Distinct immunopathologic characteristics of various types of chronic rhinosinusitis in adult Chinese.
BACKGROUND
Chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) is reported to be different in inflammatory patterns of the sinonasal mucosa in white patients. Studies in nonwhite populations may further be helpful to understand the pathogenic mechanisms of CRS.


OBJECTIVE
To investigate the immunopathologic profiles of CRSwNP and CRSsNP in adult Chinese.


METHODS
Histologic characteristics of surgical samples were analyzed in 50 controls, 94 CRSsNP patients, and 151 CRSwNP patients. Tissue samples from 17 controls, 36 CRSsNP patients, and 45 CRSwNP patients were stained for CD3, CD4, CD8, CD20, CD68, myeloperoxidase, and dendritic cell lysosome-associated membrane protein. Expression profiles of transcription factors of T-cell subsets in relation to cytokines and a marker of natural killer T cell (Valpha24) were examined by means of quantitative RT-PCR.


RESULTS
Over half of CRSwNP patients presented noneosinophilic inflammation. CRSwNP had a higher number of eosinophils, plasma cells, and CD3(+), CD8(+), CD20(+), and CD68(+) cells and a lower myeloperoxidase expression rate than CRSsNP. Expression levels of transcription factors and cytokines of T(H)1/T(H)2/T(H)17 were increased, whereas the expression rate of Forkhead box p3 and TGF-beta1 was decreased in both CRSsNP and CRSwNP compared with controls. Comparing CRSsNP and CRSwNP, CRSsNP had higher levels of IFN-gamma expression, whereas only eosinophilic CRSwNP demonstrated an enhanced expression of GATA-3 and IL-5. Compared with noneosinophilic CRSwNP, an exaggerated T(H)2/T(H)17 reaction and Valpha24 expression were found in eosinophilic CRSwNP.


CONCLUSIONS
Both Chinese CRSsNP and CRSwNP patients demonstrate impaired regulatory T cell function and enhanced T(H)1/T(H)2/T(H)17 responses. CRSsNP is confirmed to be a predominant T(H)1 milieu, whereas T(H)2 skewed inflammation with predominant T(H)17 reactions, and infiltration of natural killer T cells can be demonstrated only in eosinophilic CRSwNP, but not in noneosinophilic CRSwNP.
Cao
Ping-Ping
PP
Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Li
Hua-Bin
HB
Wang
Bao-Feng
BF
Wang
Shui-Bin
SB
You
Xue-Jun
XJ
Cui
Yong-Hua
YH
Wang
De-Yun
DY
Desrosiers
Martin
M
Liu
Zheng
Z
D000328:Adult; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D016207:Cytokines / Q000276:immunology / Q000378:metabolism*; D004804:Eosinophils / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D009298:Nasal Polyps / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D055611:Natural Killer T-Cells / Q000276:immunology / Q000378:metabolism; D012220:Rhinitis / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D012852:Sinusitis / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology* / Q000378:metabolism; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000378:metabolism; D014157:Transcription Factors / Q000276:immunology / Q000378:metabolism
D016207:Cytokines; D014157:Transcription Factors