Differentiation of chronic sinus diseases by measurement of inflammatory mediators.
BACKGROUND
Chronic rhinosinusitis (CRS) clinically is a heterogeneous group of sinus diseases, which may cover different disease entities, or may represent a disease continuum. Studying inflammatory cells and mediators in clearly defined disease subgroups may lead to a better differentiation of chronic sinus diseases.


METHODS
Sinonasal mucosal tissue from 10 nasal polyp (NP) patients, 13 cystic fibrosis patients (CF-NP), eight CRS subjects without polyps, and nine control patients were stained for CD3, CD25, CD68, CD20, myeloperoxidase (MPO), CD138 and tissue homogenates were assayed for eotaxin, interleukin (IL)-1beta, IL-2sRalpha, IL-5, interferon (IFN)-gamma, IL-8, transforming growth factor (TGF)-beta1, tumor necrosis factor-alpha, and MPO by enzyme-linked immunosorbent assay or UNICAP system.


RESULTS
Nasal polyp and CF-NP showed increased numbers and activation of T cells, while only NP displayed an increase in plasma cells. Nasal polyp had significantly higher levels of eosinophilic markers [eosinophils, eotaxin, and eosinophil cationic protein (ECP)] compared with CRS, controls and CF-NP. Chronic rhinosinusitis was characterized by a Th1 polarization with high levels of IFN-gamma and TGF-beta, while NP showed a Th2 polarization with high IL-5 and immunoglobulin (Ig) E concentrations. Nasal polyp and CF-NP were discriminated by edema from CRS and controls, with CF-NP displaying a very prominent neutrophilic inflammation.


CONCLUSIONS
Based on cellular and mediator profiles, we suggest that CRS, NP, and CF-NP are distinct disease entities within the group of chronic sinus diseases.
Van Zele
T
T
Upper Airway Research Laboratory (URL), Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent.
Claeys
S
S
Gevaert
P
P
Van Maele
G
G
Holtappels
G
G
Van Cauwenberge
P
P
Bachert
C
C
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D002908:Chronic Disease; D016207:Cytokines / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018836:Inflammation Mediators / Q000032:analysis*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000175:diagnosis / Q000473:pathology; D020545:Respiratory Mucosa / Q000737:chemistry / Q000473:pathology; D012852:Sinusitis / Q000145:classification* / Q000175:diagnosis* / Q000473:pathology; D013601:T-Lymphocytes / Q000737:chemistry
D015703:Antigens, CD; D016207:Cytokines; D018836:Inflammation Mediators