Eotaxin-1在真菌球型鼻-鼻窦炎合并鼻息肉中的表达与嗜酸性粒细胞浸润的相关性

目的观察真菌球型鼻-鼻窦炎合并鼻息肉的组织病理学特点,检测Eotaxin-1在真菌球型鼻-鼻窦炎合并鼻息肉中的表达及与嗜酸性粒细胞浸润的相关性,探讨Eotaxin-1在真菌球型鼻-鼻窦炎合并鼻息肉发病过程中的作用。方法收集真菌球型鼻-鼻窦炎合并鼻息肉20例和鼻中隔偏曲矫正术患者代偿性肥大的下鼻甲黏膜15例，用HE染色法观察组织中的嗜酸性粒细胞浸润，免疫组织化学法检测组织中Eotaxin-1的表达，比较两组之间的表达差异,分析组织中嗜酸性粒细胞浸润数目与Eotaxin-1表达的相关性。结果①真菌球型鼻-鼻窦炎合并鼻息肉上皮脱落、鳞状上皮化生现象明显，间质为大量疏松结缔组织，其中可见较多的淋巴细胞、嗜酸性粒细胞和巨噬细胞浸润及大量的毛细血管增生，有时可见较多的纤维组织增生，黏膜内未见真菌菌丝和孢子;②Eotaxin-1在下鼻甲黏膜上皮细胞中有少量表达，真菌球型鼻-鼻窦炎合并鼻息肉表达Eotaxin-1明显增多（P＜0.05），主要由上皮细胞和血管内皮细胞分泌,间质中可见嗜酸性粒细胞和巨噬细胞表达Eotaxin-1;③组织中嗜酸性粒细胞浸润数目和Eotaxin-1的表达明显相关（P＜0.05）。结论真菌球型鼻-鼻窦炎合并鼻息肉组织呈慢性炎症改变,其中可见较多的嗜酸性粒细胞浸润，真菌可能通过介导Eotaxin-1的过量表达，引起嗜酸性粒细胞聚集活化增多，是真菌球型鼻窦炎合并鼻息肉发生的重要因素之一,拮抗Eotaxin-1发挥功能可能对其临床防治有意义。

Relationship between Eotaxin-1 expression and eosinophili infiltration in nasal polyps with fungal ball rhino-sinusitis

To explore the histopathological characteristics of nasal polyps with fungal ball rhino-sinusitis, and to determine the expression of Eotaxin-1 and its relationship with eosinophili infiltration. MethodsTwenty cases of nasal polyps with fungal ball rhino-sinusitis and fifteen cases of normal inferior turbinate mucosa were enrolled in this study. Immunohistochemical staining for Eotaxin-1 protein and HE staining for eosinophils were performed in two groups. Results① Lost epithelium and squamous metaplasia were usually observed in nasal polyps with fungal ball rhino-sinusitis. In the stroma there were a lot of lymphocyte, eosinophil and phagocyte infiltration, sometimes there were a lot of fibrocytes, also there were briskly capillary hyperplasia, but there were no fungi in the nasal mucous. ② Eotaxin-1 constitutively expressed in the inferior turbinate mucosa and highly expressed in nasal polyps with fungal ball rhino-sinusitis (P＜0.05). Eotaxin-1 immuno-reactivity was mostly determined in the epithelium and vascular endothelial cells. Some eosinophils and phagocytes in the stroma were also identified as Eotaxin-1 positive cells; ③ Tissue eosinophilia in nasal polyps with fungal ball rhino-sinusitis was associated with the expression of Eotaxin-1 protein (P＜0.05). ConclusionFungi are probably responsible for tissue eosinophilia by increasing the Eotaxin-1 protein in nasal polyps with fungal ball rhino-sinusitis. Eotaxin-1 antagonist may contribute to the treatment of nasal polyps with fungal ball rhino-sinusitis.