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Fang KM, Chiu YL, Hong RW, Cheng PC, Cheng PW, Liao LJ. The Interleukin-15 and Interleukin-8 Axis as a Novel Mechanism for Recurrent Chronic Rhinosinusitis with Nasal Polyps. Biomedicines 2024; 12:980. [PMID: 38790942 PMCID: PMC11117578 DOI: 10.3390/biomedicines12050980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
The prevention of postoperative recurrence after endoscopic sinus surgery (ESS) relies on targeting specific pathological mechanisms according to individuals' immunological profiles. However, essential biomarkers and biological characteristics of difficult-to-treat chronic rhinosinusitis (CRS) patients are not well-defined. The aim of this study was to explore the immunologic profiles of subgroups of CRS patients and determine the specific cytokines responsible for recalcitrant or recurrent CRS with nasal polyposis (rCRSwNP). We used 30 cytokine antibody arrays to determine the key cytokines related to recurrent polypogenesis. Enzyme-linked immunosorbent assay (ELISA) experiments were conducted to assess the levels of these key cytokines in 78 patients. Polymorphonuclear leukocytes (PMNs) isolated from nasal polyps were challenged with specific cytokines to examine the levels of enhanced interleukin (IL)-8 production. Finally, we used immunohistochemistry (IHC) staining to check for the presence and distribution of the biomarkers within nasal polyps. A cytokine antibody array revealed that IL-8, IL-13, IL-15, and IL-20 were significantly higher in the recalcitrant CRSwNP group. Subsequent ELISA screening showed a stepwise increase in tissue IL-8 levels in the CHR, CRSsNP, and CRSwNP groups. PMNs isolated from nine CRSwNP cases all demonstrated enhanced IL-8 production after IL-15 treatment. IHC staining was labeled concurrent IL-8 and IL-15 expression in areas of prominent neutrophil infiltration. Our results suggest that IL-15 within the sinonasal mucosa plays a crucial role in promoting IL-8 secretion by infiltrating PMNs in recalcitrant nasal polyps. In addition, we propose a novel therapeutic strategy targeting the anti-IL-15/IL-8 axis to treat CRS with nasal polyposis.
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Affiliation(s)
- Kai-Min Fang
- Department of Nursing, Oriental Institute of Technology, College of Healthcare and Management, New Taipei City 220, Taiwan;
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
| | - Yen-Ling Chiu
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (Y.-L.C.); (R.-W.H.)
| | - Ruo-Wei Hong
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (Y.-L.C.); (R.-W.H.)
| | - Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; (P.-C.C.); (P.-W.C.)
- Department of Electrical Engineering, Yuan Ze University, Taoyuan 320, Taiwan
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Carsuzaa F, Béquignon É, Dufour X, de Bonnecaze G, Lecron JC, Favot L. Cytokine Signature and Involvement in Chronic Rhinosinusitis with Nasal Polyps. Int J Mol Sci 2021; 23:ijms23010417. [PMID: 35008843 PMCID: PMC8745309 DOI: 10.3390/ijms23010417] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 02/07/2023] Open
Abstract
Cytokines are well known to play a central role in chronic rhinosinusitis with nasal polyps (CRSwNP), particularly in maintenance of the inflammatory response and the recruitment of eosinophils. The pathophysiological concepts concerning the involvement of inflammatory cytokines in CRSwNP have gradually evolved. Although the Th2 cytokines environment associated with an eosinophilic infiltration has retained a central role in the genesis of polyps, the role of other cytokine subpopulations has also and more recently been detailed, leading to a specific and complex signature in CRSwNP. The purpose of this review is to summarize the current state of knowledge about the cytokine signature in CRSwNP, the role of cytokines in the pathogenesis of this disease and in the intercellular dialog between epithelial cells, fibroblasts and inflammatory cells. Knowledge of this precise cytokine signature in CRSwNP is fundamental in the perspective of potential targeting biotherapies.
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Affiliation(s)
- Florent Carsuzaa
- Laboratoire Inflammation Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, 86000 Poitiers, France; (X.D.); (J.-C.L.); (L.F.)
- Oto-Rhino-Laryngologie et Chirurgie Cervico-Maxillo-Faciale, Centre Hospitalier Universitaire de Poitiers, 86021 Poitiers, France
- Correspondence: ; Tel.: +33-(0)5-49-44-43-28
| | - Émilie Béquignon
- Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, 94010 Créteil, France;
- INSERM U955, Équipe 13, Centre Henri Mondor de Recherche Biomédicale, 94000 Créteil, France
| | - Xavier Dufour
- Laboratoire Inflammation Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, 86000 Poitiers, France; (X.D.); (J.-C.L.); (L.F.)
- Oto-Rhino-Laryngologie et Chirurgie Cervico-Maxillo-Faciale, Centre Hospitalier Universitaire de Poitiers, 86021 Poitiers, France
| | - Guillaume de Bonnecaze
- Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Toulouse, 31400 Toulouse, France;
| | - Jean-Claude Lecron
- Laboratoire Inflammation Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, 86000 Poitiers, France; (X.D.); (J.-C.L.); (L.F.)
- Service Immunologie et Inflammation, Centre Hospitalier Universitaire de Poitiers, 86021 Poitiers, France
| | - Laure Favot
- Laboratoire Inflammation Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, 86000 Poitiers, France; (X.D.); (J.-C.L.); (L.F.)
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Hox V, Lourijsen E, Jordens A, Aasbjerg K, Agache I, Alobid I, Bachert C, Boussery K, Campo P, Fokkens W, Hellings P, Hopkins C, Klimek L, Mäkelä M, Mösges R, Mullol J, Pujols L, Rondon C, Rudenko M, Toppila-Salmi S, Scadding G, Scheire S, Tomazic PV, Van Zele T, Wagemann M, van Boven JFM, Gevaert P. Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper. Clin Transl Allergy 2020; 10:1. [PMID: 31908763 PMCID: PMC6941282 DOI: 10.1186/s13601-019-0303-6] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 12/02/2019] [Indexed: 02/05/2023] Open
Abstract
Because of the inflammatory mechanisms of most chronic upper airway diseases such as rhinitis and chronic rhinosinusitis, systemic steroids have been used for their treatment for decades. However, it has been very well documented that—potentially severe—side-effects can occur with the accumulation of systemic steroid courses over the years. A consensus document summarizing the benefits of systemic steroids for each upper airway disease type, as well as highlighting the potential harms of this treatment is currently lacking. Therefore, a panel of international experts in the field of Rhinology reviewed the available literature with the aim of providing recommendations for the use of systemic steroids in treating upper airway disease.
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Affiliation(s)
- Valerie Hox
- 1Cliniques Universitaires Saint-Luc Brussels, Av. Hippocrate 10, 1200 Brussels, Belgium
| | - Evelijn Lourijsen
- 2Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - Arnout Jordens
- 3Upper Airway Research Laboratory, Dep. of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | | | - Ioana Agache
- Faculty of Medicine, Transsylvania University, Brasov, Romania
| | - Isam Alobid
- 6Hospital Clínic, IDIBAPS, CEBERES Universitat de Barcelona, Catalonia, Spain.,7Centro Medico Teknon, Barcelona, Spain
| | - Claus Bachert
- 3Upper Airway Research Laboratory, Dep. of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.,8Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Koen Boussery
- 9Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Paloma Campo
- 10Allergy Unit, Hospital Regional Universitario of Málaga, IBIMA, ARADyAL, Malaga, Spain
| | - Wytske Fokkens
- 2Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - Peter Hellings
- 11Department of Ear, Nose and Throat Disease, University Hospitals, Louvain, Belgium
| | - Claire Hopkins
- 12ENT Department, Guy's & St Thomas' Hospital, London, UK
| | - Ludger Klimek
- Center of Rhinology and Allergology, Wiesbaden, Germany
| | - Mika Mäkelä
- 14Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Joaquim Mullol
- 6Hospital Clínic, IDIBAPS, CEBERES Universitat de Barcelona, Catalonia, Spain
| | - Laura Pujols
- 6Hospital Clínic, IDIBAPS, CEBERES Universitat de Barcelona, Catalonia, Spain
| | - Carmen Rondon
- 10Allergy Unit, Hospital Regional Universitario of Málaga, IBIMA, ARADyAL, Malaga, Spain
| | | | - Sanna Toppila-Salmi
- 14Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Sophie Scheire
- 9Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | | | - Thibaut Van Zele
- 3Upper Airway Research Laboratory, Dep. of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | | | - Job F M van Boven
- 20Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands
| | - Philippe Gevaert
- 3Upper Airway Research Laboratory, Dep. of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
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Hwang JW, Kim JH, Kim HJ, Choi IH, Han HM, Lee KJ, Kim TH, Lee SH. Neutrophil extracellular traps in nasal secretions of patients with stable and exacerbated chronic rhinosinusitis and their contribution to induce chemokine secretion and strengthen the epithelial barrier. Clin Exp Allergy 2019; 49:1306-1320. [DOI: 10.1111/cea.13448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/16/2019] [Accepted: 06/06/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Jae Woong Hwang
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
| | - Jae Hyung Kim
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
| | - Hyun Jung Kim
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
| | - In Hak Choi
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
| | - Hye Min Han
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
| | - Ki Jung Lee
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
| | - Tae Hoon Kim
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
| | - Sang Hag Lee
- Department of Otorhinolaryngology‐Head & Neck Surgery, College of Medicine Korea University Seoul South Korea
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5
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[Immunology of chronic rhinosinusitis with nasal polyps as a basis for treatment with biologicals]. HNO 2019; 67:15-26. [PMID: 30167718 DOI: 10.1007/s00106-018-0557-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial inflammation of the nasal and paranasal mucosa. Until now, no internationally standardized classification could be developed. In most cases, CRS is phenotypically classified according to chronic rhinosinusitis with (CRScNP) and without nasal polyps (CRSsNP). However, recent studies could show that there are numerous endotypes within these phenotypes based on different inflammatory mechanisms. This review describes the important immunological mechanisms of CRScNP and highlights modern treatment options with biologicals directly addressing particular immunological processes. METHODS Current knowledge on immunological and molecular processes of CRS, particularly CRScNP, was extracted from Medline, PubMed, national and international study- and guideline-registers, and the Cochrane library by a systematic review of the literature. RESULTS Based on current literature, various immunological mechanisms for CRS and CRScNP could be identified. Relevant studies for the treatment of eosinophilic conditions such as asthma or CRScNP are presented and, if available, results of these studies are discussed. CONCLUSION The growing insight into the underlying immunological mechanisms of CRScNP could pave the way for new personalized treatment options such as biologicals in the future.
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Könnecke M, Klimek L, Mullol J, Gevaert P, Wollenberg B. Subtypisierung der Polyposis nasi: Phänotypen, Endotypen und Komorbiditäten. ALLERGO JOURNAL 2018. [DOI: 10.1007/s15007-018-1542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Koennecke M, Klimek L, Mullol J, Gevaert P, Wollenberg B. Subtyping of polyposis nasi: phenotypes, endotypes and comorbidities. ALLERGO JOURNAL INTERNATIONAL 2018; 27:56-65. [PMID: 29564208 PMCID: PMC5842507 DOI: 10.1007/s40629-017-0048-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/12/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a heterogeneous, multifactorial inflammatory disease of the nasal and paranasal mucosa. It has not been possible to date to develop an internationally standardized, uniform classification for this disorder. A phenotype classification according to CRS with (CRSwNP) and without polyposis (CRSsNP) is usually made. However, a large number of studies have shown that there are also different endotypes of CRS within these phenotypes, with different pathophysiologies of chronic inflammation of the nasal mucosa. This review describes the central immunological processes in nasal polyps, as well as the impact of related diseases on the inflammatory profile of nasal polyps. MATERIALS AND METHODS The current knowledge on the immunological and molecular processes of CRS, in particular CRSwNP and its classification into specific endotypes, was put together by means of a structured literature search in Medline, PubMed, the national and international guideline registers, and the Cochrane Library. RESULTS Based on the current literature, the different immunological processes in CRS and nasal polyps were elaborated and a graphical representation in the form of an immunological network developed. In addition, different inflammatory profiles can be found in CRSwNP depending on related diseases, such as bronchial asthma, cystic fibrosis (CF), or NASID-Exacerbated Respiratory Disease (N‑ERD). CONCLUSION The identification of different endotypes of CRSwNP may help to improve diagnostics and develop novel individual treatment approaches in CRSwNP.
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Affiliation(s)
- Michael Koennecke
- Lübeck Campus, Department of Otorhinolaryngology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Joaquim Mullol
- Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, CIBERES Spain
| | - Philippe Gevaert
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - Barbara Wollenberg
- Lübeck Campus, Department of Otorhinolaryngology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
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8
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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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9
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Lin XS, Luo XY, Wang HG, Li CW, Lin X, Yan C. Expression and distribution of dendritic cells in nasal polyps. Exp Ther Med 2013; 5:1476-1480. [PMID: 23737902 PMCID: PMC3671826 DOI: 10.3892/etm.2013.986] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 02/08/2013] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to investigate the expression, distribution and function of dendritic cells (DCs) and to study their role in nasal polyps. The study involved 55 participants, 45 of whom had nasal polyps and were the study group and 10 who had normal inferior turbinates and were the control group. Immunohistochemical staining was used to visualize the expression and distribution of the S-100 protein. A double immunostaining method was used to visualize the CD1a and CD40 expression and the images were analyzed with Axioplan 2 microscopy. The expression level of the S-100 protein in the nasal polyps was higher than that in the normal inferior turbinates with a significant difference (P<0.01). The distribution area, number and density of the double stained cells in the nasal polyps were all greater than in the normal inferior turbinates (P<0.01). The S-100 protein and double stained cells were mainly located in the lamina propria below the mucous membrane. The present study demonstrates that DCs are involved in the pathogenesis of nasal polyps and the presence of CD40-positive DCs suggests that this was related to the reciprocal interaction between the DCs and T lymphocytes.
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Affiliation(s)
- Xin-Sheng Lin
- Department of Otolarynology-Head and Neck Surgery, The Shantou Central Hospital/Affiliated Shantou Hospital of Sun Yet-Sen University, Shantou, Guangdong 515041
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Perić A, Vojvodić D, Perić AV, Radulović V, Miljanović O. Correlation between cytokine levels in nasal fluid and scored clinical parameters in patients with nasal polyposis. Indian J Otolaryngol Head Neck Surg 2012; 65:295-300. [PMID: 24427664 DOI: 10.1007/s12070-011-0447-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 12/26/2011] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to compare the cytokine levels in nasal fluid in subjects with nasal polyposis (NP) and co-morbid asthma and NP patients without asthma and to correlate these levels with clinical parameters of severity of disease. Forty NP patients (20 asthmatic and 20 nonasthmatic) were enrolled. Nasal secretion samples were collected from nasal cavities of all 40 subjects. The levels of Th1 cytokines IL-2, IL-12 and IFN-γ, Th2 cytokines IL-4, IL-5, IL-6, and IL-10, chemokine IL-8, and proinflammatory cytokines IL-1β, TNF-α and TNF-β were measured using flow cytometric method. Each of the 40 patients was staged clinically according to global nasal symptom score, endoscopic score, and Lund-Mackay computed tomography (CT) score. The concentrations of Th2 cytokines IL-5, IL-6 and IL-10 were significantly higher (P < 0.01, P < 0.01, P < 0.05) in patients with NP and asthma compared with NP patients without asthma. Positive correlations were observed between concentration of IL-2 in nasal secretions and global nasal symptom score, endoscopic score, and Lund-Mackay score only in NP patients without asthma. We also found positive correlation between CT score and the levels of IL-8, IL-4, and IL-1β in nonasthmatic patients. Finally, our results showed a positive correlation between IL-5 levels in nasal fluid and endoscopic score only in asthmatic patients. NP in asthmatic patients have different immunological patterns compared to those without asthma. We also concluded that concentrations of cytokines measured in nasal fluid were not sensitive enough to determine the severity of disease.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Rhinology Unit, Military Medical Academy, Crnotravska 17, 11040 Belgrade, Serbia
| | - Danilo Vojvodić
- Division of Clinical Immunology, Institute of Medical Research, Military Medical Academy, Belgrade, Serbia
| | - Aneta V Perić
- Institute of Pharmacy, Military Medical Academy, Belgrade, Serbia
| | - Vesna Radulović
- Municipal Institute for Lung Diseases and Tuberculosis, Belgrade, Serbia
| | - Olivera Miljanović
- Center of Human Genetics and Immunology, Clinical Center of Montenegro, Podgorica, Montenegro
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11
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Bleier BS, Mulligan RM, Schlosser RJ. Primary human sinonasal epithelial cell culture model for topical drug delivery in patients with chronic rhinosinusitis with nasal polyposis. ACTA ACUST UNITED AC 2011; 64:449-56. [PMID: 22309277 DOI: 10.1111/j.2042-7158.2011.01409.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The primary human sinonasal epithelial cell culture (HSNEC) allows for in-vitro modelling of mucosal responses to topical therapy. Cultures grown from healthy donors may underestimate changes in individuals with chronic sinonasal disease thereby yielding inaccurate results with respect to this large patient population. The purpose of this study was to analyse HSNECs derived from patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) to determine whether expected disease dependent variables salient to topical drug delivery persist in culture. METHODS Cultures were grown from patients with CRSwNP. Ciliary beat frequency (CBF) (basal and stimulated), permeability (trans and paracellular), inflammatory response, and glucocorticoid dose response were measured and compared with healthy controls. KEY FINDINGS Methylcholine stimulated CBF was greater in CRSwNP versus controls (ΔCBF(60 min) 7.25 ± 1.02 vs 0.89 ± 1.04 Hz, respectively). Paracellular permeability was greater in CRSwNP versus controls (basolateral dextran(120 min) 18.97 ± 3.90 vs 11.31 ± 4.35 µg/ml, respectively). Lipopolysaccharide (0.1 mg/ml) stimulated interleukin-6 (IL-6) and IL-8 secretion was increased in CRSwNP versus controls (IL-6 Δbaseline 1738.72 ± 654.82 vs 1461.61 ± 533.51%, respectively; IL-8 Δbaseline 137.11 ± 0.83 vs 111.27 ± 0.67%, respectively). CRSwNP cultures were more sensitive than controls to dexamethasone (1 µg/ml) dependent IL-6 and IL-8 suppression. CONCLUSIONS HSNECs derived from patients with CRSwNP retained their primary phenotype with respect to ciliary function, epithelial permeability, irritant induced inflammatory cytokine secretion, and glucocorticoid dose response.
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Affiliation(s)
- Benjamin S Bleier
- Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
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12
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Abstract
Nasal polyps (NPs) represent a common clinical end point for a myriad of inflammatory disease processes involving the paranasal sinuses. Chronic rhinosinusitis is the most common cause for NPs, but not all NPs are created equally. This article outlines the current understanding of pathogenesis in nasal polyposis and discusses the implications on therapy.
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13
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Muscarinic acetylcholine receptors present in human osteoblast and bone tissue. Eur J Pharmacol 2010; 650:34-40. [PMID: 20888332 DOI: 10.1016/j.ejphar.2010.09.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 07/29/2010] [Accepted: 09/14/2010] [Indexed: 01/27/2023]
Abstract
Acetylcholine is the predominant neurotransmitter in the neuromuscular junction, and a role in bone has been postulated. The expression of nicotinic receptors has been reported in osteoblasts, but the expression and function of muscarinic receptor in bone remain obscure. In this study, we investigated the expression and functional activities of muscarinic receptor subtypes in human osteoblast cell lines and animal and human bone tissue. The mRNA levels of muscarinic receptor subtypes were detected by reverse-transcription polymerase chain reaction. We found that muscarinic subtypes m1, m2, m3, m4, and m5 were expressed at different levels in human osteosarcoma HOS cells, rat femur, and human rib bone tissue; m1, m4, m5 were in cultured mouse femur bone cells and cultured mouse calvarial bone cells; m2, m3, m4 were in bovine bone. The mRNA of neuronal markers, light-, medium- and heavy-neurofilament, was not found in human bone tissues to exclude the possible contamination from neuronal tissue. Methacholine induced an elevation in cytosolic calcium concentration and proliferation in HOS cells. Both effects were blocked by atropine. We conclude that muscarinic receptor is present in bone tissue to evoke calcium signaling and modulate cell proliferation. Different muscarinic receptor subtypes are distributed in various parts of the animal skeletal system including the different species and bone portions. Bone remodeling involving osteoblast proliferation leads the possibilities that muscarinic receptor may play roles in bone remodeling.
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14
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Sun X, Wang D, Yu H, Hu L. Serial cytokine levels during wound healing in rabbit maxillary sinus mucosa. Acta Otolaryngol 2010; 130:607-13. [PMID: 19958244 DOI: 10.3109/00016480903352975] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Collagen deposition was increased in regenerative rabbit maxillary mucosa, and the elevated collagen deposition during wound healing was associated with increased interleukin (IL)-6 and IL-8, and decreased IL-10. OBJECTIVES To observe the natural progression of wound healing in rabbit maxillary sinus mucosa and to detect the expression of relevant cytokines. METHODS A rabbit wound-healing model was established in the maxillary sinus. At different times after injury, the sizes of maxillary ostia were recorded, and histological changes in the sinus mucosa were examined by means of hematoxylin and eosin (H&E) and Masson trichrome staining. Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of IL-6, IL-8, IL-10, and collagen types I and III. RESULTS A large amount of immature spindled collagen deposition was observed in the basal lamina and lamina propria of regenerative mucosa. IL-6 was increased significantly in regenerative mucosa after injury, especially at 14 days post wounding when compared with normal mucosa. IL-8 was also increased significantly in regenerative mucosa; however, IL-10 was decreased significantly when compared with normal mucosa. IL-6 and IL-8 showed a significant correlation with the expression level of collagen type I.
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Affiliation(s)
- Xicai Sun
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Bachert C, Van Bruaene N, Toskala E, Zhang N, Olze H, Scadding G, Van Drunen CM, Mullol J, Cardell L, Gevaert P, Van Zele T, Claeys S, Halldén C, Kostamo K, Foerster U, Kowalski M, Bieniek K, Olszewska-Ziaber A, Nizankowska-Mogilnicka E, Szczeklik A, Swierczynska M, Arcimowicz M, Lund V, Fokkens W, Zuberbier T, Akdis C, Canonica G, Van Cauwenberge P, Burney P, Bousquet J. Important research questions in allergy and related diseases: 3-chronic rhinosinusitis and nasal polyposis - a GALEN study. Allergy 2009; 64:520-33. [PMID: 19317839 DOI: 10.1111/j.1398-9995.2009.01964.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chronic rhinosinusitis is one of the most common health care challenges, with significant direct medical costs and severe impact on lower airway disease and general health outcomes. The diagnosis of chronic rhinosinusitis (CRS) currently is based on clinical signs, nasal endoscopy and CT scanning, and therapeutic recommendations are focussing on 2 classes of drugs, corticosteroids and antibiotics. A better understanding of the pathogenesis and the factors amplifying mucosal inflammation therefore seems to be crucial for the development of new diagnostic and therapeutic tools. In an effort to extend knowledge in this area, the WP 2.7.2 of the GA(2)LEN network of excellence currently collects data and samples of 1000 CRS patients and 250 control subjects. The main objective of this project is to characterize patients with upper airway disease on the basis of clinical parameters, infectious agents, inflammatory mechanisms and remodeling processes. This collaborative research will result in better knowledge on patient phenotypes, pathomechanisms, and subtypes in chronic rhinosinusitis. This review summarizes the state of the art on chronic rhinosinusitis and nasal polyposis in different aspects of the disease. It defines potential gaps in the current research, and points to future research perspectives and targets.
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Figueiredo CR, Santos RP, Silva IDCG, Weckx LLM. Microarray cDNA to identify inflammatory genes in nasal polyposis. ACTA ACUST UNITED AC 2007; 21:231-5. [PMID: 17424886 DOI: 10.2500/ajr.2007.21.2968] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The objective of this study was to investigate the spectrum of inflammatory gene expression in patients with nasal polyposis. METHODS The cDNA microarray technique was used to identify gene expression in tissue samples from nasal polyps and adjacent inflammatory nasal mucosa of 21 patients with nonallergic nasal polyposis. To validate the microarray analysis, we compared the expression of five genes by reverse transcription-polymerase chain reaction (RT-PCR): tumor necrosis factor, IL-5, IL-9, fibroblast growth factor, and transforming growth factor (TGF)-beta1. RESULTS We tested 96 different inflammatory genes in our samples. Thirty-six genes exhibited differences in expression between the two tissue types. In all 36 genes the level of expression was greater in the inflammatory mucosa than the polyps. The RT-PCR confirmed the cDNA results. CONCLUSION We believe that the high expression of TGF-beta1 in inflammatory mucosa compared with the low expression in polyps may reflect an important role in the inhibitory mechanisms of nasal polyposis.
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Affiliation(s)
- Claudia R Figueiredo
- Department of Otorhinolaryngology, Head and Neck Surgery, Federal University of São Paulo, Brazil.
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Chen YS, Langhammer T, Westhofen M, Lorenzen J. Relationship between matrix metalloproteinases MMP-2, MMP-9, tissue inhibitor of matrix metalloproteinases-1 and IL-5, IL-8 in nasal polyps. Allergy 2007; 62:66-72. [PMID: 17156344 DOI: 10.1111/j.1398-9995.2006.01255.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Nasal polyps (NP), a subgroup of chronic rhinosinusitis, are characterized by interleukin 5 (IL-5) mediated infiltration of eosinophils in sinus mucosa, leading to pseudostratified ciliated columnar epithelium, thickening of the epithelial basement membrane and tissue edema. Matrix metalloproteinases (MMP) constitute a large group of Zn2+ dependent endopeptidases with the ability to degrade extracellular matrix and are possibly responsible for the development of tissue edema in chronic sinusitis. OBJECTIVE The aim of this study was to determine the expression of MMP-2, MMP-9 and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) mRNA and to locate the distribution of MMP-2, MMP-9 and TIMP-1 by immunohistochemistry in ethmoid sinus mucosa in NP. Furthermore the correlation between IL-5 or IL-8 and MMP-2, MMP-9 or TIMP-1 is examined. METHODS Nasal polyps of 33 patients and 18 specimens of inferior turbinate mucosa were examined by real time RT-PCR for MMP-2, MMP-9, TIMP-1, IL-5 and IL-8 mRNA expression. Immunohistochemical labeling for MMP-2, MMP-9 and TIMP-1 was performed. RESULTS Differences between both locations were detectable for MMP-9 (P < 0.001) and IL-5 (P=0.003) but not for MMP-2 (P=0.278), TIMP-1 (P=0.515) and IL-8 (P=0.386). Correlation was detected only between TIMP-1 and IL-5 (r=0.422, P =0.014). Cytoplasmic staining of MMP-2 was present in the apical part of the ciliated cells, submucosal glands and in smooth muscle cells. Matrix metalloproteinase-9 was expressed in surface epithelium, in seromucous glands and in polymorphonuclear cells. CONCLUSIONS Expression of MMP-9 and IL-5 mRNA are associated with NP. The correlation between IL-5 and TIMP-1 indicates the role of TIMP-1 in maintaining the homeostasis in NP.
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Affiliation(s)
- Y-S Chen
- Department of Otorhinolaryngology, Plastic Head and Neck Surgery, University Hospital RWTH Aachen, Germany
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Abstract
PURPOSE OF REVIEW Patients with advanced head and neck cancer are being treated with chemo-radiotherapy, and life is being prolonged, with or without persistent disease, for longer than was previously. Hypercalcaemia may present in patients with advanced or disseminated head and neck cancer, and, as such, these patients may present to a larger variety of clinicians for advice concerning their symptoms and illness. Modes of presentation of hypercalcaemia and treatment strategies are reviewed. RECENT FINDINGS There were previously few large series of head and neck cancer patients diagnosed with hypercalcaemia, which may or may not have been related to their cancer being treated. Investigations, by way of blood/serum calcium level, may identify such patients. Patients with cancer-related hypercalcaemia have a poor prognosis, but many may respond temporarily to treatment when offered, with an improvement of their quality of life and death. SUMMARY Hypercalcaemia should and must be considered in all patients who have or possibly have a diagnosis of a head and neck cancer and who present unwell with symptoms of fatigue, lethargy and somnolence. Investigation must include serum calcium (corrected for serum albumin binding) and parathyroid hormone level. Patients may be treated by a combination of rehydration and bisulphonate therapy until the serum calcium is reduced to a level below 3 mmol/l. The majority of patients diagnosed with hypercalcaemia due to head and neck malignancy die of their diseases in the short term, but some may enjoy a prolongation of life with reasonable quality if diagnosed and treated aggressively.
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Affiliation(s)
- Patrick J Bradley
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, Nottingham, UK.
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