title: Serum level of interleukin-21 is elevated in chronic rhinosinusitis.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) is an inflammatory disease of the sinuses and mucosa with unclear pathogenesis. Interleukin (IL)-21 is mainly expressed in activated cluster of differentiation (CD)4(+) T cells and has potent regulatory effects on the immune system.
  
  
  OBJECTIVE
  This study is to determine whether IL-21 in the blood is correlated with CRS.
  
  
  METHODS
  The blood samples from CRS patients and normal controls were analyzed in correlation with clinical features. The eosinophil percentage was counted, and serum levels of total immunoglobulin E (IgE) and IL-21 were analyzed by enzyme-linked immunosorbent assay (ELISA). In addition, IL-21 and interferon (IFN)-γ secreted from stimulated peripheral blood mononuclear cells (PBMCs) were measured by ELISA, and their mRNA expression levels were analyzed by real-time quantitative polymerase chain reaction (RT-qPCR). Disease severity was scored based on computed tomography (CT) scan, nasal endoscopy, and global osteitis scoring scale (GOSS).
  
  
  RESULTS
  A total of 55 CRS and 37 healthy subjects were recruited. The average levels of serum total IgE were 20 kU/L in normal group, 290 kU/L in CRS with nasal polys (CRSwNP), and 187 kU/L in CRS without nasal polys (CRSsNP). IL-21 levels were 28 pg/mL in normal group, 54 pg/mL in CRSwNP, and 71 pg/mL in CRSsNP. Both IgE and IL-21 were significantly elevated in both CRS patient subgroups. However, no significant difference was found between these two patient subgroups. The serum IL-21 levels correlated well with the disease severity in the patients. In addition, the secreted IL-21 was enhanced significantly in the patient's PBMCs stimulated by phytohemagglutin (PHA).
  
  
  CONCLUSIONS
  IL-21 could be a target for diagnosis and treatment of CRS.
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Pin-Zhir
authors.initials: PZ
authors.lastname: Chao
authors.forename: Ming-Shium
authors.initials: MS
authors.lastname: Hsieh
authors.forename: Fei-Peng
authors.initials: FP
authors.lastname: Lee
authors.forename: Shao-Yi
authors.initials: SY
authors.lastname: Chen
authors.forename: Chao-Wen
authors.initials: CW
authors.lastname: Cheng
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Chang
authors.forename: Yun-Tien
authors.initials: YT
authors.lastname: Lin
authors.forename: Lai-Lei
authors.initials: LL
authors.lastname: Ting
authors.forename: Yung-Feng
authors.initials: YF
authors.lastname: Lin
authors.forename: Chien-Ho
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007371:Interferon-gamma / Q000096:biosynthesis; D007378:Interleukins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012220:Rhinitis / Q000276:immunology*; D012852:Sinusitis / Q000276:immunology*; D000098546:Interleukin-21
chemical_list: D007378:Interleukins; D007073:Immunoglobulin E; D007371:Interferon-gamma; D000098546:Interleukin-21