Abstract
Cross-linking of antigen-specific IgE bound to the high-affinity IgE receptor (FcεRI) on the surface of mast cells with multivalent antigens results in the release of mediators and development of type 2 inflammation. FcεRI expression and IgE synthesis are, therefore, critical for type 2 inflammatory disease development. In an attempt to clarify the relationship between eosinophilic chronic rhinosinusitis (ECRS) and mast cell infiltration, we analyzed mast cell infiltration at lesion sites and determined its clinical significance. Mast cells are positive for c-kit, and IgE in uncinated tissues (UT) and nasal polyps (NP) were examined by immunohistochemistry. The number of positive cells and clinicopathological factors were analyzed. Patients with ECRS exhibited high levels of total IgE serum levels and elevated peripheral blood eosinophil ratios. As a result, the number of mast cells with membranes positive for c-kit and IgE increased significantly in lesions forming NP. Therefore, we classified IgE-positive mast cells into two groups: membrane IgE-positive cells and cytoplasmic IgE-positive cells. The amount of membrane IgE-positive mast cells was significantly increased in moderate ECRS. A positive correlation was found between the membrane IgE-positive cells and the radiological severity score, the ratio of eosinophils, and the total serum IgE level. The number of cytoplasmic IgE-positive mast cells was significantly increased in moderate and severe ECRS. A positive correlation was observed between the cytoplasmic IgE-positive cells and the radiological severity score, the ratio of eosinophils in the blood, and the total IgE level. These results suggest that the process of mast cell internalization of antigens via the IgE receptor is involved in ECRS pathogenesis.
Highlights
Chronic rhinosinusitis (CRS) is a condition characterized by chronic mucosal inflammation in paranasal sinuses for more than 12 weeks, which causes nasal obstruction, rhinorrhea, and posterior nasal discharge
Each CRS patient was examined for serum levels of IgE, eosinophil ratio, and 1-s forced expiratory volume/forced vital capacity (FEV1/FVC) ratio
Serum IgE levels were found to be high in severe cases of eosinophilic chronic rhinosinusitis (ECRS), while moderate and severe ECRS cases showed an increased eosinophil count in the peripheral blood
Summary
Chronic rhinosinusitis (CRS) is a condition characterized by chronic mucosal inflammation in paranasal sinuses for more than 12 weeks, which causes nasal obstruction, rhinorrhea, and posterior nasal discharge. ECRS forms multiple nasal polyps (NP) in a bilateral nature and tends to relapse even after surgery [1,2]. This disease is relieved by steroid administration, and steroid therapy is considered to be the most effective treatment [3,4]. ECRS lesions are characterized by an infiltration of numerous eosinophils In these patients, increases in peripheral blood allergic factors are observed, including an increase in eosinophils and IgE. This disease frequently occurs in patients with aspirin intolerance, in which aspirin causes asthma [5]
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