Inflammatory cells in nasal mucosa and nasal polyps

OBJECTIVE: Since some controversy exists concerning the frequency of inflammatory cells in nasal polyps, we have compared the frequency of tissue inflammatory cells (lymphocytes, neutrophils, eosinophils and plasma cells) including 11 kinds of lymphocyte subsets in the same specimens of nasal mucosa and nasal polyps. METHODS: Histopathological observations and flow cytometric analyses were performed on eight mucosal specimens of the inferior turbinates of patients with nasal polyps and on 13 polyp specimens. RESULTS: Nasal polyps contained significantly more eosinophils, neutrophils and plasma cells than nasal mucosa, and EG2+ cells (activated eosinophils) were significantly more frequent in nasal polyps than in nasal mucosa. Flow cytometric analysis showed that there were no significant differences in the frequencies of lymphocytes and lymphocyte subsets (CD1+, CD2+, CD3+, CD5+, CD7+, CD4+, CD8+, CD10+, CD19+, CD20+ and HLA-DR+ cells) including CD4/8 ratios between nasal mucosa and polyps, though, both nasal mucosa and polyps contained significantly more lymphocytes than eosinophils, neutrophils or plasma cells. The T cell lineage (CD2+, CD3+, CD5+ and CD7+ cells) was found in high frequency and B cell lineage (CD10+, CD19+ and CD20+ cells) in low frequency in both nasal mucosa and polyps. The frequency of HLA-DR+ cells (most of which were activated T cells) was not significantly different between nasal mucosa and nasal polyps. CONCLUSION: Histopathological and flow cytometric analyses were performed on the composition of inflammatory cells in nasal mucosa of the inferior turbinates and in polyps from the same patients. The elevated numbers of activated eosinophils, neutrophils and plasma cells in nasal polyps compared with nasal mucosa suggest that inflammatory processes play important roles in the pathophysiology of nasal polyps. The frequencies of lymphocytes and lymphocyte subsets were not significantly different between these two tissues.     

Roles of CD43, CD20 and local IgE in the pathogenesis of nasal polyps]

OBJECTIVE: To estimate the roles of CD43, CD20 and total IgE in the pathogenesis of nasal polyps. METHOD: Twenty-six cases of nasal polyps and 20 cases of mucosa of middle turbinates were used in present study. RESULTS: The number of CD43+ cells, CD20+ cells and plasma cells in nasal polyps were significantly more than that in middle turbinates (P < 0.01). The positive rate of local IgE+ cells in nasal polyps was significantly higher than in middle turbinate (P < 0.01). CONCLUSION: There were active cellular immunity and humoral immunity in nasal polyps. Local allergy may play a role in the pathogenesis of nasal polyps.     

CD43CD20及总IgE在鼻息肉组织中表达的研究

目的　探讨CD4 3 、CD2 0 及总IgE在鼻息肉组织中的表达 ,分析其在鼻息肉发病中的作用。方法　采用免疫组化SP法及HE染色对 2 5例鼻息肉和 2 0例中鼻甲粘膜进行研究。结果　鼻息肉组织中CD 43 细胞和CD 2 0 细胞、浆细胞数显著多于中鼻甲粘膜组织 (P <0 0 1) ,总IgE阳性表达率为44 %,显著高于中鼻甲粘膜组织的 10 %(P <0 0 5 )。结论　鼻息肉中存在活跃的细胞免疫和体液免疫 ,鼻粘膜局部变态反应可能参与鼻息肉的发病。     

Intercellular adhesion molecule-1 expression in nasal polyps treated with corticosteroid

PURPOSE: The aim of this study was to compare intracellular adhesion molecule-1 (ICAM-1) expression in nasal polyp cases who were administered topical corticosteroid and in middle turbinates. MATERIALS AND METHODS: Twenty-four patients with nasal polyps were included in the study group. These patients were treated with 100 microg budesonide in each nostril twice daily for 2 months before the surgery. Twenty-one nonatopic patients with concha bullosa were included in the control group. The specimens were taken from patients undergoing endoscopic surgery. RESULTS: In polyps, significantly higher mean ICAM-1 intensity scores were found by comparison with the control turbinates. CONCLUSIONS: Corticosteroid treatment in patients with nasal polyps does not diminish ICAM-1 to that of turbinate tissue. The initiating events in the formation of nasal polyps still occur in these patients despite treatment with the topical nasal steroid.     

Tenascin在鼻息肉组织中的表达及其临床意义

目的：探讨Tenascin(TN)在鼻息肉组织中的表达和分布特征及其在鼻息肉发生中的可能作用。方法：采用免疫组化链霉菌抗生物素蛋白—过氧化物酶(SP)法检测24例鼻息肉标本(鼻息肉组)和15例慢性肥厚性鼻炎下鼻甲标本(下鼻甲组)中TN的表达，并以5例健康者(对照组)下鼻甲黏膜作对照。结果：鼻息肉组和下鼻甲组黏膜上皮细胞及腺上皮细胞均表达TN；鼻息肉组TN的黏膜上皮阳性细胞表达的吸光度值显著高于下鼻甲组(P＜0．01)；鼻息肉组TN的腺上皮阳性细胞表达的吸光度值显著高于下鼻甲组(P＜0．01)；对照组下鼻甲组织中黏膜上皮及腺体几乎检测不到TN的表达；鼻息肉组腺体TN阳性率明显高于下鼻甲组(P＜0．05)。结论：TN在鼻息肉组织中的高表达与鼻息肉的发生、发展相关；TN在鼻腔内的表达细胞是黏膜上皮细胞和浆液性腺上皮细胞。     

MUC5AC在人类鼻息肉及下鼻甲黏膜上皮的表达

目的 :探讨MUC5AC与鼻息肉及慢性肥厚性鼻炎黏液过量分泌的关系。方法 :免疫组织化学ABC法检测 2 7例鼻息肉、19例慢性肥厚性鼻炎下鼻甲及 9例正常下鼻甲黏膜上皮MUC5AC的表达。结果 :鼻息肉黏膜上皮及慢性肥厚性鼻炎下鼻甲黏膜上皮MUC5AC阳性细胞表达率明显高于正常下鼻甲黏膜上皮 (P <0 .0 5 ) ,且MUC5AC阳性表达细胞主要为杯状细胞。结论 :MUC5AC在鼻息肉及慢性肥厚性鼻炎下鼻甲黏膜上皮呈高表达 ,且阳性细胞为杯状细胞 ,表明MUC5AC确实对鼻息肉及慢性肥厚性鼻炎的黏液过量分泌起了一定作用。     

水通道蛋白1在鼻息肉组织中的表达

目的明确水通道蛋白1(Aquaporin1,AQP1)在鼻息肉组织的表达及分布并探讨其与鼻息肉组织水肿的关系.方法取正常下鼻甲组织14例和鼻息肉组织26例,4%多聚甲醛固定,石蜡包埋,连续切片,应用免疫组织化学技术检测AQP1蛋白在鼻息肉组织的表达及分布.结果鼻息肉组AQP1在血管内皮,浆液性腺中的阳性细胞表达率显著高于正常下鼻甲(P＜0.01);而下鼻甲组AQP1在上皮细胞层和纤毛细胞层的阳性细胞表达率显著高于鼻息肉组.结论提示AQP1在鼻息肉中的高表达与鼻息肉组织水肿的发生密切相关,具体调控机制有待进一步明确.     

Fas及Bcl-2在鼻息肉组织中的表达及意义

目的：探讨Fas和Bcl 2在鼻息肉组织中的表达及与鼻息肉发病的关系。方法：应用S P免疫组化法检测36例鼻息肉组织及19例下鼻甲组织中Fas和Bcl 2的表达情况。结果： （1）Fas在鼻息肉上皮及腺上皮的表达弱于对照组（P＜0.05）；（2）Bcl 2在鼻息肉上皮及腺上皮的表达强于对照组（P＜0.05）；（3）鼻息肉上皮细胞中Fas、Bcl 2蛋白的表达无相关性（P＞0.05）。结论：（1）Fas和 Bcl 2在鼻息肉发生发展中起重要作用；（2）在NP上皮细胞中， Fas和Bcl 2无相关性，因此这两种凋亡基因在NP的形成过程中各起独立作用，协调抑制NP上皮细胞的凋亡。     

血管通透性因子在鼻息肉中的表达及意义

目的探讨血管通透性因子（ｖａｓｃｕｌａｒｐｅｒｍｅａｂｉｌｉｔｙｆａｃｔｏｒ，ＶＰＦ）在鼻息肉组织中的表达及意义。方法将９例鼻息肉标本及８例下鼻甲粘膜标本行ＶＰＦ及其受体ｆｌｋ１的免疫组化染色，光镜观查。结果ＶＰＦ在鼻息肉组织的血管内皮细胞和腺体细胞的表达明显高于下鼻甲组织（Ｐ＜０．０１，Ｐ＜０．０５），ｆｌｋ１在血管内皮细胞的表达明显高于下鼻甲组织（Ｐ＜０．０１）。结论ＶＰＦ对鼻息肉发生过程中组织极度水肿的产生可能有非常重要的作用。     

Expression and distribution of Aquaporin 1 in the nasal polyps]

OBJECTIVE: To confirm the expression and distribution of Aquaporin 1 (AQP1) in the nasal polyps and to investigate the relation between AQP1 and the nasal polyp edema. METHODS: fourteen cases of normal inferior turbinates and 26 cases of nasal polyps were used. The expression and distribution of AQP1 in nasal polyps were examined by immunohistochemical technique. RESULTS: The level of AQP1 in the epithelial cells and serous cells from nasal polyps was higher than that in inferior turbinates, and the level of AQP1 in the epithelial cells and cilium cells from inferior turbinate was higher than that in nasal polyps. CONCLUSION: There is close relationship between AQP1 and nasal polyp edema.     

血管通透性因子在鼻息肉中的表达及意义

目的 探讨血管通透性因子（ｖａｓｃｕｌａｒ ｐｅｒｍｅａｂｉｌｉｔｙ ｆａｃｔｏｒ，ＶＰＦ）在鼻息肉组织中的表达及意义。方法 将９例鼻息肉标本及８例下鼻甲粘膜标本行ＶＰＦ及其受体ｆｌｋ－１的免疫组化染色，光镜观查。结果 ＶＰＦ在鼻息肉组织的血管内皮细胞和腺体细胞的表达明显高于下鼻甲组织（Ｐ〈０．０１，Ｐ〈０．０５），ｆｌｋ－１在血管内皮细胞的表达明显高于下鼻甲组织（Ｐ〈０．０１）。结论 ＶＰＦ对鼻     

Expression patterns of galectin-1 and galectin-3 in nasal polyps and middle and inferior turbinates in relation to growth regulation and immunosuppression

BACKGROUND: The term nasal polyposis describes benign growth processes in the nasal and sinus mucosa, which are mainly located in the middle meatus and never in the inferior meatus. As a step to define the biochemical determinants relevant for growth regulation, we focused on endogenous lectins known for anti-apoptotic (galectin-3) and immunomodulatory (galectin-1) activities. DESIGN: Using computer-assisted microscopy, we performed an immunohistochemical investigation defining the quantitative parameters of expression of galectin-1 and galectin-3 in 10 nasal polyps, 10 middle turbinates, and 10 inferior turbinates, all of which were obtained from surgical resection. RESULTS: Our data show that galectin-3 expression is markedly (P<.001) higher in nasal polyps than in turbinates. No relation to the allergic status was discovered. Galectin-1 expression is higher in nasal polyps than in middle turbinates (P<.001) in nonallergic patients compared with allergic ones (in glandular epithelium, P =.009; in connective tissue, P =.006). The lowest galectin-1 expression was observed in the middle turbinate. CONCLUSIONS: These data are in line with a positive influence of galectin-3 on growth and an immunoregulatory role of galectin-1, mimicking an increased expression dependent on glucocorticoid.     

复发性鼻息肉中T淋巴细胞亚群的表达

目的 :检测复发性鼻息肉组织中T淋巴细胞亚群的表达 ,探讨T淋巴细胞介导的免疫反应在鼻息肉复发中所起的作用。方法 :应用荧光免疫流式细胞术检测 17例复发性鼻息肉患者鼻息肉组织、外周血T淋巴细胞亚群CD4 、CD8 、CD4 5RO 的表达 ,并与正常人下鼻甲黏膜及外周血的相应指标进行比较。 结果 :复发性鼻息肉组织中有大量T淋巴细胞浸润 [(39.6 5±2 .0 8) % ],而在健康下鼻甲黏膜中几乎未见CD3 细胞。在复发性鼻息肉中 ,CD3 CD4 细胞[(6 4.4 46± 5 .2 97) % ]多于CD3 CD8 细胞 [(35 .5 5 4± 5 .2 97) % ](P <0 .0 5 ) ,CD3 CD4 5RO 细胞 [(2 2 .6 49± 2 .789) % ]也显著多于正常人外周血CD3 CD4 5RO 细胞 [(3.896± 0 .384 ) % ](P<0 .0 5 ) ,CD3 CD4 /CD3 CD8 比值为 1.95 6± 0 .0 93,复发性鼻息肉患者外周血比值为 2 .36 7±0 .12 8,正常人外周血比值为 1.6 0 6± 0 .0 96 ,其差异均有统计学意义 (均P <0 .0 5 )。结论 :复发性鼻息肉组织中有大量T淋巴细胞表达 ,且T细胞亚群比例失调 ,显示细胞免疫功能的紊乱在鼻息肉的形成与复发中起重要作用     

鼻息肉上皮细胞增殖活性和凋亡活性的比较

目的 探讨鼻息肉上皮细胞增殖和凋亡平衡状态及其发病学意义。方法 实验组（鼻息肉组）29例,对照组（下鼻甲组）11例,采用免疫组化染色法检测增殖细胞核抗原（proliferation cell nuclear antigen, PCNA）的表达。采用TUNEL过氧化酶原位标记法检测原位细胞凋亡。结果 ①鼻息肉上皮PCNA 阳性细胞指数（PIPCNA）和凋亡细胞指数（AI）均大于下鼻甲（30.02±5.89,5.33±2.79）(两者P＜0.01),但鼻息肉上皮PIPCNA/AI值（1.95±0.66）小于下鼻甲（6.93±3.32）(P＜0.01)。②鼻息肉上皮PIPCNA（53.60±11.10） 大于AI（29.48±8.20）(P＜0.01)。结论 鼻息肉上皮细胞增殖活性和凋亡活性均增强,凋亡活性增强幅度较大,但总的来说,鼻息肉上皮细胞增殖率仍然大于细胞凋亡率,细胞累积增多,导致了鼻息肉上皮细胞的过度增殖。     

Expression of vascular endothelial growth factor and transforming growth factor-beta 1 in nasal polyps]

OBJECTIVE: To study the expression and significance of vascular endothelial growth factor/vascular permeability factor (VEGF/VPF) and transforming growth factor-beta 1(TGF-beta 1) in nasal polyps. METHODS: Expression of VEGF/VPF and TGF-beta 1 in nasal polyps from 34 patients and middle turbinates from 30 patients with deviation of nasal septum was prospectively studied with immunohistochemistry. Tissue sections were observed under optical microscope. RESULTS: (1) The VEGF/VPF positivity in vascular endothelium and in glandular cell was significantly higher in nasal polyps than in middle turbinates (P < 0.01 and P < 0.05, respectively); (2) The TGF-beta 1 positivity in extracellular matrix and in cells in the stroma was significantly higher in nasal polyps than in middle turbinates(P < 0.005); (3) The distribution and shape of TGF-beta 1 expressing cells in nasal polyps were similar to that of eosinophil, their positivities were significantly correlative; (4) The positivity of VEGF/VPF and TGF-beta 1 did not correlate with clinical type in nasal polyps (P > 0.05). CONCLUSION: (1) The VEGF/VPF may play a key role in the formation of heavy edema of nasal polyps; (2) The TGF-beta 1 may contribute to some of the pathologic changes observed in nasal polyps, such as thickening of the epithelial basement membrane and stromal fibrosis; (3) Eosinophils in nasal polyps represent a major source of TGF-beta 1.     

Expression and distribution of aquaporin-2 in nasal polyps]

OBJECTIVE: To study the distribution and expression of aquaporion-2 (water channel protein; AQP-2) in nasal polyps and to evaluate the role of AQP-2 in the formation of nasal polyps. METHODS: Eleven samples of normal inferior turbinates and forty-six samples of nasal polyps were used. In the group of nasal polyps, there were ten cases of type II phase 1, twelve type II phase 2, ten type II phase 3 and fourteen type III. The expression of AQP-2 in both groups was studied with immunohistochemical technique. RESULTS: 1. Both the number of AQP-2 positive cells and the area density in the epithelial cell layer from nasal polyps were higher than those from inferior turbinates (P < 0.01, P < 0.05 respectively); In the group of nasal polyps, the area density from type III, type II phase 2 and type II phase 3 was significantly higher than that from type II phase 1 (P < 0.05); 2. Both the number of AQP-2 positive cells and the area density in the subepithelial tissue from type III, type II phase 2 and type II phase 3 nasal polyps were higher than those from type II phase 1 nasal polyps and inferior turbinates(P < 0.05), whereas the difference between the latter two was not significant(P > 0.05). CONCLUSION: The high expression of AQP-2 protein in nasal polyps may contribute to the genesis and development of nasal polyps.     

水通道蛋白-5在人鼻息肉组织中的表达

目的：探讨水通道蛋白-5(aquaporin-5,AQP-5)在维护正常鼻生理功能及在鼻息肉发病机制中的作用;明确AQP-5在下鼻甲和鼻息肉组织中不同部位的表达及分布。方法：取30例鼻息肉组织和12例下鼻甲组织,用4%多聚甲醛固定,石蜡包埋,连贯切片,应用免疫组织化学技术检测AQP-5在下鼻甲黏膜组织和鼻息肉组织中的阳性细胞的表达及分布。结果：下鼻甲AQP-5的黏膜固有层腺体的阳性细胞表达显著高于鼻息肉组织;而鼻息肉组织AQP-5的血管内皮的阳性细胞表达则显著高于下鼻甲黏膜组织。结论：AQP-5在鼻息肉组织固有层毛细血管及血窦内皮细胞呈过度表达,在腺体表达减少,AQP-5在病理状态下对鼻息肉的形成有一定作用。     

Topical budesonide treatment reduces endothelial expression of intercellular adhesion molecules (vascular cell adhesion molecule-1 and P-selectin) and eosinophil infiltration in nasal polyps.

Infiltration of eosinophil granulocytes and endothelial expression of vascular cell adhesion molecule-1 (VCAM-1) and P-selectin was investigated in biopsies of polyps and inferior turbinates from 16 patients with nasal polyps, by the use of immunohistochemical staining and stereological quantification before, during and after topical treatment with budesonide (Rhinocort Turbuhaler). Before glucocorticoid treatment a higher density of eosinophil profiles (p < 0.005), making up a larger proportion of the total cellular infiltrate (p < 0.0005), was found in the polyps compared with the inferior turbinates. Endothelial VCAM-1 expression was higher in polyps than in inferior turbinates (p < 0.005), in contrast with the expression of P-selectin, which was more frequently expressed in the inferior turbinates (p < 0.05). Topical glucocorticoid treatment reduced the density of eosinophil profiles (p < 0.05) and the endothelial expression of VCAM-1 (p < 0.007) and P-selectin (p < 0.02) in polyps. Eosinophil counts and VCAM-1 expression returned to pre-treatment levels 8 weeks after discontinuation of budesonide treatment. The observed reduction in endothelial expression of cellular adhesion molecules may interfere with cellular recruitment in nasal polyps and thus contribute to the known anti-inflammatory effect of glucocorticoid in nasal polyposis.