Chronic Rhinosinusitis with Nasal Polyps: Age and Disease Severity Differences in the Levels of Inflammatory Markers

Abstract

Background and objectives: The aim of our study was to analyze the concentrations of inflammatory markers in the nasal tissue of patients with chronic rhinosinusitis with nasal polyps (CRSwNPs) and controls of different age groups, as well as to find associations between age, inflammation development, and NPs. Materials and methods: Patients were divided into two groups—patients with CRSwNPs and control subjects who had nasal surgery for another reason beside CRS. Our analysis was performed across three different age groups (18–30 years, 31–50 years, and 51 years and more). Tissue biopsies from the sinus cavity for all study participants were taken and frozen at −80 °C, until use. The concentrations of IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-13, IL-21, and IL-22, were quantified using a magnetic bead-based multiplex assay. Results: In the group aged 18–30 years, the levels of inflammatory markers IL-1, IL-2, IL-5, and IL-22 were significantly higher in patients with CRSwNPs than the control subjects. Among patients aged 31–50 years, significantly higher concentrations of IL-2, IL-4, IL-5, and IL-22 were recorded in patients with CRSwNPs, as compared to the control subjects. In the oldest group (aged 51 years and more), patients with CRSwNPs had significantly higher concentrations of IL-2, IL-4, and IL-22, as compared to the control group. In the CRSwNP group, only the concentration of IL-21 was significantly higher among patients aged 31–50 years, as compared with those aged 51 years and older (p = 0.013). Conclusions: IL-2 and IL-22 levels were significantly higher in patients with CRSwNP than the control, across all age groups. Only the concentration of IL-21 was higher among patients with CRSwNP in the middle age group, as compared to the oldest group. IL-2, IL-4, and IL-22 levels correlated with the severity of CRSwNPs. Elevated concentrations of IL-2, IL-4, and IL-22 were determined in patients’ groups with higher sinonasal outcome test (SNOT-22) scores, pointing to more severe clinical symptoms.

Involvement of CD40-CD40L and ICOS-ICOSL in the development of chronic rhinosinusitis by targeting eosinophils

“…In addition, age may further contribute to this inconsistency. Although we selected adult patients to minish age-related interference, there may be altered immune response and different distributions of inflammatory mediators in further classifications of adults ( 51 – 54 ). Given that the ICOS-ICOSL signal can strengthen CD40-CD40L interaction, thus providing a co-stimulatory signal for B-cell activation ( 34 , 35 ), as well as the allergic characteristics of CRS.…”

Characteristics of mucin hypersecretion in different inflammatory patterns based on endotypes of chronic rhinosinusitis

“…Relevant studies have shown that the levels of IL‐22 and its receptor (IL‐22R1) in invasive inflammatory cells and epithelial cells of the nasal passages of patients with CRSwNP are significantly increased. IL‐22 levels are also closely related to the severity of clinical symptoms and difficulty of treating CRSwNP 19,122–124 . IL‐22 can enhance the expression of MUC1 (a membrane‐bound mucin located on the nasal mucosa) in nasal polyp tissues via an IL‐22R1 dependent pathway (Figure 3).…”

IL-10 family cytokines in chronic rhinosinusitis with nasal polyps: From experiments to the clinic

“…According to a factor analysis based on principal component analysis, IL-22 level positively correlated with type 2 cytokine levels and the Lund-Mackay CT score, which is a degree of sinus opacification ranges from 0 to 24 ( 39 ). Whereas another study compared the levels of cytokines across three different age groups and found significantly higher level of IL-22 in the mucosa from CRSwNP than in the control group across all age groups and correlated with the severity of clinical symptoms ( 40 ).…”