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PubMed1985

Congenital polyp of the prostatic urethra in childhood. Report of 3 cases and review of literature.

Congenital polyps of the prostatic urethra are supposed to be rare benign hamartomatous protrusions of the urethral wall in infants. The core contains predominantly connective tissue with cellular constituents of the lamina propria, but also smooth muscle cells, islets of glandular cells and even nerve tissue have been described. The core is lined by transitional epithelium, but in several cases squamous metaplasia has been reported. Because the polyp may act as a ball valve, mainly obstructive symptoms are presented. Suprapubic approach is generally recommended resecting a polyp; however, smaller lesions are accessible to transurethral resection. Three cases presenting different symptoms are reported. In 1 patient the polyp contained keratinized squamous epithelium.

Adolescent↗
PubMed1999

Cyclooxygenase-2 mRNA is downexpressed in nasal polyps from aspirin-sensitive asthmatics.

Exogenous prostaglandin E2 (PGE2) given by inhalation almost completely abrogates aspirin-induced asthma and the accompanying increase in cysteinyl-leukotrienes production. Cyclooxygenase (COX) may be present in cells in both constitutive (COX-1) and inducible (COX-2) forms. To increase the production of the potentially protective endogenous PGE2, COX-2 should be upregulated. We hypothesize that an abnormal regulation of COX-2 will predispose patients with asthma to develop aspirin-intolerant asthma/rhinitis (AIAR). We therefore examined the expression of COX-2 messenger RNA (mRNA) in healthy nasal mucosa (n = 11) and in nasal polyps from both patients with AIAR (n = 8) and those with aspirin-tolerant asthma/rhinitis (ATAR) (n = 20). After total mRNA extraction, COX-1 and COX-2 mRNA expression were measured using a reverse transcriptase (RT)-semiquantitative PCR technique. Hybrid primers of COX-1. glyceraldehyde-3-phosphate dehydrogenase (GAPDH) or COX-2. GAPDH were used to create PCR products that were cloned and used as internal standard controls in the competitive PCR reaction. Results are presented as mean +/- standard error of 10(6) molecules of mRNA/micrograms of total RNA. No differences in COX-1 mRNA expression were found between nasal mucosa and nasal polyps from both patients with ATAR and those with AIAR. However, COX-2 mRNA expression in nasal polyps from the AIAR group (0.38 +/- 0.10) was markedly and significantly lower than in polyps from the ATAR group (2.93 +/- 0. 52, sevenfold, p < 0.0001) and nasal mucosa (2.10 +/- 0.54, sixfold, p < 0.01). These findings suggest that an inadequate COX-2 regulation may be involved in AIAR.

Adult↗
PubMed1987

Metachromatic cell progenitors and specific growth and differentiation factors in human nasal mucosa and polyps.

We previously demonstrated that fluctuations in circulating metachromatic cell progenitors were inversely related to nasal metachromatic cell (NMC) counts and nasal symptoms in allergic rhinitis. Now, we have quantitated NMC progenitors and lineage-specific growth factors using a hemopoietic colony assay. Cell suspensions from excised collagenase-treated nasal polyps (n = 7) contained 3.8 +/- 1.1 granulocyte colony-forming cells per 10(6) cells plated, compared to less than or equal to 0.5 in human tonsil suspensions, less than or equal to 0.5 in nasal mucosal epithelial scrapings, and 33 +/- 8 in peripheral blood of patients with ragweed allergic rhinitis (p less than 0.01). The percentage of metachromatic cells in nasal-polyp-derived colonies was 47 +/- 10 compared with 3.0 +/- 0.7 in peripheral blood colonies (p less than 0.005). Highly potent metachromatic cell colony-stimulating activity (CSA) was detected in supernatants from cultured human nasal epithelial scrapings from both polyps and atopic nasal mucosa, but not from nonatopic nasal mucosa. Supernatants from polyp mononuclear cells stimulated with phytohemagglutinin also contained metachromatic cell-CSA, which had an approximate molecular size of 25 to 70,000 daltons on column chromatography. An IL-3-like activity was also detected in these supernatants. These observations provide further evidence for in situ hemopoietic mechanisms in human nasal mucosa, involving epithelium-derived stimulation of local metachromatic cell progenitor growth and differentiation in allergic rhinitis.

Basophils↗
PubMed1995

Eosinophil infiltration is related to increased expression of vascular cell adhesion molecule-1 in nasal polyps.

Endothelial adhesion molecules are important in the recruitment of leukocytes to inflammatory sites. Nasal polyps characteristically contain a leukocyte infiltrate in which eosinophils often are remarkably prominent. We have studied whether this feature is related to a particular profile of adhesion molecules on the local microvascular endothelium. Nasal polyps were obtained from 15 patients. Mucosal biopsy specimens of the lower and the middle turbinate from the same patients as well as from three control subjects served as reference tissue. Expression of endothelial adhesion molecules and the relative numbers of eosinophils and neutrophils were examined by two- and three-color immunofluorescence staining. Both the number of eosinophils and the proportion of vessels positive for vascular cell adhesion molecule-1 (VCAM-1) were significantly increased in nasal polyps compared with the turbinate mucosa of the same patients (P = 0.008 and P = 0.001, respectively). By contrast, the number of neutrophils and the relative expression of E-selectin and intercellular adhesion molecule-1 were similar at both tissue sites. Furthermore, the relative number of eosinophils in nasal polyps was well correlated (rs = 0.73, P = 0.006) with the percentage of vessels positive for VCAM-1, but this was not true for neutrophils. Taken together, this direct in situ observation strongly supports the crucial role suggested for VCAM-1 in human eosinophil extravasation at inflammatory sites.

Adult↗
PubMed1992

Histochemical and immunohistochemical characteristics of mast cells in nasal polyps.

In surgically excised nasal polyps, most epithelial mast cells were formalin sensitive, chloroacetate esterase (CAE) negative, and chymase negative. Thus, this represents a population of mast cells not identified by staining for CAE. On the other hand, most stromal mast cells were formalin resistant and CAE positive, and although there was some polyp-to-polyp variability in their content of neutral protease, most of these cells were positive for both tryptase and chymase. The percentage of metachromatic cells in the epithelium and the number of metachromatic cells per unit area of polyp tissue did not correlate with an index of allergy skin test reactivity or the serum IgE concentration. The percentage of mast cells surrounded by pericellular tryptase, suggesting activation/degranulation, was significantly higher in the stroma than in the epithelium. The findings demonstrate differences between the stroma and the epithelium in phenotype and state of activation of mast cells; these are postulated to be due to distinct microenvironmental factors that affect mast cells at these sites.

Acetates↗
PubMed2001

Effect of macrolides on the expression of HLA-DR and costimulatory molecules on antigen-presenting cells in nasal polyps.

To clarify the basis of macrolide therapy for improvement of chronic sinusitis, we investigated the effect of macrolides on the expression of HLA-DR and costimulatory molecules such as CD54 and CD80 on macrophages in nasal polyps. Nasal polyps taken from 54 patients who had or had not been treated with macrolides were immunohistochemically studied. The percentages of CD68-positive macrophages expressing HLA-DR or CD54 were not significantly different between patients treated with macrolides and those not treated with macrolides. However, among patients exhibiting no atopic predisposition, the number of CD80-positive macrophages was higher in patients treated with macrolides than in those not treated. In addition, the percentage of CD80-positive macrophages was negatively correlated with the percentage of infiltrating eosinophils in the polyps. These results demonstrate that macrophages act as antigen-presenting cells, expressing both major histocompatibility complex II and costimulators, and that the expression of CD80 may play a key role in the immune responses occurring in a nasal polyp. Macrolides may modulate the mucosal immune responses through CD80 expression.

Adolescent↗
PubMed2004

Vocal efficiency measurements in subjects with vocal polyps and nodules: a preliminary report.

Vocal efficiency is a quantitative measure of the ability of the larynx to convert subglottal power to acoustic power. On the basis of the scant previous literature and clinical intuition, we tested the hypothesis that vocal efficiency, as an indicator of the functional status of the larynx, is abnormally reduced in persons with vocal nodules and polyps. Because the most difficult aspect of obtaining measures of vocal efficiency has been the determination of subglottal pressure, we applied a noninvasive airflow interruption technique for this purpose. Subjects with normal voices (n = 22), vocal polyps (n = 14), and vocal nodules (n = 16) phonated at different intensities into a mask connected by way of piping to a flow meter, a pressure transducer, and an acoustic microphone. Inflation of a balloon-type valve located within the piping provided interruption of phonation. The intraoral pressure plateau occurring during flow interruption was used to estimate subglottal pressure. Subglottal power and acoustic power were determined, and their quotient provided a measure of vocal efficiency. The vocal efficiency in the normal subjects averaged 1.15 x 10(-5) at 70 dB, 3.17 x 10(-5) at 75 dB, 7.52 x 10(-5) at 80 dB, and 1.41 x 10(-4) at 85 dB. The vocal efficiency in the patients with vocal polyps averaged 3.62 x 10(-6) at 70 dB, 8.34 x 10(-6) at 75 dB, 2.10 x 10(-5) at 80 dB, and 4.26 x 10(-5) at 85 dB. The vocal efficiency in the patients with vocal nodules averaged 4.32 x 10(-6) at 70 dB, 1.57 x 10(-5) at 75 dB, 4.26 x 10(-5) at 80 dB, and 8.34 x 10(-5) at 85 dB. As compared to the normal subjects, the patients with laryngeal polyps or vocal nodules had significantly reduced vocal efficiency. These results provide quantitative verification of the clinical impression of inefficient phonation in patients with mass lesions of the vocal folds.

Adult↗
PubMed2006

Differential gene expression profiling of vocal fold polyps and Reinke's edema by complementary DNA microarray.

OBJECTIVES: Our purpose was to determine whether complementary DNA (cDNA) microarray analysis (MA) can establish distinct gene expression profiles for 2 phenotypically similar vocal fold lesions: Reinke's edema (RE) and polyps. Established transcript profiles can provide insight into the molecular and cellular processes involved in these diseases. METHODS: Eleven RE specimens and 17 polyps were analyzed with MA for 8,745 genes. Further MA profiling was attempted within each lesion group to identify molecular markers for reflux exposure and smoking. Prediction analysis was used to predict lesion classification for 2 unclassified samples. A real-time polymerase chain reaction was performed to corroborate MA transcript levels for selected significant genes. RESULTS: Sixty-five genes were found to differentiate RE and polyps (p = .0088). For RE, 19 genes were differentiated for reflux exposure (p = .016). No genes were found to differentiate smokers from nonsmokers. For polyps, no genes were found to differentiate for reflux (p = .16) and smoking (p = .565). Categorization of unclassified lesions was possible with a minimum of 13 genes. CONCLUSIONS: We demonstrate the feasibility of benign lesion classification based on MA. Microarray analysis is useful not only for improving diagnosis and classification of such lesions, but also for potentially generating prognostic indicators and targets for therapy.

Adult↗
PubMedDate not supplied

Analysis of glycoproteins from nasal polyps and papillomas by affinity chromatography.

Glycoproteins were isolated from the particulate fraction of four nasal polyps and three nasal papillomas by affinity chromatography on lectins conjugated with agarose (Concanavalin A [Con A], wheat germ agglutinin [WGA], Ricinus communis agglutinin [RCA], peanut agglutinin [PNA], and Dolichos biflorus agglutinin [DBA]). The glycoprotein mixtures so isolated were then analyzed by sodium dodecyl sulfate gel electrophoresis. Glycoprotein profiles of nasal polyps were similar to each other, but were distinctively different from those of nasal papillomas. Binding sites for Con A, WGA, and RCA isolated from nasal papillomas contained intense bands with a molecular weight less than 15,000 daltons, which were absent in nasal polyps. The major component of PNA-binding sites of nasal polyps is of a molecular weight of 65,000 daltons, which was not detected in nasal papillomas.

Adult↗
PubMed2004

Intranasal steroids decrease eosinophils but not mucin expression in nasal polyps.

Increased mucin expression is a feature of nasal polyposis. Corticosteroids reduce polyp size and symptoms, but their effect on mucin production remains unknown. In this study, the effects of intranasal corticosteroids on MUC5AC mucin expression, nasal resistance, eosinophil and neutrophil infiltration, epidermal growth factor receptor (EGFR), interleukin (IL)-8, and tumour necrosis factor (TNF)-alpha expression was assessed in nasal polyps. In nine subjects, one nasal polyp was removed surgically before treatment and another was removed after 8 weeks of intranasal fluticasone (400 microg.day(-1)). Tissues were processed for in situ hybridisation and immunohistochemical staining. Described effects of fluticasone on nasal polyps (reduction in nasal resistance and in eosinophil infiltration) were evaluated. Morphometric analysis was performed to assess the effect of fluticasone on epithelial-, MUC5AC-, EGFR- and IL-8-stained areas, TNF-alpha-stained cells, and neutrophil numbers. Treatment with fluticasone decreased nasal resistance and intra-epithelial eosinophils. The MUC5AC-stained area in the epithelium was unchanged by treatment; MUC5AC mRNA expression was unaffected by treatment. EGFR-stained area, intra-epithelial neutrophil numbers, IL-8 and TNF-alpha expression were also unchanged by therapy. Intranasal fluticasone was effective in decreasing nasal airflow resistance and intra-epithelial eosinophils but had no effect on mucin or epidermal growth factor receptor expression or on neutrophil recruitment.

Administration, Intranasal↗
PubMed1996

Differential activity of nitric oxide synthase in human nasal mucosa and polyps.

Nitric oxide (NO) plays an important regulatory role in airway function and seems to be implicated in the pathophysiology of several airway diseases. To better understand the involvement of NO in the upper airways, we examined the presence of nitric oxide synthase (NOS) activity in human nasal mucosa and nasal polyp tissues. Nasal mucosa was obtained from seven patients undergoing septoplasty, and nasal polyps came from nine patients following polypectomy. NOS activity was quantified in tissue homogenates using the citrulline release assay and localized in tissue sections using reduced nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase histochemistry. The results showed that nasal polyps (n = 9) contained higher levels of total NOS activity (mean +/- SD 5.94 +/- 5.71, range 1.29-18.0 pmol.min-1.mg protein) than nasal mucosa tissues (n = 7) (0.28 +/- 0.22, range 0.01-0.57 pmol.min-1.mg protein). In addition, nasal polyps mainly contained inducible NOS activity (4.67 +/- 4.57, range 1.23-15.5 pmol.min-1.mg protein) whereas in nasal mucosa all NOS activity detected was in constitutive form. In both cases, NOS activity was localized in the epithelial cells. Since NO synthase is induced in inflamed upper airways, we conclude that NO may be an important inflammatory mediator in the respiratory system and that the epithelium may be a source of NO production in the human upper airways.

Adult↗
PubMed1997

Allergen-induced release of GM-CSF and IL-8 in vitro by nasal polyp tissue from atopic subjects prolongs eosinophil survival.

Eosinophilia is a feature of nasal polyposis. The aim of this study was to determine the role of cytokines and allergen in maintaining the eosinophilic infiltrate in this condition. Polyp fragments from house dust mite (HDM)-sensitive atopic individuals and nonatopic individuals were cultured in the presence of HDM, or phytohaemagglutinin (PHA) or culture medium alone. Culture supernatants were assayed for interleukins (IL) 3, 5, and 8 and granulocyte macrophage colony stimulating factor (GM-CSF), and eosinophil survival enhancing activity (ESEA) in vitro. Significant ESEA was produced spontaneously. When polyp tissue from atopics, but not from nonatopics, was stimulated with allergen for 2 days there was a further increase in ESEA associated with a median 12 and fourfold increase in IL-8 and GM-CSF, respectively. This increased ESEA was markedly reduced with anti-GM-CSF and, to a lesser extent, anti-IL-8 blocking antibodies. When stimulated with PHA, polyp tissue from atopic subjects also produced increased ESEA, implicating possible T-cell involvement. This was associated with a small (twofold), but significant, increase in IL-8 and a less consistent increase in GM-CSF. However, anti-IL-8 or anti-GM-CSF blocking antibodies failed to reduce the ESEA in these supernatants, suggesting involvement of other mechanisms. This study suggests that in sensitized individuals, allergen may contribute to polyp eosinophilia by stimulating the production of granulocyte/macrophage colony stimulating factor and interleukin 8.

Allergens↗
PubMed1995

Ornithine decarboxylase and tyrosine kinase activity in juvenile polyps of childhood.

Juvenile polyps (JP) are the most common colonic tumor in children. Although considered benign, malignant transformation has been reported in JP. Ornithine decarboxylase (ODC) and tyrosine kinase (TyK) enzymes are markers for a rapid cell proliferation index. DNA aneuploidy score and p53 gene expression are late malignant changes seen in patients with colon cancer. In this study, we investigated ODC and TyK activities as well as DNA aneuploidy score and p53 expression in juvenile polyps compared with the adjacent normal colonic mucosa. Results showed that ODC was significantly increased in JP compared with the adjacent normal colonic mucosa. TyK activity was increased in 3/5 polyps and decreased in 2/5 polyps compared with the mucosa. Mean TyK activity was higher in JP compared with normal mucosa but did not reach significance (707 and 632 pmol/mg pmol, respectively). Moreover, changes in phosphorylization of TyK proteins was also observed in JP but not in normal mucosa. JP had a normal DNA aneuploidy score and showed no expression of p53 gene. We conclude that JP do not express p53 gene and aneuploidy but had higher activity of ODC and TyK enzymes, suggesting a higher stage of cell proliferation.

Adolescent↗
PubMed2000

Maxillary sinus polyps secondary to dental extraction.

Polyps of the maxillary sinus were obtained from six patients who had reported upper tooth extraction with oroantral perforation prior to the development of symptoms, from 11 patients with chronic sinusitis, and from 12 patients with allergy. Histopathological features, scanning electron microscopy of the polyp epithelium and clinical data were compared in those groups of patients. The post-traumatic polyps differed from those of other aetiologies by showing the presence of granulomas, less numerous inflammatory cells with very few eosinophils, nearly normal surface epithelium (smaller surface area occupied by nonciliated epithelium, absence of epithelial squamous cells, normal frequence of goblet cells), rapid appearance of symptoms, and shorter duration of the disease. It seems that the specific characteristics of the injury-induced polyps results from a different mechanism of their formation, involving primarily abnormal mucosal repair and to a lesser extent an inflammatory process.

Adolescent↗
PubMed2000

Plasma cell polyp of the vocal fold.

Plasma cell polyps of the vocal fold (plasma cell granulomas) are rare inflammatory polyps of the larynx. They should be included in the clinical and histological differential diagnosis of laryngeal polyps. Histologically they are polyclonal aggregates of plasma cells. It is essential to distinguish them from monoclonal, neoplastic plasma cell proliferations. The treatment of choice is surgical resection, although radiotherapy, laser ablation, antibiotics and steroids have been used successfully. We present a case of plasma cell granuloma presenting as a vocal fold polyp, treated surgically.

Aged↗
PubMed2003

Nasal polyps: still more questions than answers.

Nasal polyps are common, affecting one to four per cent of the population. Their cause, however, remains unknown and it is possible that it is not the same in all patients. They have a clear association with asthma, aspirin sensitivity and cystic fibrosis. Histologically they demonstrate large quantities of extracellular fluid, mast cell degranulation and an infiltrate of inflammatory cells, usually eosinophils. While this appearance would suggest an allergic pathology there is little conclusive evidence to support this in most patients. There is, however, some preliminary evidence to suggest that a local allergic process could be the cause. While allergic fungal sinusitis is a well defined clinical entity with recognized diagnostic criteria the ubiquitous nature of fungal spores makes the role of fungal infection in patients with nasal polyps difficult to determine and currently this remains unclear. Surgical treatment of nasal polyps has declined in recent years as the benefits of medical treatment have become increasingly recognized. There is good evidence to support the use of corticosteroids both as a primary and post-operative treatment in the majority of patients. Other medical treatments require further evaluation before they could be considered a viable alternative to steroids. Assessment of the literature regarding surgical intervention is difficult and there is little evidence on which to base a surgical treatment philosophy. The authors believe that an endoscopic approach using a microdebrider facilitates accurate removal of polyps with preservation of normal anatomy.

Asthma↗
PubMed2004

Fibroblast growth factor receptor expression in aural polyps: predictor of cholesteatoma?

The cytokine, fibroblast growth factor (FGF) and its receptors (FGFR) have a pivotal role in wound repair and have been demonstrated in the perimatrix of active cholesteatoma. Aural polyps are a recognized inflammatory reaction of middle-ear mucosa to cholesteatoma, but may arise in its absence. This study examines 28 archival aural polyp specimens, seeking an increased expression for FGFR1 and FGFR3 in polyps associated with cholesteatoma, when compared with those arising in non-cholesteatomatous, mucosal disease, but produced a null result. There was no difference demonstrated in staining intensity between those polyps associated with cholesteatoma and those without. There was a strong correlation between staining patterns of FGFR1 and FGFR3 (r = 0.4, p <0.03). The expression pattern, of nuclear and perinuclear localization, may support the view that nuclear translocation of growth factors, and their receptors, could be related to the cellular proliferation that is associated with cholesteatoma.

Adolescent↗
PubMed2005

Simultaneous antrochoanal and sphenochoanal polyps: a rare clinical entity.

Choanal polyps almost always appear as solitary growths and most commonly arise from the maxillary sinus. Sphenochoanal and ethmoidochoanal polyps are extremely rare. Co-existence of more than one choanal polyp is even more infrequent. We present a patient with an antrochoanal and an accompanying sphenochoanal polyp for the first time in the literature. We discuss the clinical presentation, pathogenesis and surgical management of this rare clinical entity.

Adult↗