Abstract
Sinonasal polyposis (SNP) is a chronic inflammatory pathology with an unclear aetiopathogenesis. Human papillomavirus (HPV) infection is one candidate for the development of SNP for its epithelial cell trophism, hyperproliferative effect, and the induction of immune-modulatory molecules as HLA-G. We enrolled 10 patients with SNP without concomitant allergic diseases (SNP-WoAD), 10 patients with SNP and suffering from allergic diseases (SNP-WAD), and 10 control subjects who underwent rhinoplasty. We analyzed the presence of high- and low-risk HPV DNA and the expression of membrane HLA-G (mHLA-G) and IL-10 receptor (IL-10R) and of soluble HLA-G (sHLA-G) and IL-10 by polyp epithelial cells. The results showed the presence of HPV-11 in 50% of SNP-WoAD patients (OR:5.5), all characterized by a relapsing disease. HPV-11 infection was absent in nonrelapsing SNP-WoAD patients, in SNP-WAD patients and in controls, supporting the hypothesis that HPV-11 increases risk of relapsing disease. HPV-11 positive SNP-WoAD patients presented with mHLA-G and IL-10R on epithelial cells from nasal polyps and showed secretion of sHLA-G and IL-10 in culture supernatants. No HLA-G expression was observed in HPV negative polyps. These data highlight new aspects of polyposis aetiopathogenesis and suggest HPV-11 and HLA-G/IL-10 presence as prognostic markers in the follow-up of SNP-WoAD.
Highlights
Sinonasal polyposis (SNP) is a chronic inflammatory pathology characterized by the formation of nasal polyps at the level of the nasal cavity and paranasal sinuses, resulting from an edematous multifocal degeneration of the mucosa
We previously demonstrated a generalized defect in soluble human leukocyte antigen (HLA)-G (sHLA-G) production by peripheral blood mononuclear cells of SNP patients [23] that seems to be mainly related to the interleukin (IL)-10/HLA-G pathway
We detected the presence of LR-Human papillomavirus (HPV)-11 in 50% (5/10) of samples obtained from patients with SNP-WoAD
Summary
Sinonasal polyposis (SNP) is a chronic inflammatory pathology characterized by the formation of nasal polyps at the level of the nasal cavity and paranasal sinuses, resulting from an edematous multifocal degeneration of the mucosa. These benign lesions affect approximately 1–4% of the general population, with a slight preference towards elderly men [1]. They are most often treated with steroids or surgery, nasal polyps removed by surgery have a 70% chance of recurrence. The mucosal types of HPV fall in two groups: low-risk types (LR-HPV) (mainly HPV-6 and -11), which induce benign cell hyperproliferation, and the high-risk types (HR-HPV), which lead to malignancies as invasive cervical carcinoma, anal cancer, and oropharyngeal carcinomas
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