MBP-Positive and CD11c-Positive Cells Are Associated with Different Phenotypes of Korean Patients with Non-Asthmatic Chronic Rhinosinusitis

Abstract

BackgroundAsthmatic nasal polyps primarily exhibit eosinophilic infiltration. However, the identities of the immune cells that infiltrate non-asthmatic nasal polyps remain unclear. Thus, we thought to investigate the distribution of innate immune cells and its clinical relevance in non-asthmatic chronic rhinosinusitis (CRS) in Korea.MethodsTissues from uncinate process (UP) were obtained from controls (n = 18) and CRS without nasal polyps (CRSsNP, n = 45). Nasal polyps (NP) and UP were obtained from CRS with nasal polyps (CRSwNP, n = 56). The innate immune cells was evaluated by immunohistochemistry such as, eosinophil major basic protein (MBP), tryptase, CD68, CD163, CD11c, 2D7, human neutrophil elastase (HNE) and its distribution was analyzed according to clinical parameters.ResultsIn comparisons between UP from each group, CRSwNP had a higher number of MPB+, CD68+, and CD11c+ cells relative to CRSsNP. Comparisons between UP and NP from CRSwNP indicated that NP have a higher infiltrate of MBP+, CD163+, CD11c+, 2D7+ and HNE+ cells, whereas fewer CD68+ cells were found in NP. In addition, MBP+ and CD11c+ cells were increased from UP of CRSsNP, to UP of CRSwNP, and to NP of CRSwNP. Moreover, in UP from CRSwNP, the number of MBP+ and CD11c+ cells positively correlated with CT scores. In the analysis of CRSwNP phenotype, allergic eosinophilic polyps had a higher number of MBP+, tryptase+, CD11c+, 2D7+ cells than others, whereas allergic non-eosinophilic polyps showed mainly infiltration of HNE+ and 2D7+ cells.ConclusionsThe infiltration of MBP+ and CD11c+ innate immune cells show a significant association with phenotype and disease extent of CRS and allergic status also may influences cellular phenotype in non-asthmatic CRSwNP in Korea.

Age‐associated changes in chronic rhinosinusitis endotypes

“…Because the presence of atopy and smoking history may affect CRS endotype, stratified analyses were performed on the age‐related changes of each CRS subtype. In the ENP groups, the age‐related changes in inflammatory mediators consistently demonstrated that type 3 (IL‐17A) and type 1 (IFN‐γ) increased with ageing, irrespective of atopy status or smoking history (Figure 2A).…”

The role of interleukin-33 in chronic rhinosinusitis

“…A diagnosis of asthma was performed by an allergist based on medical history and lung function analysis, including methacholine challenge tests. Nasal polyps (NPs) were classified into two groups: eosinophilic NP, which was defined as having an eosinophil count of more than 10% of the inflammatory cell population, and non-eosinophilic NP, which did not fulfil this criterion 24. Additional information and details of the subjects' characteristics are listed in table 1.…”

“…The mRNA levels in UP and NP tissues were evaluated using quantitative real-time (qRT)-PCR analysis as previously described 24. Detailed qRT-PCR conditions are described in the Methods section in the Online Repository (http://www.thorax.bmj.com).…”

Emerging Endotypes of Chronic Rhinosinusitis and Its Application to Precision Medicine

“…Among these signs, tissue eosinophilia is the most important regarding disease recurrence and comorbidities 7. Approximately 70%-80% of CRSwNP cases accounts for eosinophilic types in the Western country, whereas 30%-40% cases constitute eosinophilic NP in Asian countries, including South Korea and China 29. Eosinophilic CRS is a better responder to steroid therapy vs non-eosinophilic CRS 67.…”

“…However, there are no standard methods to evaluate tissue eosinophilia due to uneven distribution throughout the tissue 8. Multiple inflammatory cells exist in most NP tissue, but the function and pathological roles of these cells are not yet completely elucidated 9. Even in eosinophilic NP, neutrophils and macrophages exist and may play a role in nasal polypogenesis 2.…”