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Eotaxin synthesis by nasal polyp fibroblasts.

Nasal polyps is a chronic inflammatory disease of the upper airway characterized by structural abnormalities including stromal fibrosis. Fibroblasts are a rich source of cytokines and inflammatory mediators and are thought to play an important role in the development of fibrosis. In addition, there is considerable evidence for the participation of eosinophils in the pathophysiology of nasal polyps. Although increased numbers of eosinophils are present in nasal polyps, the mechanisms responsible for their selective accumulation are not completely clear. Eotaxin is a chemokine that promotes the selective recruitment of eosinophils. Thus, it may be an important molecule for the recruitment of eosinophils in nasal polyps. The purpose of this study was to investigate whether nasal polyp fibroblasts synthesize eotaxin after stimulation with lipopolysaccharide, IL-1beta or TNF-alpha. Using primary nasal polyp tissue-derived fibroblast lines, we demonstrated that LPS, IL-1beta and TNF-alpha induced the gene expression and protein production of eotaxin in nasal polyp fibroblasts. This responsiveness to LPS, IL-1beta and TNF-alpha was time- and dose-dependent. These findings support the hypothesis that fibroblasts could play an important role in the recruitment of eosinophils in nasal polyps through the production of eotaxin.

Cells, Cultured↗

Lymphocyte subpopulations and cytokines in nasal polyps: is there a local immune system in the nasal polyp?

PURPOSE: The pathogenesis of chronic hyperplastic rhinosinusitis with massive nasal polyposis is still not entirely known. The present study evaluates the lymphocyte subpopulations and their production of cytokines using a technique for detection of intracytoplasmic cytokines by flow cytometry. This information may allow us to determine whether the source of these lymphocytes is from peripheral blood, the common mucosal immune system, or both. METHODS: Detection of intracytoplasmic cytokines by flow cytometry was performed using a fluoresceinated monoclonal antibody directed against CD4+ and CD8+ lymphocytes and a rhodamine-labeled intracytoplasmic monoclonal antibody directed against four cytokines. In this way, the percentage of lymphocytes synthesizing TH1 and TH2 cytokines were identified in nasal polyp lymphocytes and the corresponding peripheral blood lymphocytes of 13 patients. RESULTS: Lymphocytes producing interferon-gamma and IL-2, as well as IL-4 and IL-5, were found in the nasal polyps, suggesting that the nasal polyp possesses both TH1 and TH2 cytokine expression. There are also significant differences between the percentage of lymphocytes producing these cytokines between nasal polyps and peripheral blood, suggesting that nasal polyp lymphocytes derive from at least another source than only peripheral blood lymphocytes. Statistical analysis of four groups of patients demonstrated that no statistically significant difference in the lymphocyte subpopulations in atopic versus non-atopic patients, nor aspirin-intolerant versus aspirin-tolerant patients. In general, CD8 cells always produce more interferon-gamma than IL-2 in both peripheral blood and nasal polyps. In contrast with this data, CD4 cells produce more IL-2 in the peripheral blood than in nasal polyps. CONCLUSIONS: Data support the concept that nasal polyp lymphocyte subpopulations may be derived from both the local mucosal immune system as well as from random migration of peripheral blood lymphocytes secondary to adhesion molecules and chemokines, which are known to be present in nasal polyps.

Adenoids↗

Comparative assessment of cell proliferation and accumulation of extracellular matrix in nasal polyps.

In nasal polyps constantly associated with chronic inflammation, a dysregulation of epithelial cell proliferation has been described. Involvement of extracellular matrix accumulation is also suggested in the formation and growth of nasal polyps. In this study, we attempted to evaluate the activity of the proliferation of epithelial cells and fibroblasts and the relation between fibronectin accumulation and these cell proliferations in nasal polyps. The pathological specimens of 30 patients were examined which manifested proliferating cell nuclear antigen (PCNA) expression in epithelial cells and fibroblasts and in fibronectin expression. PCNA expression was quantified by calculating the index for each sample. No significant difference in PCNA index was found between epithelial cells and fibroblasts. However, a significant correlation was found between the epithelial and fibroblastic PCNA index. In addition, fibronectin immunopositivity was well correlated with the activity of proliferation of fibroblasts. Therefore, proliferation of fibroblasts is also an important factor in the growth of nasal polyps, and its relationship with fibronectin accumulation may play a role in the pathogenesis of nasal polyposis.

Adult↗

[The role of chosen cytokines in etiology of nasal polyps].

UNLABELLED: Nasal polyposis is a chronic inflammatory disease of the nasal mucus. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of interleukins 2 and 4 in patients with nasal polyps and to compare cytokine profile of patients with allergy versus patients without allergy. MATERIAL AND METHODS: Twelve patients with nasal polyps were selected, six of them allergic to dust and six non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin test to dust and the serum levels of IgE. Blood sample was obtained from patients and examined for the expression of Interleukin 2 and 4 by intracellular staining procedure, after stimulation with PMA (phorbol 12-myristate 13-acetate) and allergen (D. pteronyssimus, Allergopharma). RESULTS: Statistical analysis of 2 groups of patients demonstrated that no significant difference in the interleukins expression in allergic versus non-allergic patients was observed (p > 0.05). In patients who used intranasal local steroid before treatment we observed significant decrease of 11-2 level after allergen stimulation (p = 0.034). CONCLUSION: No differences of expression of Interleukin-4 between allergic versus non-allergic patients suggests that the allergic mechanism does not play an important role in the aetiology and formation of nasal polyps. To confirm this, further research needs to be undertaken.

Adult↗

Comparison of the role of nasal polyp and normal nasal mucosal epithelial cells on in vitro eosinophil survival. Mediation by GM-CSF and inhibition by dexamethasone.

Eosinophilic infiltration of the respiratory mucosa is considered an inflammatory hallmark of allergic rhinitis, bronchial asthma and nasal polyposis. However, the mechanisms involved in this infiltration have not yet been totally elucidated. The objective of this study was to investigate and compare the influence of epithelial cell secretions from both nasal polyps (NP) and normal nasal mucosa (NM) on in vitro eosinophil survival. Epithelial cells were identified by microscopy and immunohistochemistry, cultured to confluence, and human epithelial cell conditioned media (HECM) was generated from cultures. Eosinophils were isolated at high viability and purity (> 90%) from peripheral blood and incubated with HECM. HECM from both NM and NP increased eosinophil survival in a dose-dependent manner, this effect being maximal at a concentration of 25% for NM (73.4% +/- 5.5%, n = 26, P < 0.001) and of 10% for NP (74.5% +/- 8.4%, n = 18, P < 0.001). Incubation of monoclonal antibody to human GM-CSF with HECM, neutralized the induction of eosinophil survival by HECM from both NM and NP. HECM from NP contained higher concentrations of GM-CSF (111 +/- 25.4 pg/ml, n = 17) than HECM from NM (97.1 +/- 15.2 pg/ml, n = 8), without reaching statistical significance. Pre-incubation of dexamethasone with eosinophils also blocked HECM-induced eosinophil survival from both NM (10(-8)-10(-5) M; IC50 = 9.5 nM) and NP (10(-7)-10(-5) M; IC50 = 83 nM). These results suggest that: firstly eosinophil infiltration into the respiratory mucosa during allergic reaction and nasal polyposis may be modulated at least in part by GM-CSF from epithelial cells; and secondly epithelial cells from NP might have a more potent effect on inducing eosinophil infiltration of the respiratory mucosa than epithelial cells from NM. Finally, we may consider this as a reliable in vitro model to compare the role of epithelial cells from inflammatory (NP) and non-inflammatory (NM) tissue in respiratory inflammation.

Cell Survival↗

Nasal mucosal gene expression in patients with allergic rhinitis with and without nasal polyps.

BACKGROUND: Nasal polyps are a common problem that is difficult to diagnose and treat, in part because the cause of nasal polyposis is unknown. Although information on the pathogenesis of polyposis is lacking, there are reports suggesting that a genetic predisposition underlies this disorder. OBJECTIVE: We sought to better understand the basis of nasal polyposis associated with allergic rhinitis. We hypothesize that the expression of unique genes is associated with the nasal polyposis phenotype. METHODS: We examined 12000 human genes transcribed in the nasal mucosa of patients with allergic rhinitis with and without nasal polyps. Biopsy specimens of the mucosa of patients with and without polyps were obtained after the patients refrained from the use of topical or systemic steroid therapy for 2 weeks. RESULTS: Thirty-four genes were differentially expressed between the patient groups, including those for inflammatory molecules and putative growth factors. The greatest differential expression identified by the array analysis was for a group of genes associated with neoplasia, including mammaglobin, a gene transcribed 12-fold higher in patients with polyps compared with control patients with rhinitis alone. Quantitative RT-PCR confirmed this differential expression and documented that the number of mammaglobin mRNA copies is actually 64-fold greater in tissues of patients with polyps versus control patients. The specificity of mammaglobin protein expression was evaluated by means of immunohistochemistry, which showed specific staining in nasal polyp mucosal goblet cells only in patients with polyps. CONCLUSION: These data suggest that nasal polyposis involves deregulated cell growth, using gene activation in some ways similar to a neoplasm. In addition, mammaglobin, a gene of unknown function associated with breast neoplasia, might be related to polyp growth.

Adult↗

Interleukin-3 interleukin-5, and granulocyte-macrophage colony-stimulating factor expression in nasal polyps.

PURPOSE: Nasal polyps (NP) are grape-like clusters of chronically inflamed tissue. Little is known about the underlying cells and cytokines involved in nasal polyposis. For the present study, we hypothesize that elevated tissue levels of interleukin-3 (IL-3), interleukin-5 (IL-5), and granulocyte-macrophage colony-stimulation factor (GM-CSF) contribute to eosinophil recruitment and activation in NP. MATERIALS AND METHODS: To begin to test this hypothesis, we evaluated IL-3, IL-5, and GM-CSF levels and distributions in nasal polyp specimens obtained intraoperatively from 13 patients and two normal controls. For these studies, nasal polyp levels were determined by enzyme-linked immunosorbent assay (ELISA), and IL-3, IL-5, and GM-CSF distribution was determined by immunohistochemistry. RESULTS: Immunohistochemical staining of the NP indicated that in all 13 patient samples, IL-3, IL-5, and GM-CSF were associated with infiltrating cells, primarily eosinophils, in the NP. Quantitation of IL-3, IL-5, and GM-CSF in NP tissue homogenates indicated that IL-3, IL-5, and GM-CSF levels were evaluated in the NP tissues when compared with control tissues. Additionally, elevation of individual cytokines correlated with previous polypectomy (IL-3), steroid use (IL-3, IL-5, and GM-CSF), asthma (IL-5), and age (GM-CSF). CONCLUSION: These data support our hypothesis that IL-3, IL-5, and GM-CSF are likely to play a key role in eosinophil recruitment/activation and NP formation and support recently advanced theories that cytokines play a key role in the pathogenesis of this disease.

Adult↗

A short course of oral prednisone followed by intranasal budesonide is an effective treatment of severe nasal polyps.

BACKGROUND: Nasal polyposis is an inflammatory disease of unknown etiology. This study aimed to evaluate the effect of a short course of oral prednisone followed by intranasal budesonide on nasal symptoms, polyp size, nasal flow, and computed tomography scan. METHODS: Eighty-four patients with severe nasal polyps were included. After a steroid washout period, patients were randomized into two groups: group A (n = 63) received oral prednisone for 2 weeks and group B (n = 21) did not receive any steroid treatment. Patients from group A received intranasal budesonide for 12 weeks. RESULTS: Atopy was positive in 36.8% of patients. Blood eosinophilia was higher in asthmatic (7.2 +/- 0.7%, P < .05) than in nonasthmatic (3.0 +/- 0.4%) patients. Asthmatic patients showed higher scores on nasal obstruction and loss of smell than nonasthmatics. Oral steroids caused a significant improvement in all nasal symptoms and improved polyp size (2.1 +/- 0.1, P < .05) and nasal flow (560 +/- 35 cm/s, P < .05) compared with nontreated patients (2.8 +/- 0.1 and 270 +/- 34 cm/s, respectively). Intranasal budesonide maintained the improvement on nasal symptoms, polyp size, and nasal flow. Steroid treatment reduced the computed tomography scan score (15.4 +/- 1, P < .05) compared with before treatment (18.2 +/- 0.8). CONCLUSION: A short course of oral steroids improved all nasal symptoms, polyp size, and nasal flow, whereas intranasal steroid maintain this effect.

Administration, Intranasal↗

Infarcted angiomatous nasal polyps.

Angiomatous nasal polyps are a rarely reported subtype of inflammatory sinonasal polyps that are characterized by extensive vascular proliferation and ectasia. Compromise of their vascular supply may occasionally lead to infarction, resulting in clinical, radiological and pathological features that simulate a neoplastic process. In the present paper, the salient characteristics of this unusual entity are described. The clinical, radiological and pathological features of two patients with infarcted angiomatous nasal polyps are presented. Grossly, the polyps had an unusual inhomogenous appearance and texture and were associated with a foul odor. CT findings included bony expansion and destruction. MRI findings included markedly inhomogenous contrast enhancement on T1-weighted images. Histopathologically, both cases showed abundant vascular ectasia, with widespread intraluminal thrombosis and necrosis. Recanalization and reparative changes were also present. Angiomatous nasal polyps are poorly documented in the literature. Although entirely benign, they may simulate neoplastic processes, thus awareness of their existence is of considerable importance.

Adult↗

[Obstructive sleep apnea and obstructing nasal polyps].

BACKGROUND: Nasal obstruction may be a causative factor in the etiology of obstructive sleep apnea. No studies were found that dealt with the role of nasal polyps in sleep apnea. METHOD: Two male patients, 69 and 44 years old, were examined in our clinic because of nasal polyps occluding the nasal cavity. Their main complaint was nasal breathing obstruction with hyposmia. The clinical history revealed snoring but neither apnea nor daytime sleepiness was reported. Both patients underwent full nocturnal 12-channel polysomnography (PSG) prior to endonasal sinus surgery. PSG and nasal endoscopy were performed 3 months postoperatively. RESULT: The patients showed an increased apnea hypopnea index (AHI) from 21.1 to 76.6 and 7 to 38.8 respectively. Excessive daytime sleepiness (EDS) appeared and relative duration of REM sleep decreased. Nasal CPAP therapy was recommended. CONCLUSION: Although patients felt relieved after surgery since their nasal breathing problem was solved, the results with respect to AHI, EDS, and sleep pattern were unexpected. Perhaps these findings can be explained by surgical alteration of nasal receptors or by a postoperative switch from oral to nasal nocturnal breathing.

Adult↗

A possible role of aerodynamic factors in nasal polyp formation.

Nasal polyps are apparently the result of multiple deleterious influences acting together. For the establishment of nasal polyps, not only are specific inflammatory changes in the nasal mucosa required but also accessory factors that render the inflamed mucosa susceptible to polyp formation. In this study, it was demonstrated that the unilateral polyposis in patients with deviated septum occurred much more frequently on the concave side (33:14). Inflammatory factors affect both sides equally but the deviated septum influences the air flow through the nasal cavities separately. The air flow rate on the concave side is greater than on the convex side. Since the upper part of the lateral wall of the nasal cavity where polyps occur is the most constricted, the air currents are most rapid and then the air pressure is decreased, tending to form an area of negative pressure. It appears that the negative pressure induces the inflamed mucosa to project into the nasal cavity resulting in polyp formation.

Adult↗

Lipid peroxidation and some antioxidant enzymes in nasal polyp tissue.

Nasal polyp (NP) is considered an inflammatory condition in nasal and paranasal sinus cavities and is frequently encountered in otolaryngology clinics. Although the pathophysiology of nasal polyps is poorly understood, it seems likely that the epithelium may play a critical role in the genesis of inflammatory nasal disease. The aim of this study was to investigate the role of free radicals and antioxidant enzymes in NP and compare these findings with concha bullosa (CB). NP and CB were obtained from 27 and 23 patients, respectively. Glutathione peroxidase (GSH-Px), catalase (CAT), xanthine oxidase (XO) total (enzymic plus non-enzymic) superoxide scavenger activity (TSSA), non-enzymic superoxide scavenger activity (NSSA), superoxide dismutase (SOD), and MDA levels in NP and CB were measured. GSH-Px activiy was significantly lower in patients with NP than in the CB group. However, CAT, XO activities and MDA levels were significantly higher in patients with NP than in the CB group, but TSSA, NSSA and SOD activities were unchanged. Increases in the levels of tissue MDA in patients with NP compared to the CB group may indicate the presence of free radical damage in patients with nasal NP.

Adult↗

[Immunohistochemical study of p53 and Ki-67 in inverted papillomas and nasal polyps arising from nasal or paranasal regions].

The current study investigated immunohistochemical features of p53 and Ki-67 in 12 cases of paranasal inverted papillomas (IPs) and 14 cases of nasal polyps (NPs). Four IPs were accompanied with squamous cell carcinoma (SCC) or dysplastic lesions (DL). The p53 expressions were evaluated by "p53 score", which was defined by combined number and intensity of p53 positive cells. Ki-67 expression was evaluated by the labeling index. In both IPs and NPs, p53 expression was statistically correlated with Ki-67 index. These findings suggested the correlation among the p53 dysfunction and the aggressive epithelial growth in both IPs and NPs. The p53 expression was recognized in 9 IPs (75%), and in 6 NPs (42.9%), respectively. There were no significant differences in p53 scores and Ki-67 index between IPs and NPs. However, the distribution patterns of p53 positive cells in IPs appeared to be different from those in NPs. These immunohistochemical features may play a role in differentiating IPs from NPs. On the other hand, the p53 scores of SCC areas and Ki-67 index were significantly larger than those of IPs without SCC/DL or those of NPs (p<0.05). These results would indicate the importance of p53 in malignancy. However, our results also raise a caution that p53 expression in NPs can occur in similar staining patterns to SCC and its recognition is necessary in differentiating NPs from malignancy.

Adult↗

Functional heterogeneity of mast cells isolated from different microenvironments within nasal polyp tissue.

Nasal polyposis is a chronic inflammatory condition of the upper airways characterized by infiltration of activated inflammatory cells, including mast cells, both in the epithelium and in the stroma. The aim of this work was to study human mast cells derived from two different anatomical sites within the same nasal polyp tissue. To this end, we isolated two distinct mast cell populations, one from the epithelial and the other from the stromal layers of individual human nasal polyp tissues. We examined the mediator content of the two mast cell populations and found that stromal mast cells had a significantly higher content of tryptase compared with the epithelial mast cells from the same tissue. In addition, mast cells from the stromal compartment, but not those from the epithelium, released a significant amount of histamine after anti-IgE stimulation. By contrast, both populations released over 50% of the total histamine after non-specific stimuli (A23187 10(-6) M). The content of mediators and the response to immunological activation were not significantly altered in patients receiving topical steroid therapy. It remains to be determined if the observed differences are the result of an intrinsic characteristic of the mast cell populations localized to separate tissue compartments, or reflect a different in vivo exposure to stimuli such as antigens, or different surrounding structural or infiltrating cells. In conclusion, these data provide evidence of functional heterogeneity and differences in mediator content between mast cell subpopulations from a single human tissue. The failure of release of epithelial mast cell mediators from an immunologic stimulus may have implications concerning acute effects of antigen exposure in nasal polyposis.

Adult↗

Detection of Epstein-Barr virus-infected mucosal lymphocytes in nasal polyps.

Primary nasal lymphomas of T or NK cell origin are known to be associated with Epstein-Barr virus (EBV). However, it is not known whether EBV is normally present in nasal mucosa as distinct to nasopharyngeal tissue. This study investigates the prevalence of EBV infection in 13 cases of nasal polyps. EBV DNA was detected in 2 of 13 (15%) by Southern blot hybridization and in 9 of 13 (69%) by polymerase chain reaction. In situ hybridization for EBV-encoded small nuclear RNAs (EBER) was positive in 11 of 13 (85%) cases; the virus was present in stromal lymphocytes only and not in the epithelial cells. Immunohistochemistry for EBV proteins in 7 cases revealed EBV nuclear antigen (EBNA)-2, latent membrane protein (LMP)-1, and ZEBRA (the switch protein encoded by gene BZLF1) expression in rare isolated stromal lymphocytes in 3 cases. Double immunostaining in 1 case showed that the LMP-1+ cells were B or T cells. Immunohistochemistry for EBV lytic proteins showed very rare viral capsid antigen (VCA)+ and membrane antigen (MA)+ cells in 1 case and very rare diffuse early antigen (EA-D)+ and VCA+ cells in 1 other case. The expression of ZEBRA, EA-D, VCA, and MA suggested a disruption of latency in very rare stromal lymphocytes leading to a productive cycle. Although the incidence of EBV positivity in nasal polyps in our population is high (85%), very low numbers of EBV+ cells are found in each case. Nevertheless, they indicate that nasal mucosa could be one of the sites of EBV persistence through a low level of infection of the resident lymphocytes and thereby provide a possible setting for the emergence of virally associated tumors in this site.

Adult↗

Microbiologic analyses of nasal polyp tissue.

Nasal polyps from 40 patients were cultured within 2 1/2 hours after surgical removal to determine whether microorganisms were present. The first 20 polyps were cultured for aerobic and anaerobic bacteria, viruses, fungi, mycoplasmas, and mycobacteria. Of these 20 polyps, eight were sterile by all tests, one grew Cryptococcus albidus, one grew Sporobolomyces, one had large numbers of Peptostreptococcus micros and Propionibacterium acnes, greater than 10(6) colony-forming units per gram (cfu/gm), and nine had aerobic bacteria including 10 different species at levels less than 10(5) cfu/gm. The second 20 polyps were cultured for aerobic bacteria only; 11 polyps were positive. Overall, 14 of 26 polyps from patients with asthma and two of 14 polyps from patients without asthma were positive for aerobic bacteria at levels greater than 10(3) cfu/gm (p less than 0.05). Multiple aerobic bacterial species tended to occur in polyps from patients with asthma (11 of 26) more frequently than in those from patients without asthma (one of 14) (p less than 0.01). There was a highly significant positive correlation between tissue neutrophilia and bacterial count (r = +0.9; p less than 0.001). The results indicate that patients with asthma have a significantly higher number and a tendency to a greater variety of aerobic bacteria in nasal polyp tissue than patients without asthma and that the number of infiltrating neutrophils is directly related to the number of bacteria.

Adolescent↗

Relationship between matrix metalloproteinases MMP-2, MMP-9, tissue inhibitor of matrix metalloproteinases-1 and IL-5, IL-8 in nasal polyps.

BACKGROUND: Nasal polyps (NP), a subgroup of chronic rhinosinusitis, are characterized by interleukin 5 (IL-5) mediated infiltration of eosinophils in sinus mucosa, leading to pseudostratified ciliated columnar epithelium, thickening of the epithelial basement membrane and tissue edema. Matrix metalloproteinases (MMP) constitute a large group of Zn2+ dependent endopeptidases with the ability to degrade extracellular matrix and are possibly responsible for the development of tissue edema in chronic sinusitis. OBJECTIVE: The aim of this study was to determine the expression of MMP-2, MMP-9 and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) mRNA and to locate the distribution of MMP-2, MMP-9 and TIMP-1 by immunohistochemistry in ethmoid sinus mucosa in NP. Furthermore the correlation between IL-5 or IL-8 and MMP-2, MMP-9 or TIMP-1 is examined. METHODS: Nasal polyps of 33 patients and 18 specimens of inferior turbinate mucosa were examined by real time RT-PCR for MMP-2, MMP-9, TIMP-1, IL-5 and IL-8 mRNA expression. Immunohistochemical labeling for MMP-2, MMP-9 and TIMP-1 was performed. RESULTS: Differences between both locations were detectable for MMP-9 (P < 0.001) and IL-5 (P=0.003) but not for MMP-2 (P=0.278), TIMP-1 (P=0.515) and IL-8 (P=0.386). Correlation was detected only between TIMP-1 and IL-5 (r=0.422, P =0.014). Cytoplasmic staining of MMP-2 was present in the apical part of the ciliated cells, submucosal glands and in smooth muscle cells. Matrix metalloproteinase-9 was expressed in surface epithelium, in seromucous glands and in polymorphonuclear cells. CONCLUSIONS: Expression of MMP-9 and IL-5 mRNA are associated with NP. The correlation between IL-5 and TIMP-1 indicates the role of TIMP-1 in maintaining the homeostasis in NP.

Adult↗

Quantitative analysis of eotaxin and RANTES messenger RNA in nasal polyps: association of tissue and nasal eosinophils.

OBJECTIVES/HYPOTHESIS: Nasal polyps develop in the ethmoidal and middle turbinate area, often in relation to inflammatory conditions. Their exact etiology and pathogenesis are still under debate. Histologically, the polyps are infiltrated by a number of inflammatory cells, with eosinophil predominating in most specimens. This finding suggests that the nasal polyp is an inflammatory growth that is controlled by the local environment. The chemokines eotaxin and RANTES (regulated on activation normal T cell expressed and secreted) have been postulated to be involved in the recruitment and activation of eosinophils to certain inflamed tissues. The purpose of this study was to investigate eotaxin and RANTES mRNA expression in nasal polyps and its effect on tissue and nasal eosinophils. METHODS: Nasal polyps (917 allergic and 30 nonallergic cases) were obtained from endoscopic sinus surgery, and 15 normal inferior turbinates also were taken. Immunohistochemical staining for eosinophils and quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) tests for eotaxin and RANTES mRNA expression were performed, and the concentration of nasal eosinophil cationic protein (ECP) was measured. RESULTS: The amounts of eotaxin mRNA in the allergic nasal polyps were 11.4 times higher and the levels in the nonallergic polyps were 6.4 times higher than in the normal inferior turbinate. However, the RANTES mRNA expression did not show any differences among the three groups. Tissue eosinophilia and nasal ECP levels were significantly correlated with eotaxin mRNA level but not with RANTES mRNA expression. CONCLUSION: Nasal polyp eosinophilic infiltration and activation correlate mainly with increased eotaxin gene expression rather than with RANTES expression.

Adolescent↗