Inflammatory cell distribution accrediting Th2 inflammation in Sinonasal polyp in Indian Population

Abstract

The pathophysiology of Chronic Rhino-Sinusitis with Nasal Polyposis (CRSwNP) showed distinct ethnic and geographic differences whereas the Western Caucasian population revealed Th2 eosinophilic inflammation in contrary to the Asian Mongolian population with Th1-Th17 non-eosinophilic inflammatory pattern. Prospective Observational study was undertaken from December 2019 to December 2021 on 50 patients who were diagnosed to have sinonasal polyposis. The collected polyp tissue was sent to the histopathological department for further microscopic evaluation. The types of inflammatory cell infiltrate studied in the tissue specimens obtained during surgery included lymphocytes, eosinophils, neutrophils, mast cells, and plasma cells. The age of patients ranged from 11 to 70 years with a mean age of 31.80±17.69 years. The male to female ratio was 1.3:1. The 62% of patients showed the predominance of eosinophil which was of grade III and grade IV category, Lymphocyte infiltrate of grades III and IV was present in 46% of cases, Mast cell was 30% and 10% of grade III and Grade IV respectively, and the Neutrophils were found only in 22% and 105 of cases of grade III & Grade IV, respectively which was the least of all inflammatory cells found in polyp tissue. The cellular predominance was shifted toward the Th2 type of inflammation with the predominance of Eosinophil, Lymphocytes, Plasma cells, and mast cells in the Asian Aryan sub origin population contrary to the Th17 type of inflammation as indicated by the least infiltration of Neutrophils as reported in Asian Mongolian Populations.