A retrospective study of changes of histopathology of nasal polyps in adult Chinese in central China

Abstract

Background: The factors contributing to the eosinophilic inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) remain elusive. This study was designed to investigate the inflammatory patterns and tissue remodeling of CRSwNP in patients from central China at two time points over 14 years apart and the influence of age. Methods: One hundred and eight CRSwNP patients enrolled in 2000 and 2001 (group A), and 134 CRSwNP patients enrolled in 2014 and 2015 (group B) were retrospectively studied. Hematoxylin-eosin stained tissue sections were used to study characteristics of inflammation and tissue remodeling. Immunohistochemistry was used to further evaluate the cells positive for eosinophil cationic protein (ECP), IL-5, IgE, tryptase or myeloperoxidase (MPO). Time-and age-related difference was analyzed. Results: The number of eosinophils and proportion of eosinophilic CRSwNP were increased, whereas the numbers of total inflammatory cells and lymphocytes were decreased in group B as compared with group A. Group B had severer epithelial squamous metaplasia and basement membrane thickening, and a lower number of mucosal glands than group A. Higher numbers of ECP + , IL-5 + and IgE + cells were detected in group B than those in group A. The elderly (≥ 60 yrs) and non-elderly (< 60 yrs) had a comparable number of eosinophils and ratio of eosinophilic CRSwNP. Conclusion: Eosinophilic inflammation has been significantly augmented over time, which is associated with increased Th2 response and IgE production, and accompanied by exaggerated epithelium remodeling in CRSwNP patients from central China. Age has no significant influence on eosinophilic inflammation.

Application of Clinical Scores in the Differential Diagnosis of Chronic Rhinosinusitis With Nasal Polyps in a Chinese Population

“…Although the prevalence of Eos inflammation among CRSwNP patients in Asia has been reported as <50%, that percentage has been increasing in recent years. 5,[21][22][23][24][25] Patients with Eos CRSwNP are more prone to relapse than patients with non-Eos CRSwNP; however, Eos CRSwNP is sensitive to steroid therapy. Therefore, it is important to identify the markers of CRSwNP in order to develop new therapeutic strategies and improve patient outcomes.…”

Agonist of PPAR-γ Reduced Epithelial-Mesenchymal Transition in Eosinophilic Chronic Rhinosinusitis with Nasal Polyps via Inhibition of High Mobility Group Box1

“…IL-5 regulates the activity of eosinophils and there are positive interactions between them [12]. As regard to tissue remodeling, basement membrane was thicker and squamous metaplasia of epithelium was more frequently in eosinophilic inflammation [13]. In previous studies, HMGB1 has been shown to support the survival of eosinophilic granulocytes [14] and has been confirmed to relate to tissue remodeling, such as in COPD [15,16].…”

Predictive and Diagnostic Value of Nasal Nitric Oxide in Eosinophilic Chronic Rhinosinusitis with Nasal Polyps

“…Currently, eCRSwNP is the predominant CRSwNP subtype in Beijing, China [14]. Besides, over time, there has been a significant increase in eosinophilic inflammation associated with increased IgE production and Th2 response in patients from Central China with CRSwNP [15]. Therefore, to determine prognosis and long-term management strategies, Chinese rhinologists need to discriminate the phenotypes of patients with CRSwNP early.…”