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[A study on the expression of IL-8 and IL-3 in human nasal polyp and polyposis].

OBJECTIVE: To study the expression of IL-8 and IL-3 in human nasal polyp and polyposis. METHOD: Using immunohistochemical methods detect the expressions of IL-8 and IL-3 in 52 cases of middle turbinate,nasal polyp and nasal polyposis,and calculating the positive area percentages in each group. All datas were analysed with SNK test, Kruskal-Wallis test and Mann-Whitney test. RESULT: There were very significant differences between either two groups about the expressions of IL-8. There were significant differences between either two groups about the expressions of IL-3. CONCLUSION: IL-8 is not only one of the causes in nasal polyp, but also plays an important role in the recurrence of nasal polyposis. The expression of IL-8 in polyp is different from that in polyposis, it indicate that polyp and polyposis have different mechanism. IL-3 is important for the accumulation of eosinophil and is a key factor in the mechanism of polyposis.

Adolescent↗

[The T-lymphocytes subsets expression in the human recurrent nasal polyps].

OBJECTIVE: To investigate the expression of T-lymphocyte subsets (CD4+, CD8+ and CD45RO+ cells) in human recurrent nasal polyps. METHOD: Nasal polyps tissue samples and peripheral blood were obtained from 17 patients, normal human inferior turbinate mucosa and peripheral blood were obtained as well. Flow cytometry was adopted to detect the expression of surface markers of the T-lymphocytes. All data were analyzed with t-test. RESULT: There were significantly large number of CD4+, and CD45RO+ cells in the tissue of recurrent nasal polyps. The expression percentage of CD3+ CD4+ cells was significantly higher than that of CD3+ CD8+ cells. Ratio of CD3+ CD4+/CD3+ CD8+ was 1.956 +/- 0.093. CONCLUSION: There were generous of T-lymphocytes expression in human recurrent nasal polyps. The ratio of the T-lymphocytes subsets was abnormal high than the usual and this indicated the immunological function were in disorder in the local area. The abnormally higher expression of CD3+ CD4+ cells in the local area may play an important role in the recurrence of human nasal polyps.

Adolescent↗

[Antieosinophil action of IL-12 in human polyp culture].

RATIONALE: Tissue eosinophilia is an important pathophysiological issue in bronchial asthma and nasal polyps. Its magnitude is regulated by several mechanisms, including selective migration of eosinophils to peripheral tissues and prolongation of survival. A key role in this processes is assigned to Th2 originating cytokines: IL-3, IL-5, GM-CSF. It has been previously demonstrated that IL-12 diminishes tissue eosinophilia in an animal model, and Hofstra showed that IL-12 together with IL-18 prevents allergen-induced increase bronchial hyperresponsiveness, BAL eosinophilia and the development of allergen-specific Th2 cells. METHODS: Nasal polyps were obtained during routine surgery and were cultured in fragments of approximately 30 mg for 2, 6, and 15 days in RPMI 1640 in the absence or presence of IL-12. Afterwards a dose-dependency was tested at day 2 of culture. Polyp tissue from cultures was than processed to slides, stained with Giemsa and cells were counted in light microscopy (400x). RESULTS: Eosinophils represented 62.8+/-21.3% of residing cells in nasal polyps at the day 0. IL-12 (1 microg/ml) caused a significant time-dependent decrease in the percentage of Eos after 2 and 6 days. The effect of IL-12 at day 2 was concentration-dependent: control, 28.2+/-2.9; at 10 ng/ml, 13.9+/-6.4 (n=4, p<0.05); at 100 ng/ml, 11.6+/-2.1 (p<0.01); at 1 microg/ml, 7.5+/-1.5 (p<0.005). CONCLUSION: IL-12 acts as potent topical antieosinophilic agent. Its action can be seen in a cultured polyp environment. It is visible already after two days and is concentration-dependent. Further study is needed to elucidate tissue mechanisms of this action.

Adult↗

A case of gastric hyperplastic polyp with malignant transformation.

In this paper we report a case of hyperplastic polyp with malignant transformation. The patient was followed up by annual radiographic and endoscopic examination during 9 years. The first gastroscopy revealed a semi-pedunculated polyp beneath the esophageal-cardiac junction, 1.5cm in diameter and slightly reddish with smooth surface. Histological findings showed a hyperplastic polyp. There was slight change in size, but no change in histological examination of the lesion during the follow-up. In 1996, the biopsy specimen showed an atypical epithelium and the polyp was removed by snear polypectomy. A microscopic examination revealed a well-differentiated adenocarcinoma. Immunohistochemically, p53 and Ki-67 immunostaining showed positive in the carcinoma portion of the adenocarcinoma bearing a hyperplastic polyp in the stomach.

Aged↗

A study of the symptomatology of hypertrophied anal papillae and fibrous anal polyps.

BACKGROUND: The presence of Hypertrophied anal papillae and fibrous anal polyps are often ignored in proctology practice. But the experience is that they tend to produce minor but disturbing symptoms. This study is aimed to assay the impact and utility of attending these two conditions concurrently while dealing with cases of fissure in ano. PATIENTS AND METHODS: The study was carried out in 136 patients with chronic anal fissure having concomitant hypertrophied anal papillae or fibrous anal polyps. After relieving sphincter spasm by sphincterotomy, the polyps or papillae were destroyed using the radio frequency device. A comparison was made for the associated complaints like pruritus, pricking sensation, wetness, crawling sensation in the anus etc. before and after the removal of papillae or polyps by an independent observer blinded to the procedure. RESULTS: After one month of the procedure, the associated symptoms were reduced to a significant extent along with a nearly total decline in the primary complaints of pain and bleeding. There was significant reduction in pruritus (p=0.0003), discharge per anus (p=0.0006), crawling sensation in the anus (p=0.0004) and that of incomplete evacuation (p=0.001) At the follow up after 18 months, only 9 % of patients had recurrence of either anal fissure or symptoms like pruritus. CONCLUSION: This study establishes that removal of hypertrophied anal papillae and fibrous polyps should be carried on a routine basis during surgical treatment of anal fissure. This would add to the effectiveness and completeness of the procedure.

Anus Diseases↗

[Examination expression of CD3 and CD69 in nasal polyps].

OBJECTIVE: To investigate the infiltration of T lymphocytes with CD3 expression as surface marker and the activation of T lymphocytes with CD69 expression as activation marker. METHODS: Nasal polyp tissue samples and peripheral blood were obtained from 21 patients. The normal inferior turbinate mucosa and peripheral blood were obtained as comparison. Flow cytometry was adopted to detect the expression of CD3 and CD69 of T lymphocytes. RESULTS: Nasal polyp tissue consisted of abundant T lymphocytes. Activation marker CD69 was expressed in T lymphocytes of nasal polyps (36.96 +/- 2.50)% and peripheral blood (4.66 +/- 0.18)% from the same patient. The expression rates of CD69 after a short-term stimulation (5 h) in response to PDB were (59.88 +/- 2.59)% and (92.76 +/- 0.55)% respectively. While T lymphocytes was rarely detected in normal inferior turbinate and the expression of CD69 was low in peripheral blood from normal human but almost all T lymphocytes were activated after stimulation. CONCLUSIONS: There were generous of T lymphocytes infiltrating in nasal polyps. The expression of CD69 in T lymphocytes was abnormally high, which indicated that T lymphocytes infiltrating in nasal polyps were in activated state immunologically.

Adolescent↗

Aeroallergen hypersensitivity: comparing patients with nasal polyps to those with allergic rhinitis.

Immunoglobulin E-mediated allergy generally has not been considered to be important in the pathogenesis of nasal polyps, despite elevated immunoglobulin E in polyp exudates, tissue eosinophilia, and degranulated mast cells. In previous reports, patients with nasal polyps were more likely to have positive skin tests to perennial than to seasonal allergens. It is postulated that nasal polyps result from the constant nature of perennial allergen exposure. The objective of this report is to compare the prevalence of sensitization to six aeroallergens in a group of nasal polyp (NP) patients, a group of allergic rhinitis (AR) patients, and those subjects with positive skin tests in the National Health and Nutrition Examination Survey (NHANES) II. Twenty-five consecutive NP patients evaluated over a 3-month period of time at Northwestern Allergy and Immunology Outpatient Center, in addition to 50 of the allergic rhinitis patients evaluated over the same time, were chosen randomly. All were skin tested with the following antigens: dog, cat, dust mite, grass, tree, and ragweed. Published skin test data from the NHANES II study of 14,367 individuals was obtained also. The percent of NP patients, AR patients, and NHANES II subjects with sensitization to perennial allergens was 72, 96, and 7.6%, respectively. The difference between the AR and NP patients was statistically significant (p = 0.006). The percent of NP, AR, and NHANES II subjects sensitized to seasonal allergens was 84, 86, and 17.7%, respectively. No statistical significance existed between the AR and NP patients, regarding seasonal allergens. Although the AR and NP had similar levels of reactivity to perennial and seasonal allergens, the NHANES II group was more than twice as likely to be sensitized to a seasonal allergen. The NP and AR groups were similar in prevalence of reactivity to seasonal allergens, but the NP patients in our population actually were less likely to be sensitized to perennial allergens than individuals with AR.

Air Pollution↗

[Results of transcervical surgical therapy on endometrium polyps].

OBJECTIVE: To evaluate short-term and long-term outcomes of the transcervical hysteroscopic ablation of endometrial polyps. DESIGN: A prospective clinical study. SETTING: Gynecology-Obstetrics Ward, Regional Hospital, Pardubice. METHODS: The study included 283 patients in whom in the period of September 1997 to June 1999 hysteroscopic ablations of the endometrial polyp were performed. The mean age of the collection was 58.3 years. 78.2% operations were performed as an outpatient procedure. We evaluated short-term outcomes, longterm outcomes and complications 5 years after the procedure. The patients were examinated by vaginal ultrasound 6 months after operation and then repeatedly in 12 months intervales. SHORT-TERM OUTCOME: There were performed 283 hysteroscopic ablations of the endometrial polyp in the period from September 1997 to June 1999. In one case (0.35%) the operation was complicated by uterine perforation without necessity of any intervention, in 6 cases (2.12%) the procedure was finished in the second session. In 3 patients (1.06%) the endometrial polyp showed malignant transformation. Long-term outcome: In 252 cases (89.05%) we did not notice any long-term complication. In the other cases (10.95%) the endometrial pathology was found by the vaginal sonography and it was necessary to perform other intervention. In 2 cases (0.71%) endometrial cancer was found. CONCLUSION: Hysteroscopic ablation of the endometrial polyp is at present fully indicated method for treatment of this pathology. The follow up by vaginal sonography is an elementary condition for the early diagnosis of the long-term complications.

Endometrial Neoplasms↗

[The effect of fungi in the pathogenesis of nasal polyps and chronic rhinosinusitis].

OBJECTIVE: To study the effect of fungi in the pathogenesis of nasal polyps and chronic rhinosinusitis (CRS). METHOD: This study were divided two groups, the first was the experimental group: Nasal mucus membrane and nasal polyps were collected from patients with CRS (with and without polyps), and the second was the control group, nasal mucus were collected from OHc. Fungal-specific PCR were performed on each sample. The anther was used 0.9% sol sodium chloride to wash the autopsy tissues 5 times, and then PCR analysis was performed. chi-squared analysis was used to test for statistical difference between these groups. RESULT: PCR technique detected fungal DNA were 89.2% and 89.4% in nasal polyps and nasal mucous membrane respectively, and 66.7% in normal control subjective. There were statistically significant difference in these groups. After using 0.9% sol sodium chloride to wash the autopsy tissues, the fungi's positive rate was dropped. CONCLUSION: Fungi was important in the pathogenesis of nasal polyps and CRS.

Adolescent↗

[Factors affecting on the surgery of polyp of vocal cord].

OBJECTIVE: To analyze the factors affecting on the surgery of polyp of vocal cord so as to enhance the success rate of surgery and improve the treatment effect. METHOD: Two thousands seven hundreds and ninety-two cases with polyp of vocal cord were summarized retrospectively according to the types of surgery they received. The factors affecting on the three kinds of surgery were analyzed which including the differences of patients, the types of polyp, the skill of surgeons, the instrument and the anaesthesia. RESULT: The unsuccessful rates in group A, group B and group C were 6.46%, 4.12% and 1.53% respectively. The occurrence rates of complications in three groups were 0.19%, 0 and 1.16% respectively. The proportion of the factors affecting on the surgeries in group A, B, C were the differences of patients 61.77%, 6.67%, 85.71%; the types of polyp 27.94%, 60.00%, 0; the skill of surgeons 30.88%, 46.67%, 0%; the instrument 8.82%, 13.33%, 14.29% and the anaesthesia 16.18%, 33.33%, 0%. CONCLUSION: The main factor affecting the surgery of polyp of vocal cord in group A, C is the differences of patients. The main factor inducing to the complications of surgery is the anaesthesia. All factors affecting on the surgeries should be considered carefully before operation and the necessary measures to avoid the complications must be took.

Adolescent↗

Update on nasal polyps: etiopathogenesis.

PURPOSE OF REVIEW: Nasal polyps is a common ENT disease with high medical failure and recurrence rate, reflecting unknown pathogenesis. The present review is an update on the etiopathogenesis of nasal polyps. RECENT FINDING: Several mechanisms have been proposed for the formation of nasal polyps, including allergy, mucosal allergy, autonomic imbalance, nitric oxide, superantigens, infection, abnormal transepithelial ion transport, mucopolysaccharide abnormality, mechanical obstruction and epithelial rupture. Eosinophils comprises more than 60% of the cell population. Activated T cells, mast cells and plasma cells are also increased compared with the normal nasal mucosa. The stroma has numerous mediators, including cytokines, growth factors, adhesion molecules, and immunoglobulins. Both Th1 and Th2 types of cytokines are upregulated independent of the atopic status. An increased production of GM-CSF, IL5, RANTES and eotaxin can contribute to chronic eosinophilic inflammation by regulating the migration, survival and activation of eosinophils. CONCLUSION: Nasal polyps is a multifactorial disease, with infectious, noninfectious, inflammation, anatomic and genetic abnormalities. Chronic inflammation remains the central major factor in nasal polyps.

Humans↗

[Investigation of GR mRNA quantu expression in chronic sinusitis and nasal polyps].

OBJECTIVE: To detect the expression of the glucocorticoid receptor-alpha/beta (GR-alpha/beta) mRNA in nasal polyp and normal nasal mucosa and investigate the significance of receptor-alpha/beta in GC-insensitive and GC-sensitive patients. METHODS: The expression of GR-alpha/beta mRNA in 40 samples of nasal polyp and 30 normal nasal mucosa was examined by using Fluorescent quantitative PCR. RESULTS: Forty cases were screened from the 80 cases after follow-up, including 26 cases of GC-sensitive and 14 cases of GC-insensitive. the levels of GR-beta mRNA in group of GC-insensitive [(5.72 +/- 0.58) x 10(2) copy/microg] were significantly higher than that of GC-sensitive [(4.82 +/- 0.28) x 10(2) copy/microg, t = -6.65, P < 0.01] and normal nasal mucosa [(4.44 +/- 0.35) x 10(2) copy/microg, t = -9.19, P < 0.01]. There was difference between group of GC-insensitive and other two groups of GC-sensitive and normal nasal mucosa (P < 0.01). The ratio of GR-alpha/GR-beta showed significant difference between the group of GC-sensitive (829.42 +/- 67.36) and that of GC-insensitive (535.70 +/- 89. 00, t = 11.74, P < 0.01). CONCLUSIONS: The high expression of GR-beta mRNA and low expression of GR-alpha mRNA in nasal polyp show the status of "insensitive" in chronic sinusitis and nasal polyp. The GR-beta may play an important role in evaluating the effect of glucocorticoid in chronic sinusitis and nasal polyps.

Adult↗

[Effect of erythromycin on apoptosis of epithelial cell in nasal polyps].

OBJECTIVE: To study the effect of erythromycin on apoptosis and expression of Bax and Bcl-2 of epithelial cell in nasal polyps. METHODS: Epithelial cells from thirty nasal polyps and fifteen inferior turbinates were cultured in Dulbecco Eagle and Ham F12 (1:1) and divided into two groups (one group were treated with Erythromycin). Apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling and expression of Bcl-2 and Bax detected by immunohistochemistry at 1, 3, 5 days after culture. RESULTS: The apoptosis indexes (AI) of epithelial cell in nasal polyps after cultured for 1, 3, 5 days with erythromycin were (33.23 +/- 6.50)%, (38.21 +/- 7.22)% and (52.63 +/- 7.86)% respectively. The AI of epithelial cell in inferior turbinates were (31.02 +/- 5.60)%, (32.13 +/- 7.15)% and (39.64 +/- 7.48)% respectively. There was significant difference between two groups at 5 day after culture (P < 0.05). Expression of Bax and Bcl-2 of epithelial cell was significantly higher in nasal polyps than that in inferior turbinates (P < 0.01). Expression of Bax of epithelial cell cultured with erythromycin was significantly higher than that in the controls (P < 0.05). Apoptosis was clearly promoted after 5 day culture with Erythromycin (P < 0.05). CONCLUSIONS: Erythromycin promoted expression of Bax and apoptosis of epithelial cell in nasal polyps.

Adolescent↗

Is dosage of hormone replacement therapy related with endometrial polyp formation?

PURPOSE OF INVESTIGATION: To evaluate the effect of different doses of hormone replacement therapy (HRT) on endometrial polyp formation. METHODS: 398 menopausal women were initially evaluated through transvaginal ultrasound and patients who already had endometrial polyps were excluded from the study. One hundred and six (26.6%) eligible patients were enrolled and randomized into two groups of 53 patients to receive two different doses of HRT. RESULTS: Six patients with endometrial polyps were detected in the first group and one patient in the second one (p = 0.0502 for total chi-square and p = .1172 for chi-square with continuity correction) after a mean duration of treatment of 26 months and 28,5 months, respectively. There was no difference in the mean number or the mean volume of the polyps between the two subgroups with positive results. CONCLUSION: Our study showed that endometrial polyp formation may be related with HRT dosage.

Dose-Response Relationship, Drug↗

Supplemental calcium suppresses colonic mucosal ornithine decarboxylase activity in elderly patients with adenomatous polyps.

Epidemiological and animal studies suggest a role for calcium in the chemoprevention of colorectal neoplasia. This study was designed to investigate whether supplemental oral calcium has a suppressant effect on colonic mucosal ornithine decarboxylase (ODC) and tyrosine kinase activities in patients with adenomatous polyps or a history of adenomatous polyps and whether this is affected by age. ODC and tyrosine kinase activities were measured in rectal mucosal biopsies of 19 male patients (age, years 46-85 years; mean, 66 years) with adenomatous polyps or a history of adenomatous polyps before and after 1 week of calcium supplementation p.o. (CaCO3; 2500 mg/day) and 2 weeks after cessation of calcium treatment. The basal rectal mucosal ODC activity of patients greater than or equal to 64 years old was nearly 4-fold higher than that of patients less than 64 years old (P less than 0.005). In patients greater than or equal to 64 years old, there was a significant decrease in rectal mucosal ODC activity following 1 week of calcium p.o. compared to those age less than 64 years (P less than 0.05). Overall tyrosine kinase activity did not differ significantly in either patient group before or after calcium supplementation p.o. However, the concentration of phosphotyrosine membrane proteins with molecular weights between 40,000 and 60,000 and between 80,000 and 100,000 were suppressed in patients age greater than or equal to 64 years after 1 week of calcium treatment p.o. These patients also had a corresponding decrease in their rectal mucosal ODC activity. Alternatively, patients whose ODC was not affected by calcium showed no apparent change in the relative concentration of rectal mucosal phosphotyrosine membrane proteins. Our data indicate that there is an age-related increase in basal rectal mucosal ODC activity in patients with adenomatous polyps which can be suppressed with calcium supplementation p.o., suggesting a role for dietary calcium in the chemoprevention of colorectal neoplasia.

Aged↗

[Etiology of nasal polyps: an update].

Nasal polyps are the results of chronic inflammation of nasal mucosa. Ethiopathology of nasal polyposis is still unclear and investigated. The main aim of this study was the assessment of interleukin 2 (IL-2), 4 (IL-4) and 13 (IL-13) and interferon gamma (IFN-gamma) expressions in two groups of patients with nasal polyps: non-allergic and allergic to dust. Twelve patients with nasal polyposis were selected, six of them allergic and six non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Blood sample was obtained from patients and examined for the expression of Interleukin 2, 4, and 13 and IFN-gamma by intracellular staining procedure after stimulation with PMA/ionomycin (phorbol 12-myristate 13-acetate) and allergen (D. pteronyssimus, Allergopharma). Negative correlation was found between expression of Interleukin 2, 4, 13 after PMA/ionomycin and allergen stimulation (p > 0.05) into two groups. Although mean expression of IFN-gamma and IL-2 were lower in allergic patients with nasal polyps. Mean value of IL-4 and IL-13 were higher in allergic patients in comparison to non-allergic, but the correlations were not significant. We did not find correlations between expression of investigated interleukins and bronchial asthma and ASA-intolerance existed in patients (p > 0.05). We found that expression of IFN-gamma was significantly lower in patients with polyps recurrences followed by polypectiomies (p = 0.05). In patients who used intranasal local steroid before treatment we observed significant decrease of 11-2 and 11-13 levels after allergen stimulation (p = 0.,034, p = 0.023). No specific differences of expression of investigated cytokines between allergic versus non-allergic patients suggests that the allergic mechanism may not play an fundamental role in the aetiology and formation of nasal polyps. Furthermore local steroids seem to be used in every patient after polypectomy because of their anti-inflammatory stimulation.

Adult↗

A method to quantitate the relative nuclear area of colorectal polyps by image analysis.

Image analysis of the nuclear area was performed on Feulgen-stained sections from 94 colorectal polyps: 57 colorectal adenomas with or without invasive growth, 28 hyperplastic polyps and 9 Peutz-Jeghers hamartomas (without dysplasia or carcinoma). The lowest mean values of nuclear area were recorded in control cases: in hyperplastic polyps (27.3%), followed by hamartomatous polyps (34.7%). The nuclear area was significantly increased in tubular adenomas with low-grade dysplasia (37.9%), in villous adenomas with low-grade dysplasia (41.16%) and in tubular and villous adenomas with high-grade dysplasia (47.0% and 46.0%, respectively). The nuclear area in villous adenomas with invasive growth was significantly higher than in all other adenomas without invasive growth (56.0%). The present data suggest that the nuclear area in colorectal polyps (as deduced by image analysis studies) correlates well with the degree of nuclear atypia. Thus, measurements of nuclear area appear to be an important parameter in studies aiming to elucidate the malignant potential of these lesions.

Adenoma↗

[Quality of life survey on patients with chronic rhinosinusitis and nasal polyps].

OBJECTIVE: To explore the health-related quality of life (QOL) status of patients with chronic rhinosinusitis and nasal polyps. METHODS: One hundred and twenty patients with chronic rhinosinusitis and nasal polyps and two hundred individuals passing health examination were enrolled by random and their QOL scores were assessed by using QOL instruments including existing SF-36 questionnaire (Chinese version ) and SNOT-20 questionnaire translated into Chinese, of which clinimetric and psychometric properties were tested. RESULTS: The feasibility, reliability, validity, and responsibility of Chinese version of SNOT-20 questionnaire all passed the test. By the assessment of SF-36 questionnaire, it revealed that scores of six domains such as physical functioning, role physical, bodily pain, mental health, vitality, and general health from patients with chronic rhinosinusitis and nasal polyps were lower than that of control group except social functioning and role emotional (P < 0.05). It showed by Chinese version of SNOT-20 questionnaire that patients exceeded healthy individuals in the scores of twenty items of three domains including physical problems, functional limitations, and emotional consequences, of which the most five important items affecting health status were respectively need to blow nose, thick nasal discharge, lack of a good night's sleep, dizziness, and post-nasal discharge (P < 0.05). CONCLUSIONS: QOL instruments such as Chinese version of SF-36 and SNOT-20 questionnaires can effectively differentiate the QOL status between patients with chronic rhinosinusitis and nasal polyps and healthy individuals. The negative impact of chronic rhinosinusitis and nasal polyps on patients' QOL includes physical functioning, role physical, bodily pain, mental health, vitality, general health, and emotional consequences. The problems of nasal discharge, sleep, and dizziness should be sufficiently emphasized in clinical treatment.

Adolescent↗