title: Relationship of eosinophils and plasma cells to biofilm in chronic rhinosinusitis.
abstract: BACKGROUND
  This study investigates the relationship of eosinophils and plasma cells to biofilm in chronic rhinosinusitis (CRS). A prospective observational study was performed at the Keck Hospital, University of Southern California, Department of Otolaryngology, Los Angeles, CA.
  
  
  METHODS
  A total of 29 patients, 20 undergoing endoscopic sinus surgery for CRS and 9 control patients undergoing septoplasty for nasal obstruction without history or evidence of CRS, were included in this study. Contiguous sinonasal mucosa sample sections were examined by hematoxylin and eosin (H&E), fluorescence in situ hybridization (FISH), and immunohistochemistry (IHC) for biofilm, microbes, eosinophil major basic protein (EMBP), and cluster designation 27 (CD27). EMBP and CD27 were used as eosinophil and plasma cell markers, respectively.
  
  
  RESULTS
  Biofilm was visualized in 15 of 20 patients with CRS on H&E sections, confirmed by microbial presence using FISH. Biofilm was not identified in tissue samples of the nine control patients. On IHC analysis, CD27 and EMBP expression were significantly higher in patients with CRS compared with control (p < 0.05) and had greater expression in biofilm-positive patients compared with biofilm-negative patients. Nasal polyps correlated with higher expression of CD27 and EMBP, but in CRS patients without polyps CD27 and EMBP was also significantly greater in biofilm-positive specimens compared with biofilm-negative specimens.
  
  
  CONCLUSIONS
  Biofilm presence in CRS appears to correlate to host inflammatory response involving plasma cell and eosinophil recruitment.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90031, USA.
authors.forename: Hamid
authors.initials: H
authors.lastname: Arjomandi
authors.forename: Jason
authors.initials: J
authors.lastname: Gilde
authors.forename: Sutao
authors.initials: S
authors.lastname: Zhu
authors.forename: Sean
authors.initials: S
authors.lastname: Delaney
authors.forename: Christian
authors.initials: C
authors.lastname: Hochstim
authors.forename: Kashif
authors.initials: K
authors.lastname: Mazhar
authors.forename: Bozena
authors.initials: B
authors.lastname: Wrobel
authors.forename: Alexander
authors.initials: A
authors.lastname: Markarian
authors.forename: Rizwan
authors.initials: R
authors.lastname: Masood
authors.forename: Dale
authors.initials: D
authors.lastname: Rice
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018441:Biofilms / Q000254:growth & development*; D015415:Biomarkers / Q000378:metabolism; D002908:Chronic Disease; D047093:Eosinophil Major Basic Protein / Q000235:genetics*; D004804:Eosinophils / Q000378:metabolism*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007155:Immunologic Factors / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism; D009300:Nasal Septum / Q000601:surgery; D010950:Plasma Cells / Q000378:metabolism*; D011446:Prospective Studies; D012220:Rhinitis / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism / Q000601:surgery; D012852:Sinusitis / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism / Q000601:surgery; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000235:genetics*
chemical_list: D015415:Biomarkers; D007155:Immunologic Factors; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7; D047093:Eosinophil Major Basic Protein