Inflammatory markers in the nasal mucosa and polyp-modified tissues in chronic rhinosinusitis with nasal polyps

Abstract

Introduction. To date, chronic rhinosinusitis with nasal polyps (CRSwNP) has not yet been extensively studied: the molecular factors and mechanisms involved in the initiation of polypous transformations in nasal mucosa (NM) and sustaining their recurrence probability are still to be determined. Simultaneously, it is necessary to understand the molecular rearrangement in NM tissues to make clinical prognosis and choose an adequate therapeutic or surgical strategy for CRSwNP treatment. The aim of the study was to identify the features of how inflammatory markers localize and are distributed in the NM and polyps in various morphological CRSwNP types. Materials and methods. We studied morphological and chemical structure of nasal polyps and mucosa of the inferior turbinates. The material was obtained during surgical management of patients diagnosed with CRSwNP. The comparison group involved the patients with a deviated septum who underwent septorhi-noplasty and had neither polyposis nor concomitant inflammatory/allergic pathology. The NM removed in surgeries was used to compare morphological and chemical changes. Immunohistochemistry was applied to determine the localization and distribution of SP, NK1, nNOS, iNOS, and IL1b in the tissues. Results. The formation of nasal polyps was found to be accompanied by morphological and chemical altera-tions in the mucous membrane of the inferior turbinates. In polyps of different morphological types, the changes in the activity of inflammatory markers were specific. Conclusion. The data obtained indicate that changes in the NM of the inferior turbinates, which accompany polyposis development, give certain pathological causes that induce and maintain the pathological process. We have revealed the features of the specific signaling microenvironment in the nasal cavity, which provide special conditions for the formation of polyps of various types. The specificity of the activity and distribu-tion of inflammatory markers in the polyps of different morphological types may serve as a prerequisite for the development of personalized therapy for the disease. Keywords: chronic rhinosinusitis with nasal polyps, inflammation, neurokinin receptors, substance P, nitric oxide