Histological Features of the Nasal Mucosa in Hematopoietic Stem Cell Transplantation

Ortiz, Érica; Sakano, Eulália; Meirelles, Luciana Rodrigues de; Vigorito, Afonso Celso; Cintra, Maria Letícia; Paschoal, Ilma Aparecida; Chone, Carlos Takahiro

doi:10.2500/ajra.2011.25.3644

Cited by 7 publications

(15 citation statements)

References 25 publications

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“…Previous studies have shown an increase in the number of apoptotic bodies in the sinonasal mucosa of HSCT with chronic GVHD [16]. This result could also explain the greater risk of rhinosinusitis in these patients, as described in the literature.…”

Section: Discussionmentioning

confidence: 62%

“…A previous study found that hematopoietic stem cell-transplanted patients experience epithelial injury after transplantation, showing a reduction in the number of cilia (77%) and goblet cells (50%) and a 50% change in the ciliary ultrastructure, independent of sinonasal infections [16]. These abnormalities would trigger mucous dryness, malfunctions of mucociliary clearance, and inadequate lubrication that prevents the surface maintenance of defense proteins (lysozymes, lactoferrins and IgA) [19].…”

Section: Discussionmentioning

confidence: 99%

“…These studies evaluated the histological aspects of the nasal mucosa of immunocompetent patients and patients undergoing bone marrow transplants, with and without rhinosinusitis [16, 18]. …”

Section: Methodsmentioning

confidence: 99%

“…This epithelial damage could be another causal feature for the high prevalence of sinus infections in transplanted patients [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

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Rhinosinusitis in hematopoietic stem cell-transplanted patients: influence of nasosinus mucosal abnormalities?

et al. 2014

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IntroductionRhinosinusitis is characterized by inflammation extending from the mucosa of the nasal cavity into the paranasal sinuses. There are some aggravating features, such as immunosuppression, that can cause the nasal mucosal inflammation to linger for a long period, resulting in chronic or recurrent episodes. Such immunosuppression is the major feature of patients undergoing a hematopoietic stem cell transplant (HSCT); rhinosinusitis prevalence is higher in this group compared to immunocompetent patients. Nasal epithelial abnormalities have been described in, and may have some influence over, recurrent sinus infections among those patients. However, it is not clear whether rhinosinusitis can trigger mucosal abnormalities or whether a preexisting vulnerability for sinusitis recurrence is more likely. The objective of the study was to verify the influence of rhinosinusitis on nasal epithelial damage in patients undergoing hematopoietic stem cell transplantation.MethodA total of 30 allogeneic HSCT patients were divided into two groups: 24 patients with chronic or recurrent rhinosinusitis and 6 patients without rhinosinusitis. These patients underwent a biopsy of the uncinate process that was analyzed by transmission electron microscopy and optical microscopy.ResultsThe nasal mucosa analysis by optical microscopy showed no significant abnormalities. The ciliary orientation was obviously normal in the transplanted patients without rhinosinusitis. There was a trend toward a difference in the amount of cilia (decreased) and the primary modification of the ultrastructure of transplanted patients with rhinosinusitis.ConclusionHSCT patients, with and without rhinosinusitis, showed no significant histological abnormalities, except for ciliary disorientation and a possible decrease in ciliary and ultrastructural abnormalities in HSCT patients with rhinosinusitis.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…This epithelial damage could be another causal feature for the high prevalence of sinus infections in transplanted patients [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rhinosinusitis in hematopoietic stem cell-transplanted patients: influence of nasosinus mucosal abnormalities?

et al. 2014

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“…In our previous study, we demonstrated that 77% of HSCT patients had decreased or absent cilia, and 50% had ultrastructural abnormalities of the cilia after these transplants, even without the occurrence of rhinosinusitis [11]. By contrast, ciliary beating was altered or absent in only 23 to 28% of chronic and recurrent rhinosinusitis for immunocompetent patients due to the decrease or absence of cilia or ciliated cells, as well as to the disorientation of the cilia [1,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Sinonasal Ultrastructure of the Hematopoietic Stem Cell Transplant and Chronic Graft-versus-host Disease with Rhinosinusitis

Meirelles¹

2014

J Stem Cell Res Ther

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Introduction: It is believed that immunosuppression is the sole cause for the occurrence of rhinosinusitis in hematopoietic stem cell transplant (HSCT). There is a high incidence of sinusitis in recipient patients, especially in those with Chronic Graft Versus Host disease (GVHD). Histopathological abnormalities were described in recipients' sinus mucosa compared to immunocompetent patients. There were also mucosal abnormalities related to cytotoxicity in the transplanted patients with chronic GVHD but no difference in ultrastructure between HSCT patients with and without GVHD, except for increased goblet cells in patients without GVHD. The relation between the sinonasal mucosa abnormalities of these patients and rhinosinusitis is not well established yet.Objective: To verify the ultrastructure of the sinonasal mucosa of HSCT with and without GVHD with rhinosinusitis to understand the cause of high Sinusitis incidence.Method: prospective study with statistical analysis of data obtained from the evaluation of the uncinate process mucosa of patients transplanted with ( 16) and without GVHD (8) with rhinosinusitis by transmission electron and optical microscopy.Results: Of the patients, 47% ( 14) had only 1 or 2 episodes, and 33% had more than 3 episodes of rhinosinusitis. Only the presence of microvilli was significantly higher in patients without GVHD. There was no significant difference in the amount of cilia, ciliary ultrastructure, squamous metaplasia, goblet cells, vacuolization, density of the inflammatory infiltrate, intraepithelial lymphocytes, eosinophils, mucous glands, apoptotic corpuscles intraepithelial basement membrane thickness, edema and subepithelial fibrosis between groups. There was a significant decrease of cilia with Powered by Editorial Manager ® and ProduXion Manager ® from Aries Systems Corporation higher recurrence of rhinosinusitis. Conclusion:There was an increase in microvilli HSCT without GVHD with rhinosinusitis, and the ultrastructure and histological changes of HSCT with and without GVHD did not change with the recurrence of rhinosinusitis. However, there was a decrease of cilia in the epithelium of the sinonasal HSCT with higher recurrence of rhinosinusitis

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Sinonasal disorders in hematopoietic stem cell transplantation

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Ortiz

Nicola

et al. 2014

Brazilian Journal of Otorhinolaryngology

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Histological Features of the Nasal Mucosa in Hematopoietic Stem Cell Transplantation

Abstract: This tissue destruction likely enhances pathogen penetration resulting in recurrent infection.

Cited by 7 publications

References 25 publications

Rhinosinusitis in hematopoietic stem cell-transplanted patients: influence of nasosinus mucosal abnormalities?

Rhinosinusitis in hematopoietic stem cell-transplanted patients: influence of nasosinus mucosal abnormalities?

Sinonasal Ultrastructure of the Hematopoietic Stem Cell Transplant and Chronic Graft-versus-host Disease with Rhinosinusitis

Sinonasal disorders in hematopoietic stem cell transplantation

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