Increased expression of pendrin in eosinophilic chronic rhinosinusitis with nasal polyps

Taku Ito,Satoshi Ikeda,Tomoaki Asamori,Keiji Honda,Yoshiyuki Kawashima,Ken Kitamura,Keiko Suzuki,Takeshi Tsutsumi

doi:10.1016/j.bjorl.2018.07.005

Abstract

IntroductionChronic rhinosinusitis with nasal polyps is a heterogeneous disease and appropriate diagnostic algorithms in individual cases are necessary for effective medical treatment. ObjectiveThe purpose of this study was to clarify the relationship between the pendrin expression of nasal polyps and clinical and pathological characteristic features of eosinophilic chronic rhinosinusitis. MethodsA total of 68 patients were classified into eosinophilic chronic rhinosinusitis or non-eosinophilic chronic rhinosinusitis groups according to the degree of eosinophilic infiltration into the nasal polyps. Clinical, hematological, and immunohistochemical analyses were performed and statistically compared between both groups. ResultsThirty-eight were classified into eosinophilic chronic rhinosinusitis and 30 into non-eosinophilic chronic rhinosinusitis groups. There were no significant differences in age distribution, sex ratio, prevalence of asthma, or any other complications between the groups. The mean Lund–Mackay score and the number of serum eosinophils was significantly higher in the eosinophilic chronic rhinosinusitis than in the non-eosinophilic chronic rhinosinusitis groups. The pendrin expression was more frequently detected in the epithelial surface layer of nasal polyps in the eosinophilic chronic rhinosinusitis than in the non-eosinophilic chronic rhinosinusitis groups. In addition, mucin 5AC was more widely expressed in the eosinophilic chronic rhinosinusitis than in the non-eosinophilic chronic rhinosinusitis. ConclusionIncreased expression of pendrin and mucin 5AC in the nasal polyps would be associated with development of eosinophilic chronic rhinosinusitis. This finding could allow the development of a novel therapeutic agent targeted specifically to patients with eosinophilic chronic rhinosinusitis.

Highlights

Chronic rhinosinusitis with nasal polyps is a heterogeneous disease and appropriate diagnostic algorithms in individual cases are necessary for effective medical treatment
CRSwNP could be subdivided into eosinophilic (ECRS) and neutrophilic CRSwNP according to the degree of eosinophilic infiltration into the nasal polyps.[2]
We showed the relationship among pendrin, MUC5AC and eosinophil infiltration in our cases, but pendrin was not detectable in almost half of ECRS polyps

Summary

Introduction

Chronic rhinosinusitis with nasal polyps is a heterogeneous disease and appropriate diagnostic algorithms in individual cases are necessary for effective medical treatment. CRSwNP could be subdivided into eosinophilic (ECRS) and neutrophilic (non-ECRS) CRSwNP according to the degree of eosinophilic infiltration into the nasal polyps.[2] ECRS is characterized by Th2-polarization and marked expression of interleukin (IL)-4, IL-5, and IL-13.3,4 On the other hand, non-ECRS displays CD8+ T-cell inflammation in which neutrophil recruitment is mediated by IL-1␤, IFN-␥, TGF-␤1, IL-8, IL-10, and IL-17. Because both subgroups have much distinct drug responsiveness and prognosis, different medical treatments have been suggested for respective patients. Appropriate diagnostic algorithms in individual cases must be developed for effective medical treatment.[5]

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