title: Upregulation of elafin and cystatin C in the ethmoid sinus mucosa of patients with chronic sinusitis.
abstract: OBJECTIVE
  To investigate the expression levels and distribution patterns of elafin and cystatin C in normal and inflammatory human sinus mucosa and to evaluate their roles in chronic sinusitis.
  
  
  METHODS
  A controlled, prospective study.
  
  
  METHODS
  A tertiary academic institution.
  
  
  METHODS
  Normal sinus mucosa was obtained from the ethmoid sinus during surgery in 30 patients with blowout fractures. Inflammatory sinus mucosa was obtained from 30 patients undergoing endoscopic sinus surgery for chronic polypoid sinusitis.
  
  
  METHODS
  Reverse transcription-polymerase chain reaction, immunohistochemical analysis, and Western blotting.
  
  
  METHODS
  Expression levels and distribution patterns of elafin and cystatin C in normal and inflammatory mucosa.
  
  
  RESULTS
  Expression of elafin and cystatin C messenger RNAs and proteins analyzed by means of reverse transcription-polymerase chain reaction and Western blot was detected in all normal and inflammatory sinus mucosa tested. Their expression levels were increased in inflammatory vs normal mucosa. Elafin in normal and inflammatory sinus mucosa was distinctly expressed in goblet cells, which are increased in inflammatory sinus mucosa. Elafin in submucosal glands was usually weak in staining intensity, except for a few scattered submucosal glands showing moderate intensity in inflammatory sinus mucosa. Cystatin C was also localized in goblet cells and submucosal glands in normal and inflammatory mucosa. Staining intensity was increased more in inflammatory vs normal sinus mucosa.
  
  
  CONCLUSIONS
  Elafin and cystatin C may play an important role in the protection of normal sinus mucosa and further in regulation of the inflammatory condition in chronic sinusitis.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, 126-1 5 Ka Anam-Dong, SungBuk-Ku, Seoul, South Korea.
authors.forename: Chang Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Heung Man
authors.initials: HM
authors.lastname: Lee
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Joon Hyuk
authors.initials: JH
authors.lastname: Yoo
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Sang Hag
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000328:Adult; D015153:Blotting, Western; D002908:Chronic Disease; D055316:Cystatin C / Q000378:metabolism*; D053492:Elafin / Q000378:metabolism*; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000378:metabolism* / Q000601:surgery; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism* / Q000601:surgery; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012852:Sinusitis / Q000378:metabolism* / Q000601:surgery; D015854:Up-Regulation
chemical_list: D055316:Cystatin C; D053492:Elafin