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Bartier S, Coste A, Béquignon E. Biotherapy and treatment of adult primary chronic rhinosinusitis with nasal polyps: Cellular and molecular bases. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:355-362. [PMID: 33358657 DOI: 10.1016/j.anorl.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The present article reviews the molecular and cellular mechanisms involved in the pathophysiology of chronic rhinosinusitis with nasal polyps (CRSwCRSwNP) and underlying the action mechanisms of biotherapies. Biotherapy uses substances naturally produced by the organism or their specific antagonists targeting a proinflammatory mechanism. CRSwCRSwNP is a form of chronic rhinosinusitis (CRS), which is classically subdivided in to 2 types according to the presence of polyps. In recent years, the concept of endotypes emerged, with a more exhaustive definition of the types of CRS according to inflammatory mechanism, with a view to developing personalized treatments. CRSwNP pathophysiology is poorly understood. Polyps arise from a primary epithelial lesion in a context of chronic local inflammation, mainly type 2 in Europe, implicating eosinophils, IgE, Th2 cytokines (IL-4/IL-13, IL-5) and T and B cells. Biotherapy seems promising in CRSwNP. The present review details the various pathophysiological pathways underlying the action mechanisms of biotherapies, and the various published studies, assessing efficacy and mode of action in the treatment of CRSwNP.
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Affiliation(s)
- S Bartier
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France; Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Henri Mondor, 94000 Créteil, France; Université Paris-Est Créteil (UPEC), Faculté de Médecine, 94000 Créteil, France; INSERM U955, 94000 Créteil, France; CNRS, ERL 7240, 94000 Créteil, France.
| | - A Coste
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France; Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Henri Mondor, 94000 Créteil, France; Université Paris-Est Créteil (UPEC), Faculté de Médecine, 94000 Créteil, France; INSERM U955, 94000 Créteil, France; CNRS, ERL 7240, 94000 Créteil, France
| | - E Béquignon
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France; Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Henri Mondor, 94000 Créteil, France; Université Paris-Est Créteil (UPEC), Faculté de Médecine, 94000 Créteil, France; INSERM U955, 94000 Créteil, France; CNRS, ERL 7240, 94000 Créteil, France
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Du J, Lv H, Dou X, Cao Z. Nuclear Factor κB/MicroRNA-155 Upregulates the Expression Pattern of Cytokines in Regulating the Relapse of Chronic Sinusitis with Nasal Polyps and the Underlying Mechanism of Glucocorticoid. Med Sci Monit 2020; 26:e923618. [PMID: 32614806 PMCID: PMC7350531 DOI: 10.12659/msm.923618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to explore the upregulated nuclear factor κB (NF-κB)/microRNA-155 (miR-155) in regulating inflammatory responses and relapse of chronic rhinosinusitis (CRS) with nasal polyps (NP), which underlies the molecular mechanism of glucocorticoid treatment. Material/Methods The study recruited 25 patients with eosinophilic (Eos) CRSwNP, 25 patients with Non-Eos CRSwNP, 25 patients with CRS without NP (CRSsNP) and 30 patients with nasal septum deviation (control group). The expression of NF-κB/miR-155 and inflammatory cytokines was detected in epithelial tissue specimens. Additionally, a mouse model of Eos CRSwNP was established, and the mice were treated by NF-κB inhibitor, miR-155 antagomir, or dexamethasone (DEX) to explore the role of NF-κB/miR-155 and the anti-inflammatory effects of glucocorticoid treatment. Results Results showed that the expression level of NF-κB/miR-155 was significantly elevated in the Eos CRSwNP group, accompanied by the upregulation of cytokines: tumor necrosis factor (TNF)-α, interleukin (IL)-1, IL-4, IL-5 (P<0.05) compared with the control group, the CRSsNP group or the Non-Eos CRSwNP group. The upregulation of NF-κB/miR-155 increased inflammatory mediator cyclooxygenase2 (COX2) while decreasing anti-inflammatory mediator Src homology-2 domain-containing inositol 5-phosphatase 1 (SOCS1), which resulted in the aberrant expression pattern of cytokines in the mice model. DEX treatment inhibited the expression of cytokines and decreased the relapse rate of Eos CRSwNP via inhibiting NF-κB/miR-155 (P<0.05). Conclusions The upregulation of NF-κB/miR-155 was crucial in mediating the aberrant expression of inflammatory cytokines in Eos CRSwNP. This molecular mechanism is a concern with the high relapse rate of Eos CRSwNP. However, glucocorticoid treatment inhibited the relapse of CRSwNP via downregulation of NF-κB/miR-155.
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Affiliation(s)
- Jianbin Du
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China (mainland)
| | - Haijun Lv
- Department of Pathology, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China (mainland)
| | - Xin Dou
- Department of Radiology, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China (mainland)
| | - Zhongsheng Cao
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China (mainland)
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Bequignon E, Mangin D, Bécaud J, Pasquier J, Angely C, Bottier M, Escudier E, Isabey D, Filoche M, Louis B, Papon JF, Coste A. Pathogenesis of chronic rhinosinusitis with nasal polyps: role of IL-6 in airway epithelial cell dysfunction. J Transl Med 2020; 18:136. [PMID: 32209102 PMCID: PMC7092549 DOI: 10.1186/s12967-020-02309-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/16/2020] [Indexed: 12/20/2022] Open
Abstract
Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by an alteration in airway epithelial cell functions including barrier function, wound repair mechanisms, mucociliary clearance. The mechanisms leading to epithelial cell dysfunction in nasal polyps (NPs) remain poorly understood. Our hypothesis was that among the inflammatory cytokines involved in NPs, IL-6 could alter epithelial repair mechanisms and mucociliary clearance. The aim of this study was to evaluate the in vitro effects of IL-6 on epithelial repair mechanisms in a wound repair model and on ciliary beating in primary cultures of Human Nasal Epithelial Cells (HNEC). Methods Primary cultures of HNEC taken from 38 patients during surgical procedures for CRSwNP were used in an in vitro model of wound healing. Effects of increasing concentrations of IL-6 (1 ng/mL, 10 ng/mL, and 100 ng/mL) and other ILs (IL-5, IL-9, IL-10) on wound closure kinetics were compared to cultures without IL-modulation. After wound closure, the differentiation process was characterized under basal conditions and after IL supplementation using cytokeratin-14, MUC5AC, and βIV tubulin as immunomarkers of basal, mucus, and ciliated cells, respectively. The ciliated edges of primary cultures were analyzed on IL-6 modulation by digital high-speed video-microscopy to measure: ciliary beating frequency (CBF), ciliary length, relative ciliary density, metachronal wavelength and the ciliary beating efficiency index. Results Our results showed that: (i) IL-6 accelerated airway wound repair in vitro, with a dose–response effect whereas no effect was observed after other ILs-stimulation. After 24 h, 79% of wounded wells with IL6-100 were fully repaired, vs 46% in the IL6-10 group, 28% in the IL6-1 group and 15% in the control group; (ii) specific migration analyses of closed wound at late repair stage (Day 12) showed IL-6 had the highest migration compared with other ILs (iii) The study of the IL-6 effect on ciliary function showed that CBF and metachronal wave increased but without significant modifications of ciliary density, length of cilia and efficiency index. Conclusion The up-regulated epithelial cell proliferation observed in polyps could be induced by IL-6 in the case of prior epithelial damage. IL-6 could be a major cytokine in NP physiopathology.
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Affiliation(s)
- Emilie Bequignon
- Service d'Oto-Rhino-Laryngologie et de Chirurgie cervico-faciale, AP-HP, Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France. .,INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France. .,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France. .,CNRS ERL 7000, 94010, Créteil, France.
| | - David Mangin
- Service d'Oto-Rhino-Laryngologie et de Chirurgie cervico-faciale, AP-HP, Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France.,INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
| | - Justine Bécaud
- Service d'Oto-Rhino-Laryngologie et de Chirurgie cervico-faciale, AP-HP, Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France.,INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
| | - Jennifer Pasquier
- Nice Breast Institute, 06000, Nice, France.,Stem Cell & Microenvironment Laboratory, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Christelle Angely
- INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
| | - Mathieu Bottier
- INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
| | - Estelle Escudier
- Inserm U933, Paris, France.,Université Pierre et Marie Curie, Paris, France.,Service de génétique et d'embryologie médicale, AP-HP Hôpital Armand-Trousseau, Paris, France
| | - Daniel Isabey
- INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
| | - Marcel Filoche
- INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
| | - Bruno Louis
- INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
| | - Jean-François Papon
- INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France.,Service d'Oto-Rhino-Laryngologie et de Chirurgie cervico-faciale, AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France.,Faculté de Médecine, Université Paris-Sud, 94275, Le Kremlin-Bicêtre, France
| | - André Coste
- Service d'Oto-Rhino-Laryngologie et de Chirurgie cervico-faciale, AP-HP, Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France.,INSERM, U955, Equipe 13, Faculte de Medecine, 8 rue du General Sarrail, 94010, Créteil, France.,Faculté de Médecine, Université Paris-Est, 94010, Créteil, France.,CNRS ERL 7000, 94010, Créteil, France
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