otorhinolaryngology/Head & Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Timothy C Biggs
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Southampton NIHR Respiratory Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Department of Otorhinolaryngology/Head & Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Simon P Goldie
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Southampton NIHR Respiratory Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Department of Otorhinolaryngology/Head & Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Philip G Harries
- Department of Otorhinolaryngology/Head & Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Andrew F Walls
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Raymond N Allan
- NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Department of Biological Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Sylvia L F Pender
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Rami J Salib
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Southampton NIHR Respiratory Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Department of Otorhinolaryngology/Head & Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
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5
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Bennett C, Ramezanpour M, Cooksley C, Vreugde S, Psaltis AJ. Kappa-carrageenan sinus rinses reduce inflammation and intracellular Staphylococcus aureus infection in airway epithelial cells. Int Forum Allergy Rhinol 2019; 9:918-925. [PMID: 31162892 DOI: 10.1002/alr.22360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/29/2019] [Accepted: 05/09/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common disease, often refractory to conventional antimicrobial treatment. In this study we investigate the antimicrobial and anti-inflammatory effects of adding kappa-carrageenan to a commercially available sinus rinse. METHODS Kappa-carrageenan was added to Flo CRS and Flo Sinus Care sinus rinses and applied directly to air-liquid interface cultured primary human nasal epithelial cells (HNECs) from 10 CRS patients. Inflammatory markers were measured using enzyme-linked immunosorbent assay. Kappa-carrageenan-supplemented sinus rinses were applied to human bronchial epithelial cells (HBEs) in the presence of different Staphylococcus aureus strains to observe the effect on intracellular infection rates. RESULTS Flo Sinus Care with kappa-carrageenan rinse solutions resulted in a marked reduction of interleukin-6 (IL-6) production by HNECs from CRS patients (p = 0.007). Both Flo CRS and Flo Sinus Care rinses significantly reduced the S aureus intracellular infection of HBEs (p < 0.0001). The addition of kappa-carrageenan to both Flo CRS and Flo Sinus Care rinses further reduced the intracellular infection rate by an average of 2%. CONCLUSIONS The commonly used sinus irrigation product Flo Sinus Care with added kappa-carrageenan reduces IL-6 production by HNECs in vitro. Flo CRS and Flo Sinus Care rinses significantly reduced S aureus intracellular infection rates of HBE cells. Our findings may have clinical relevance for CRS patient management.
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Affiliation(s)
- Catherine Bennett
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Mahnaz Ramezanpour
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Clare Cooksley
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Sarah Vreugde
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Alkis James Psaltis
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
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Immunotherapy of gynecological cancers. Best Pract Res Clin Obstet Gynaecol 2019; 60:97-110. [PMID: 31003902 DOI: 10.1016/j.bpobgyn.2019.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/01/2019] [Indexed: 12/29/2022]
Abstract
Oncology treatments have evolved from intuitive, via empiric, to the present precision medicine, with the integration of molecular targeted therapies in our treatment arsenal. The use of the patients' powerful immune system has long been contemplated and recently led to the integration of immunotherapy to overturn the well-documented inhibitory effects of the tumor on the immune system and restore it to a state of activity against the cancer. Recent favorable results have shown the value and effectiveness of immunotherapy against gynecological cancers. In particular, the checkpoint inhibitors, targeting the programmed death-1 (PD-1) pathway, have shown durable clinical responses with manageable toxicity. Several phase II and III clinical trials testing the association of different regimen of chemotherapy and immunotherapy are ongoing in gynecological cancers, and important results are expected. In this chapter, we outline the main principles of immunotherapy for gynecological cancers and summarize the current strategies used in clinical trials.
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Abstract
PURPOSE OF REVIEW To perform analysis of evidence in current literature on the topic of genetics and chronic rhinosinusitis (CRS), with a particular focus on recent findings in the cystic fibrosis transmembrane regulator (CFTR), genes associated with primary ciliary dyskinesia, and taste receptor T2R38. Other genes that have been found to have association with CRS are also presented and discussed. RECENT FINDINGS Recent studies in CFTR and CRS research have investigated possible CFTR-potentiators for treatment of refractory CRS. The T2R38 gene has been shown to be applicable in the clinical setting with a testable phenotype and may have a role in the prognosis and influencing management strategies of CRS patients. Many genes of the immune system have been studied, with genome-wide association studies and candidate-gene approaches identifying new associations that will need replication and further elucidation. SUMMARY CRS is a multifactorial disease, with strong evidence of a genetic component in its pathophysiology for some cases. Currently, there are over 70 genes that have been genetically associated with CRS in the past 15 years. Future investigations into genetic causes and predispositions of CRS may allow for improved prognostication and development of disease-prevention strategies as well as novel therapeutic targets.
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Abstract
Bacterial pathogens and microbiome alterations can contribute to the initiation and propagation of mucosal inflammation in chronic rhinosinusitis (CRS). In this article, the authors review the clinical and research implications of key pathogens, discuss the role of the microbiome, and connect bacteria to mechanisms of mucosal immunity relevant in CRS.
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Affiliation(s)
- Thad W Vickery
- University of Colorado School of Medicine, 13001 East 17th Place, Aurora, CO 80045, USA
| | - Vijay R Ramakrishnan
- Department of Otolaryngology, Head and Neck Surgery, University of Colorado, 12631 East 17th Avenue, B205, Aurora, CO 80045, USA.
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London NR, Lane AP. Innate immunity and chronic rhinosinusitis: What we have learned from animal models. Laryngoscope Investig Otolaryngol 2016; 1:49-56. [PMID: 28459101 PMCID: PMC5409101 DOI: 10.1002/lio2.21] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial disease characterized by dysregulated inflammation. Abnormalities in innate immune function including sinonasal epithelial cell barrier function, mucociliary clearance, response to pathogen-associated molecular patterns (PAMPs) via pattern recognition receptors (PRRs), and the contribution of innate immune cells will be highlighted in this review. DATA SOURCES PubMed literature review. REVIEW METHODS A review of the literature was conducted to determine what we have learned from animal models in relation to innate immunity and chronic rhinosinusitis. RESULTS Dysregulation of innate immune mechanisms including sinonasal barrier function, mucociliary clearance, PAMPs, and innate immune cells such as eosinophils, mast cells, and innate lymphoid cells may contribute to CRS pathogenesis. Sinonasal inflammation has been studied using mouse, rat, rabbit, pig, and sheep explant or in vivo models. Study using these models has allowed for analysis of experimental therapeutics and furthered our understanding of the aforementioned aspects of the innate immune mechanism as it relates to sinonasal inflammation. These include augmenting mucociliary clearance through activation of the cystic fibrosis transmembrane conductance regulator (CFTR) and study of drug toxicity on ciliary beat frequency. Knockout models of Toll-like receptors (TLR) have demonstrated the critical role these PRRs play in allergic inflammation as loss of TLR2 and TLR4 leads to decreased lower airway inflammation. Mast cell deficient mice are less susceptible to ovalbumin-induced sinonasal inflammation. CONCLUSION Animal models have shed light as to the potential contribution of dysregulated innate immunity in chronic sinonasal inflammation.
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Affiliation(s)
- Nyall R. London
- Department of OtolaryngologyHead and Neck Surgery, Johns Hopkins School of MedicineBaltimoreMarylandU.S.A.
| | - Andrew P. Lane
- Department of OtolaryngologyHead and Neck Surgery, Johns Hopkins School of MedicineBaltimoreMarylandU.S.A.
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Orlandi RR, Kingdom TT, Hwang PH, Smith TL, Alt JA, Baroody FM, Batra PS, Bernal-Sprekelsen M, Bhattacharyya N, Chandra RK, Chiu A, Citardi MJ, Cohen NA, DelGaudio J, Desrosiers M, Dhong HJ, Douglas R, Ferguson B, Fokkens WJ, Georgalas C, Goldberg A, Gosepath J, Hamilos DL, Han JK, Harvey R, Hellings P, Hopkins C, Jankowski R, Javer AR, Kern R, Kountakis S, Kowalski ML, Lane A, Lanza DC, Lebowitz R, Lee HM, Lin SY, Lund V, Luong A, Mann W, Marple BF, McMains KC, Metson R, Naclerio R, Nayak JV, Otori N, Palmer JN, Parikh SR, Passali D, Peters A, Piccirillo J, Poetker DM, Psaltis AJ, Ramadan HH, Ramakrishnan VR, Riechelmann H, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Senior BA, Sindwani R, Stankiewicz JA, Stewart M, Tan BK, Toskala E, Voegels R, Wang DY, Weitzel EK, Wise S, Woodworth BA, Wormald PJ, Wright ED, Zhou B, Kennedy DW. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol 2016; 6 Suppl 1:S22-209. [DOI: 10.1002/alr.21695] [Citation(s) in RCA: 333] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 02/06/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Valerie Lund
- Royal National Throat Nose and Ear Hospital; London UK
| | - Amber Luong
- University of Texas Medical School at Houston
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Hirschberg A, Kiss M, Kadocsa E, Polyanka H, Szabo K, Razga Z, Bella Z, Tiszlavicz L, Kemeny L. Different activations of toll-like receptors and antimicrobial peptides in chronic rhinosinusitis with or without nasal polyposis. Eur Arch Otorhinolaryngol 2015; 273:1779-88. [PMID: 26518209 DOI: 10.1007/s00405-015-3816-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 10/22/2015] [Indexed: 11/28/2022]
Abstract
Both up- and down-regulation of the Toll-like receptors (TLRs) and antimicrobial peptides (AMPs) of the sinonasal mucosa have already been associated with the pathogenesis of chronic rhinosinusitis with (CRSwNP) or without (CRSsNP) nasal polyps. The objective of this study was to determine the expression of all known TLR and several AMP genes and some selected proteins in association with allergy, asthma and aspirin intolerance (ASA) in CRS subgroups. RT-PCR was applied to measure the mRNA expressions of 10 TLRs, four defensins, lysozyme, cathelicidin and lactoferrin (LTF) in sinonasal samples from patients with CRSsNP (n = 19), CRSwNP [ASA(-): 17; ASA(+): 7] and in control subjects (n = 12). Protein expressions were detected with immunohistochemistry (n = 10). Statistical analysis was done with the Kruskal-Wallis ANOVA, Mann-Whitney U, and Student t test. TLR2, TLR5, TLR6, TLR7, TLR8, TLR9, β-defensins 1 and 4, cathelicidin and LTF mRNA expressions were significantly (p < 0.05) increased in CRSwNP, whereas only TLR2 and LTF were up-regulated in CRSsNP compared to controls. There was no statistical difference in respect of allergy, aspirin intolerance and smoking between CRSsNP, ASA(-) and ASA(+) CRSwNP patients. TLR2, TLR3, TLR4, LTF, β defensin 2 and lysozyme protein expressions were found to be elevated in macrophages of CRSwNP samples (p < 0.05). Gene expression analysis showed markedly different expressions in CRSwNP (6 out of 10 TLR and 4 out of 7 AMP genes were up-regulated) compared to CRSsNP (1/10, 1/7). The distinct activation of the innate immunity may support the concept that CRSsNP and CRSwNP are different subtypes of CRS. These findings were found to be independent from allergy, asthma, smoking, aspirin intolerance and systemic steroid application.
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Affiliation(s)
- Andor Hirschberg
- Department of Oto-Rhino-Laryngology, St John's Hospital, Dios arok 1-3, 1125, Budapest, Hungary.
| | - Maria Kiss
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Edit Kadocsa
- Department of Oto-Rhino-Laryngology and Head-Neck Surgery, University of Szeged, Szeged, Hungary
| | | | | | - Zsolt Razga
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Zsolt Bella
- Department of Oto-Rhino-Laryngology and Head-Neck Surgery, University of Szeged, Szeged, Hungary
| | | | - Lajos Kemeny
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.,MTA-SZTE Dermatological Research Group, Szeged, Hungary
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Szabó K, Polyánka H, Kiricsi Á, Révész M, Vóna I, Szabó Z, Bella Z, Kadocsa E, Kemény L, Széll M, Hirschberg A. A conserved linkage group on chromosome 6, the 8.1 ancestral haplotype, is a predisposing factor of chronic rhinosinusitis associated with nasal polyposis in aspirin-sensitive Hungarians. Hum Immunol 2015; 76:858-62. [PMID: 26433033 DOI: 10.1016/j.humimm.2015.09.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 05/10/2014] [Accepted: 09/28/2015] [Indexed: 10/23/2022]
Abstract
Inflammation plays a central role in the pathogenesis of chronic rhinosinusitis (CRS), and TNFα is a key pro-inflammatory cytokine in the pathogenesis of this disease. In our previous studies, we showed that the TNFA -308A allele is a genetic predisposition factor in a subgroup of aspirin-sensitive (ASA+) CRS patients suffering from nasal polyps (NP) in the Hungarian population. To determine whether the TNF -308A allele or the presence of a complex, extended ancestral haplotype (8.1AH) located on chromosome 6 is responsible for the previously observed genetic effect, we performed a case-control study for examining the frequency of 8.1AH carriers in controls and in subgroups of CRS patients. Our novel observations demonstrate that the presence of the 8.1AH may be responsible for the development of severe forms of CRS (CRSwNP, ASA+) and strengthen the clinical observation that CRS patients can be classified into clinically and genetically different subgroups.
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Affiliation(s)
- Kornélia Szabó
- MTA-SZTE Dermatological Research Group, Szeged, Hungary.
| | | | - Ágnes Kiricsi
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Szeged, Hungary
| | - Mónika Révész
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Ida Vóna
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Pécs, Faculty of Medicine, Pécs, Hungary
| | - Zsolt Szabó
- Borsod-Abaúj-Zemplén Country Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Zsolt Bella
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Szeged, Hungary
| | - Edit Kadocsa
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Szeged, Hungary
| | - Lajos Kemény
- MTA-SZTE Dermatological Research Group, Szeged, Hungary; Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Márta Széll
- MTA-SZTE Dermatological Research Group, Szeged, Hungary; Department of Medical Genetics, University of Szeged, Szeged, Hungary
| | - Andor Hirschberg
- Department of Otorhinolaryngology, St. John's and North-Buda Hospitals, Budapest, Hungary
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Woods CM, Tan S, Ullah S, Frauenfelder C, Ooi EH, Carney AS. The effect of nasal irrigation formulation on the antimicrobial activity of nasal secretions. Int Forum Allergy Rhinol 2015. [PMID: 26205877 DOI: 10.1002/alr.21604] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Saline-based irrigation solutions are evidence-based rhinological treatments; however, the formulation of these solutions could theoretically alter the function of innate antimicrobial peptides. The aim of this study was to determine if the antimicrobial activity of normal human nasal secretions in vivo is altered by commercially available large volume irrigation solutions. METHODS Minimally manipulated sinonasal secretions were collected from patients with chronic rhinosinusitis (CRS; n = 10) and normal healthy volunteers (n = 20). In a subset of control patients (n = 10) secretions were collected prior to, and at 1 hour, 6 hours, and 24 hours after nasal irrigation with 4 commercial irrigation solutions. Lysozyme and lactoferrin levels were analyzed and the antimicrobial activity of secretions determined using a radial diffusion assay. RESULTS The antimicrobial activity of nasal secretions was reduced in CRS patients compared to healthy volunteers (p < 0.01), but there was no significant difference in antimicrobial peptide concentrations. Isotonic nasal irrigation reduced lysozyme and lactoferrin levels, which returned to baseline levels by 6 hours; in addition to a sustained decrease in antimicrobial activity before returning to baseline at 24 hours. Low-salt solution stimulated peptide secretion by approximately 40% at 6 hours and 24 hours, but produced a transient decrease in antimicrobial activity, returning to baseline levels by 6 hours. Hypertonic solution initially decreased lysozyme and lactoferrin levels but maintained baseline levels of antimicrobial activity and increased peptide secretion by approximately 30% at 24 hours. CONCLUSION The formulation of nasal irrigation solutions significantly affects the measured levels and functionality of sinonasal antimicrobial peptides.
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Affiliation(s)
- Charmaine M Woods
- Ear, Nose, and Throat (ENT) Department, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia
| | - Sophia Tan
- Ear, Nose, and Throat (ENT) Department, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia
| | - Shahid Ullah
- Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Bedford Park, South Australia, Australia
| | - Claire Frauenfelder
- Ear, Nose, and Throat (ENT) Department, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia
| | - Eng H Ooi
- Ear, Nose, and Throat (ENT) Department, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia
| | - A Simon Carney
- Ear, Nose, and Throat (ENT) Department, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia
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Kariya S, Okano M, Nishizaki K. Relationship between chronic rhinosinusitis and lower airway diseases: An extensive review. World J Otorhinolaryngol 2015; 5:44-52. [DOI: 10.5319/wjo.v5.i2.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 12/04/2014] [Accepted: 03/05/2015] [Indexed: 02/06/2023] Open
Abstract
Significant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. The impact of allergic rhinitis on asthma has been established. On the other hand, the relationship between chronic rhinosinusitis and lung diseases has been under investigation. Chronic rhinosinusitis is a common disease, and the high prevalence of chronic rhinosinusitis in some kinds of lung diseases has been reported. Recent studies suggest that the treatment of chronic rhinosinusitis has beneficial effects in the management of asthma. Here, we present an overview of the current research on the relationship between chronic rhinosinusitis and lower airway diseases including asthma, chronic obstructive pulmonary disease, cystic fibrosis, diffuse panbronchiolitis, primary ciliary dyskinesia, idiopathic bronchiectasis, and allergic bronchopulmonary aspergillosis.
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Cui XY, Chen X, Yu CJ, Yang J, Lin ZP, Yin M, Cheng L. Increased expression of toll-like receptors 2 and 4 and related cytokines in persistent allergic rhinitis. Otolaryngol Head Neck Surg 2014; 152:233-8. [PMID: 25505260 DOI: 10.1177/0194599814562173] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Toll-like receptors (TLRs) are the crucial components of host defenses and supposed to play a role in nasal inflammation such as chronic rhinosinusitis and seasonal allergic rhinitis. This study was performed to investigate the expression patterns of TLRs and related cytokines in persistent allergic rhinitis (PER). STUDY DESIGN Experimental study of human nasal tissue. SETTING Academic medical center. SUBJECTS AND METHODS Nasal biopsy specimens were obtained from 21 patients with PER and 21 controls from December 2012 to September 2013. Messenger RNA (mRNA) expression of TLR1-9, interleukin (IL)-1, IL-6, IL-8, IL-12, interferon (IFN)-α, and tumor necrosis factor (TNF)-α was determined by quantitative reverse transcription polymerase chain reaction. The cellular localizations as well as protein expression of TLR2 and TLR4 were further detected by immunohistochemistry and Western blotting, respectively. RESULTS TLR1-9 mRNA could be determined in nasal mucosa. Compared with the controls, mRNA expression of only TLR2 and TLR4 was significant higher in patients with PER (P < .05). In addition, mRNA expression of IL-6 and IL-8, but not IL-1, IL-12, IFN-α, and TNF-α, was upregulated in patients with PER vs control subjects (P < .05). However, these increased cytokines were not correlated with either TLR2 or TLR4 in patients with PER. Protein expression of TLR2 and TLR4 was consistent with mRNA levels (P < .05). The cellular distributions of TLR2 and TLR4 were localized in nasal epithelium, subepithelial glands and capillary endothelial cells, and immune cells. CONCLUSION TLR2 and TLR4 are increased in patients with PER and may be one of the major contributors to the persistence and aggravation of allergic inflammation in PER.
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Affiliation(s)
- Xin-Yan Cui
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xi Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chen-Jie Yu
- Department of Otorhinolaryngology, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Jun Yang
- Department of Pathology, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Zi-Ping Lin
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Min Yin
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China International Centre for Allergy Research, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China International Centre for Allergy Research, Nanjing Medical University, Nanjing, Jiangsu, China
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Bachert C, Pawankar R, Zhang L, Bunnag C, Fokkens WJ, Hamilos DL, Jirapongsananuruk O, Kern R, Meltzer EO, Mullol J, Naclerio R, Pilan R, Rhee CS, Suzaki H, Voegels R, Blaiss M. ICON: chronic rhinosinusitis. World Allergy Organ J 2014; 7:25. [PMID: 25379119 PMCID: PMC4213581 DOI: 10.1186/1939-4551-7-25] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 08/27/2014] [Indexed: 02/06/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a public health problem that has a significant socio-economic impact. Moreover, the complexity of this disease due to its heterogeneous nature based on the underlying pathophysiology - leading to different disease variants - further complicates our understanding and directions for the most appropriate targeted treatment strategies. Several International/national guidelines/position papers and/or consensus documents are available that present the current knowledge and treatment strategies for CRS. Yet there are many challenges to the management of CRS especially in the case of the more severe and refractory forms of disease. Therefore, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), a collaboration between EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus (ICON) on Chronic Rhinosinusitis. The purpose of this ICON on CRS is to highlight the key common messages from the existing guidelines, the differences in recommendations as well as the gaps in our current knowledge of CRS, thus providing a concise reference. In this document we discuss the definition of the disease, its relevance, pharmacoeconomics, pathophysiology, phenotypes and endotypes, genetics and risk factors, natural history and co-morbidities as well as clinical manifestations and treatment options in both adults and children comprising pharmacotherapy, surgical interventions and more recent biological approaches. Finally, we have also highlighted the unmet needs that wait to be addressed through future research.
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Affiliation(s)
- Claus Bachert
- Upper Airways Research Laboratory (URL), University Hospital Ghent, Kragujevac, Belgium
| | - Ruby Pawankar
- Div. of Allergy, Dept. of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Luo Zhang
- Beijing Key Laboratory of Nasal diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Chaweewan Bunnag
- Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Daniel L Hamilos
- Division of Rheumatology, Allergy & Immunology, Massachusetts General Hospital, Boston, MA USA
| | | | - Robert Kern
- Department of Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA
| | - Eli O Meltzer
- Allergy & Asthma Medical Group & Research Center, San Diego, California USA
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, Hospital Clínic - IDIBAPS, Barcelona, Catalonia Spain
| | - Robert Naclerio
- Section of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, Illinois USA
| | - Renata Pilan
- Department of Otorhinolaryngology, Clinics Hospital/University of Sao Paulo Medical School, Kragujevac, Brazil
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Seoul National University College of Medicine, Seoul, Korea
| | - Harumi Suzaki
- Dept. of Otorhinolaryngology, Showa University, Tokyo, Japan
| | - Richard Voegels
- Department of Rhinology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Michael Blaiss
- University of Tennessee Health Science Center, Memphis, Tennessee
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Detwiller KY, Smith TL, Alt JA, Trune DR, Mace JC, Sautter NB. Differential expression of innate immunity genes in chronic rhinosinusitis. Am J Rhinol Allergy 2014; 28:374-7. [PMID: 25198021 PMCID: PMC4151703 DOI: 10.2500/ajra.2014.28.4082] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Prior research has identified several components of the innate immune system that may play a significant role in chronic rhinosinusitis (CRS), but the role of innate immunity in patients with CRS is poorly understood. The objective of this study was to determine differential expression of innate immunity genes in the mucosa of patients with CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP) when compared with controls. METHODS Control patients (n = 9) and patients with CRS (n = 36) who failed medical management were prospectively enrolled. Ethmoid mucosa samples were harvested during surgery and quantitative real-time polymerase chain reaction was used to determine levels of mRNA expression of Toll-like receptor (TLR) 2 and TLR9 and interleukin-22 receptor (IL-22R). The average change in crossover threshold and fold change were calculated and differences between controls, CRSwNP, and CRSsNP were compared. Statistical analysis was performed using the Kruskall-Wallis and adjusted Mann-Whitney U tests. RESULTS Patients with CRSwNP (n = 16) and CRSsNP (n = 20) showed lower mean expression of TLR2 (p < 0.05) compared with controls. Patients with CRSsNP showed significantly higher mean expression of IL-22R (p < 0.05) than controls. CONCLUSION The sinonasal innate immune system may have a significant role in the development of CRS. We found differential expression of innate immune mediators between patients with and without nasal polyposis. These results provide further evidence of disruption of innate immunity at the mucosal level in CRS and highlight differences between polyp- and non-polyp-forming CRS phenotypes at the molecular level. In addition to our knowledge, this is the first report of altered IL-22R expression in CRSsNP patients. This study was a part of the clinical trial NCT01332136 registered in www.clinicaltrials.gov.
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Affiliation(s)
- Kara Y. Detwiller
- From the Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Timothy L. Smith
- From the Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Jeremiah A. Alt
- Department of Otolaryngology–Head and Neck Surgery, University of Utah, Salt Lake City, Utah, and
| | - Dennis R. Trune
- Oregon Hearing Research Center, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Jess C. Mace
- From the Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Nathan B. Sautter
- From the Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
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Purkey MT, Li J, Mentch F, Grant SFA, Desrosiers M, Hakonarson H, Toskala E. Genetic variation in genes encoding airway epithelial potassium channels is associated with chronic rhinosinusitis in a pediatric population. PLoS One 2014; 9:e89329. [PMID: 24595210 PMCID: PMC3940609 DOI: 10.1371/journal.pone.0089329] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 01/18/2014] [Indexed: 11/19/2022] Open
Abstract
Background Apical potassium channels regulate ion transport in airway epithelial cells and influence air surface liquid (ASL) hydration and mucociliary clearance (MCC). We sought to identify whether genetic variation within genes encoding airway potassium channels is associated with chronic rhinosinusitis (CRS). Methods Single nucleotide polymorphism (SNP) genotypes for selected potassium channels were derived from data generated on the Illumnia HumanHap550 BeadChip or Illumina Human610-Quad BeadChip for 828 unrelated individuals diagnosed with CRS and 5,083 unrelated healthy controls from the Children's Hospital of Philadelphia (CHOP). Statistical analysis was performed with set-based tests using PLINK, and corrected for multiple testing. Results Set-based case control analysis revealed the gene KCNMA1 was associated with CRS in our Caucasian subset of the cohort (598 CRS cases and 3,489 controls; p = 0.022, based on 10,000 permutations). In addition there was borderline evidence that the gene KCNQ5 (p = 0.0704) was associated with the trait in our African American subset of the cohort (230 CRS cases and 1,594 controls). In addition to the top significant SNPs rs2917454 and rs6907229, imputation analysis uncovered additional genetic variants in KCNMA1 and in KCNQ5 that were associated with CRS. Conclusions We have implicated two airway epithelial potassium channels as novel susceptibility loci in contributing to the pathogenesis of CRS.
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Affiliation(s)
- Michael T. Purkey
- Department of Otorhinolaryngology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jin Li
- Center for Applied Genomics, the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Frank Mentch
- Center for Applied Genomics, the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Struan F. A. Grant
- Division of Human Genetics, the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Martin Desrosiers
- Department of Otolaryngology, Montreal General Hospital, McGill University, Montreal, Québec Canada
| | - Hakon Hakonarson
- Center for Applied Genomics, the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
- Division of Human Genetics, the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail: (HH); (ET)
| | - Elina Toskala
- Department of Otolaryngology, Temple University, Philadelphia, Pennsylvania, United States of America
- * E-mail: (HH); (ET)
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Sedaghat AR, Cunningham MJ, Busaba NY. Connexin 32 and 43 mutations: do they play a role in chronic rhinosinusitis? Am J Otolaryngol 2014; 35:33-6. [PMID: 24119489 DOI: 10.1016/j.amjoto.2013.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Dysfunction of the sinonasal epithelium may contribute to the pathogenesis of chronic rhinosinusitis (CRS) including recurrent acute rhinosinusitis (RARS). Mutations in connexin 32 and 43 proteins have been associated with a number of human diseases. The objective of this study is to investigate the role of mutations in connexin 32 or connexin 43 genes in CRS and RARS. METHODS Prospective case series of 19 patients with CRS and /or RARS. Clinical and demographic factors were noted and buccal swabs were collected for DNA sequencing of connexin 32 and connexin 43 genes. RESULTS One patient was found to have a conservative V193I mutation in the connexin 32 gene. Connexin 43 mutations were found in two patients - a silent R239R mutation and an AAA insertion after the stop codon in the 3' UTR. None of these mutations are associated with any known diseases or predicted to lead to protein dysfunction. CONCLUSION Mutations in connexin 32 or 43 genes in patients with CRS, including RARS, appear to be rare. The etiologic role of connexin mutations in chromic rhinosinusitis is suspect, and routine sequencing for connexin mutations in patients with RARS or CRS is not cost effective.
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Affiliation(s)
- Ahmad R Sedaghat
- Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA
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Cantero D, Cooksley C, Bassiouni A, Wormald PJ, Vreugde S. Staphylococcus aureus biofilm activates the nucleotide-binding oligomerization domain containing 2 (Nod2) pathway and proinflammatory factors on a human sinonasal explant model. Int Forum Allergy Rhinol 2013; 3:877-84. [PMID: 24039208 DOI: 10.1002/alr.21213] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 06/28/2013] [Accepted: 07/05/2013] [Indexed: 01/07/2023]
Abstract
BACKGROUND The presence of Staphylococcus aureus biofilms on sinonasal mucosal surfaces is associated with recalcitrant chronic rhinosinusitis (CRS), but little is known about the innate immune response they trigger. We aimed to study the human pattern recognition receptor (PRR) nucleotide-binding oligomerization domain containing 2 (Nod2) receptor and downstream pathway in response to initial S. aureus biofilm infection. METHODS Using a validated protocol, sinonasal mucosae from 4 non-CRS donors were cultured with and without S. aureus biofilms and planktonic cells. After 24 hours, RNA was extracted and gene expression was analyzed using a human antibacterial response polymerase chain reaction (PCR) array. Immunohistochemistry was performed to confirm the presence and determine the immunolocalization of selected proteins. RESULTS C-X-C motif (CXC) chemokine ligands 1 and 2, interleukin-6 (IL-6), and genes related to the Nod2 pathway were significantly upregulated in biofilm-treated tissues compared with control samples. Nod2 pathway-specific gene expression was increased in biofilm-treated tissues compared with planktonic S. aureus-treated explants. Enhanced expression of Nod2 and nuclear factor kappa B1 (NF-κB1) was also detected with immunohistochemistry in control and biofilm-treated tissues. CONCLUSION S. aureus biofilms exerted a proinflammatory response in the mucosa and activation of the Nod2 pathway, indicating this receptor to be involved in the innate immune response to S. aureus biofilms. Further studies are required to elucidate the role of this pathway in CRS.
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Affiliation(s)
- Daniel Cantero
- Department of Otorhinolaryngology-Head and Neck Surgery, Division of Surgery, The Queen Elizabeth Hospital, and the University of Adelaide, Adelaide, South Australia, Australia
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Szabó K, Kiricsi Á, Révész M, Vóna I, Szabó Z, Bella Z, Polyánka H, Kadocsa E, Kemény L, Széll M, Hirschberg A. The -308 G>A SNP of TNFA is a factor predisposing to chronic rhinosinusitis associated with nasal polyposis in aspirin-sensitive Hungarian individuals: conclusions of a genetic study with multiple stratifications. Int Immunol 2013; 25:383-8. [PMID: 23446846 DOI: 10.1093/intimm/dxs162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Single nucleotide polymorphisms (SNPs) of the tumour necrosis factor alpha (TNFα) gene (TNFA) have been extensively studied and shown to be associated with an increased risk of the development of various chronic inflammatory diseases. Inflammation has been demonstrated to play a central role in the pathogenesis of chronic rhinosinusitis (CRS), and TNFα is a key pro-inflammatory cytokine with important functions in these processes. In order to determine whether the well-known TNFA -308 G>A SNP has a role in a genetic predisposition to CRS in the Hungarian population, we analyzed our genomic collection containing control and CRS patient samples in a case-control study, and compared the genotype and allele frequencies. There was no significant difference in the observed genotype or allele frequencies between the controls and the total CRS group. However, after careful stratification of the patient group on the basis of the observed clinical symptoms, we found a significantly higher carriage rate of the rare A allele-containing genotypes among the CRS patients with nasal polyposis (NP) who also exhibited sensitivity to aspirin (acetylsalicylic acid, ASA(+)). It is concluded that genetic variants of the TNFA gene may affect the risk of CRS in a clinically well-defined group of CRSNP(+)ASA(+) patients in the Hungarian population. Our results also emphasize that the group of CRS patients is not homogenous in that patients exhibiting different clinical symptoms exist. Their carried genetic predisposing factors, and as a result, the exact molecular events leading to the development of various forms of CRS, may also differ.
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The Pathogenesis of CRS: An Update. CURRENT OTORHINOLARYNGOLOGY REPORTS 2012. [DOI: 10.1007/s40136-012-0002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park IH, Park SJ, Cho JS, Moon YM, Kim TH, Lee SH, Lee HM. Increased expression of intelectin-1 in nasal polyps. Am J Rhinol Allergy 2012; 26:274-7. [PMID: 22801013 DOI: 10.2500/ajra.2012.26.3771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intelectin-1 is a new type of Ca(2+)-dependant soluble lectin in humans that has affinity for galactofuranose in carbohydrate chains of bacterial cell walls, indicating that intelectin-1 may play a role in immune defense against bacteria. The purpose of the current study was to determine the expression of intelectin-1 mRNA and protein and to localize intelectin-1 protein in nasal polyps and tissues from control subjects. METHODS Normal sphenoid sinus mucosa was obtained from 10 patients undergoing surgery for pituitary tumor. Nasal polyp samples were obtained from 10 patients undergoing endoscopic sinus surgery for chronic polypoid rhinosinusitis. Real-time polymerase chain reaction (PCR) was performed for intelectin-1 mRNA. Immunofluorescent staining was done for localization of intelectin-1 and quantitatively analyzed using computer-based image analysis. Western blot analysis was performed. RESULTS Real-time PCR and Western blot analysis showed that intelectin-1 expression in nasal polyps was increased compared with normal sinus mucosa. Using immunofluorescent staining, intelectin-1 was strongly stained in epithelium and submucosa of nasal polyps, and faint staining was found in normal sinus mucosa. CONCLUSIONS Intelectin-1 is expressed in human sinus mucosa and is increased in patients with nasal polyps. These results suggest a possible contribution for intelectin-1 in the pathophysiology of nasal polyps.
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Affiliation(s)
- Il-Ho Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, Seoul, South Korea
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Woods CM, Hooper DN, Ooi EH, Tan LW, Carney AS. Fungicidal activity of lysozyme is inhibited in vitro by commercial sinus irrigation solutions. Am J Rhinol Allergy 2012; 26:298-301. [PMID: 22801018 DOI: 10.2500/ajra.2012.26.3793] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Lysozyme is an innate immune peptide with bactericidal and fungicidal activity (FA). Despite increased expression of lysozyme protein in chronic rhinosinusitis (CRS) sinus mucosa, CRS patients experience repeated bacterial and/or fungal infections. Commercial sinus irrigation solutions are often used to provide symptomatic relief. However, one of the mechanisms of action of lysozyme involves ionic interactions with the microbial cell wall, which may be inhibited by ionic solutions such as commercial sinus irrigation solutions. OBJECTIVE Determine if the FA of lysozyme is reduced in the presence of solutions with increasing ionic strength and inhibited in the presence of commercial sinus irrigation solutions. METHODS Using an in vitro colony-forming unit (CFU) assay, the FA of lysozyme (5 μM) was tested against a fungi commonly isolated from CRS patients, Aspergillus fumigatus, in solutions of increasing ionic strength or commercial sinus irrigation solutions. FA was presented as percent of control. RESULTS FA of lysozyme against A. fumigatus was 95% in a 21-mM ionic strength solution. However, with increasing ionic strength, FA decreased and was abolished in a 46-mM ionic strength solution. Commercial sinus irrigation solutions abolished the FA of lysozyme against A. fumigatus. CONCLUSION The in vitro FA of lysozyme is dependent on the ionic strength of the solution. The use of sinus irrigation solutions should be further evaluated with regard to maintaining functional activity of cationic antimicrobial peptides involved in sinonasal innate immunity.
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Affiliation(s)
- Charmaine M Woods
- Flinders Ear, Nose and Throat, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia
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Jardeleza C, Jones D, Baker L, Miljkovic D, Boase S, Tan NCW, Vreugde S, Tan LW, Wormald PJ. Gene expression differences in nitric oxide and reactive oxygen species regulation point to an altered innate immune response in chronic rhinosinusitis. Int Forum Allergy Rhinol 2012; 3:193-8. [PMID: 23136082 DOI: 10.1002/alr.21114] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 08/29/2012] [Accepted: 09/25/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND The complex interplay between host, environment, and microbe in the etiopathogenesis of chronic rhinosinusitis (CRS) remains unclear. This study focuses on the host-microbe interaction, specifically the regulation of nitric oxide (NO) and reactive oxygen species (ROS) against the pathogenic organism Staphylococcus aureus (S. aureus). NO and ROS play crucial roles in innate immunity and in the first-line defense against microbial invasion. METHODS Sinonasal tissue samples were harvested from CRS and control patients during surgery. CRS patients were classified S. aureus biofilm-positive (B+) or biofilm-negative (B-) using fluorescence in situ hybridization and clinically as polyp-positive (P+) or polyp-negative (P-). Samples were assessed using an NO polymerase chain reaction (PCR) array containing 84 genes involved in NO and ROS regulation, and gene expression of all subgroups were compared to each other. RESULTS Twenty-three samples were analyzed with 31 genes significantly changed, the greatest seen in the B+P+ CRS patients. Four genes consistently displayed differential expression between the groups including the cytoprotective oxidation resistance 1 (OXR1) and peroxiredoxin 6 (PRDX6), neutrophil cytosolic factor 2 (NCF2), and the prion protein (PRNP) genes. CONCLUSION Alteration in gene expression points to impaired innate immune responses differing among CRS subgroups based on S. aureus biofilm and polyp status. The consistent alteration of 4 genes among distinct groups demonstrates that S. aureus biofilms and polyps are associated with specific changes in gene expression. Further studies are required to validate these findings in a wider cohort of patients and correlate this to protein expression and disease manifestation.
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Affiliation(s)
- Camille Jardeleza
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and the University of Adelaide, Adelaide, South Australia, Australia
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Woods CM, Hooper DN, Ooi EH, Tan LW, Carney AS. Human lysozyme has fungicidal activity against nasal fungi. Am J Rhinol Allergy 2011; 25:236-40. [PMID: 21639997 DOI: 10.2500/ajra.2011.25.3631] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The cationic antimicrobial peptide lysozyme is the most prevalent innate immune protein in nasal secretions but there is a paucity of research regarding its role in paranasal sinus disease. Lysozyme is generally regarded as an antibacterial agent; however, some data suggest activity toward yeast. This study was designed to determine if lysozyme displays fungicidal activity toward fungi commonly identified in patients with chronic rhinosinusitis (CRS) or fungal sinusitis. METHODS Using a colony-forming unit assay the fungicidal activity of lysozyme (0, 0.5, 5, and 50 micromolar; 0- to 7-hour treatment) was tested against strains of Aspergillus fumigatus, the yeast Candida albicans, and other fungi commonly identified in mucin of patients with CRS. Fungi cultured directly from the mucin of two CRS patients were also tested to determine if they were resistant to the fungicidal activity of lysozyme. RESULTS The fungicidal effect of lysozyme was both concentration and time dependent. After 7-hour treatment lysozyme (5 micromolar) had >80% fungicidal activity against A. fumigatus, Penicillium sp., Acremonium sp., C. albicans, and Candida parapsilosis. The fungicidal activity of lysozyme toward Alternaria alternata could not be determined. Lysozyme was also fungicidal toward the clinical isolates A. fumigatus and Aspergillus terreus cultured from the mucin of CRS patients. CONCLUSION Lysozyme displays fungicidal activity toward many fungi commonly identified in patients with CRS, as well as clinical fungi isolates cultured from the mucin of CRS patients. Additional studies are required to determine the regulation of lysozyme in CRS.
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Affiliation(s)
- Charmaine M Woods
- Flinders ENT, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia
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Microbiology of sinusitis: does allergy or endoscopic sinus surgery affect the microbiologic flora? Curr Opin Otolaryngol Head Neck Surg 2011; 19:199-203. [DOI: 10.1097/moo.0b013e328344f67a] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Current World Literature. Curr Opin Otolaryngol Head Neck Surg 2011; 19:229-30. [DOI: 10.1097/moo.0b013e328347afd0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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