Biofilms correlate with TH1 inflammation in the sinonasal tissue of patients with chronic rhinosinusitis.
OBJECTIVE
Determine the prevalence of bacterial biofilms in surgical chronic rhinosinusitis (CRS) patients and characterize the inflammatory response associated with biofilm CRS.


METHODS
Cross-sectional.


METHODS
Tertiary care academic center.


METHODS
Sinonasal mucosa and peripheral blood were collected from 60 CRS patients. Mucosal biofilms were demonstrated by scanning electron microscopy. Leukocyte subpopulations were determined by flow cytometry. Cytokines were identified with a luminex-based assay on the lysate of homogenized tissue or plasma.


RESULTS
Of the 60 samples, 17 were determined to be positive for the presence of biofilms. Oral steroid-naive CRS patients with biofilm demonstrated a local T(H)1 inflammatory response with significantly elevated levels of interferon-gamma (INF-gamma), granulocyte colony-stimulating factor, macrophage inflammatory protein-1 beta, and neutrophils in the sinonasal mucosa. No differences were present at the systemic level.


CONCLUSIONS
Sinonasal bacterial biofilms correlate to a T(H)1 skewed local but not systemic inflammatory response in CRS. This difference is abrogated by the use of oral steroids.
Hekiert
Adrianna M
AM
Department of Otorhinolaryngology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Kofonow
Jennifer M
JM
Doghramji
Laurel
L
Kennedy
David W
DW
Chiu
Alexander G
AG
Palmer
James N
JN
Leid
Jeffery G
JG
Cohen
Noam A
NA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018441:Biofilms; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation; D007962:Leukocytes / Q000145:classification / Q000473:pathology; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism / Q000382:microbiology* / Q000473:pathology; D012220:Rhinitis / Q000378:metabolism / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D012852:Sinusitis / Q000378:metabolism / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D018417:Th1 Cells / Q000473:pathology*
D016207:Cytokines