Inflammation and remodeling of the sinus mucosa in children and adults with chronic sinusitis.
OBJECTIVE
The sinus mucosal inflammatory response in adult patients with chronic sinusitis is well documented in the literature. In contrast, little is known about the pathogenesis of this condition in children. The objective of the study was to compare the inflammatory cell profile and the extent of tissue remodeling in the sinus mucosa of children and adults with chronic sinusitis.


METHODS
Prospective design.


METHODS
Children (n = 7) and adult patients (n = 7) with chronic sinusitis undergoing functional endoscopic sinus surgery were recruited for the study. Patients with no evidence of sinus disease (n = 6) were used as control subjects. Using immunohistochemical analysis, sinus mucosal specimens were assessed for the presence of T lymphocytes, eosinophils, basophils, mast cells, and neutrophils. The extent of submucosal collagen deposition was evaluated in histological sections using van Gieson stain.


RESULTS
The number of T lymphocytes, eosinophils, and basophils and the amount of subepithelial collagen deposition are significantly higher in the mucosa of both adults and children with chronic sinusitis compared with normal control subjects (P <.01). The number of mast cells is significantly higher in the mucosa of children with chronic sinusitis compared with normal control subjects (P <.01). The number of eosinophils and neutrophils and the amount of subepithelial collagen deposition are significantly greater in adults compared with children with chronic sinusitis (P <.01).


CONCLUSIONS
The sinus mucosal inflammatory profile is similar in adults and children with chronic sinusitis. However, the degree of tissue eosinophilia and remodeling is significantly greater in adult sinus specimens when compared with those of children with chronic sinusitis.
Sobol
Steven E
SE
Department of Otolaryngology, McGill University, Montreal, Quebec, Canada.
Fukakusa
Moto
M
Christodoulopoulos
Pota
P
Manoukian
John J
JJ
Schloss
Melvin D
MD
Frenkiel
Saul
S
Hamid
Qutayba
Q
D000293:Adolescent; D000328:Adult; D001491:Basophils / Q000378:metabolism; D002648:Child; D002908:Chronic Disease; D003094:Collagen / Q000378:metabolism; D004804:Eosinophils / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008407:Mast Cells / Q000378:metabolism; D008875:Middle Aged; D009092:Mucous Membrane / Q000378:metabolism / Q000473:pathology; D010256:Paranasal Sinuses / Q000378:metabolism / Q000473:pathology*; D011446:Prospective Studies; D012852:Sinusitis / Q000378:metabolism / Q000473:pathology*; D013601:T-Lymphocytes / Q000378:metabolism
D003094:Collagen