Nasal Mucosa Specimens Research Articles

Expression of NMU and NMUR1 in tryptase-positive mast cells and PBLs in allergic rhinitis patients' nasal mucosa.

The neuropeptide U (NMU) has been proven to elicit the release of mediators from mast cells (MCs) through its receptor NMUR1 in allergic inflammatory models. However, little is known about the correlations between NMU and MCs in human allergic rhinitis (AR). The objective of this study is to investigate the expressions of NMU and NMUR1 in the tryptase + MCs and the peripheral blood leukocytes (PBLs) in human nasal mucosa with AR. Specimens of nasal mucosa from patients with AR (n = 10) and control patients without AR (n = 8) were collected and soaked in frozen tissue liquid solution (OCT) in tum. Cryostat sections were prepared for immunofluorescence staining. Tryptase was used as a marker to detect mast cells and other tryptase + immune cells. The expression of NMU and NMUR1 was respectively determined by double staining using a confocal microscope. Neither NMU nor NMUR1 were detected in the tryptase + mast cells in the human nasal mucosa. To our surprise, both NMU and NMUR1 were co-expressed with tryptase in the PBLs within peripheral blood vessels in AR and controls. Our findings showed that NMU could not influence human nasal tryptase + mast cells directly through NMUR1 in AR. The co-expression of both NMU and NMUR1 with tryptase in the PBLs provided new insight into the potential roles of NMU and tryptase in the circulation PBLs, and the infiltrated PBLs may promote nasal allergic inflammation by producing tryptase and NMU.

Changes in percentage of GATA3+ regulatory T cells and their pathogenic roles in allergic rhinitis

To investigate the changes in percentage of GATA3+ regulatory T (Treg) cells in patients with allergic rhinitis (AR) and mouse models. The nasal mucosa specimens were obtained from 6 AR patients and 6 control patients for detection of nasal mucosal inflammation. Peripheral blood mononuclear cells (PBMC) were collected from 12 AP patients and 12 control patients to determine the percentages of Treg cells and GATA3+ Treg cells. In a C57BL/6 mouse model of AR, the AR symptom score, peripheral blood OVA-sIgE level, and nasal mucosal inflammation were assessed, and the spleen of mice was collected for detecting the percentages of Treg cells and GATA3+ Treg cells and the expressions of Th2 cytokines. Compared with the control patients, AR patients showed significantly increased eosinophil infiltration and goblet cell proliferation in the nasal mucosa (P < 0.01) and decreased percentages of Treg cells and GATA3+ Treg cells (P < 0.05). The mouse models of AR also had more obvious allergic symptoms, significantly increased OVA-sIgE level in peripheral blood, eosinophil infiltration and goblet cell hyperplasia (P < 0.01), markedly lowered percentages of Treg cells and GATA3+ Treg cells in the spleen (P < 0.01), and increased expressions of IL-4, IL-6 and IL-10 (P < 0.05). The percentage of GATA3+ Treg cells is decreased in AR patients and mouse models. GATA3+ Treg cells possibly participate in Th2 cell immune response, both of which are involved in the occurrence and progression of AR, suggesting the potential of GATA3+ Treg cells as a new therapeutic target for AR.

Drug delivery to the brain: In situ gelling formulation enhances carbamazepine diffusion through nasal mucosa models with mucin

The objective of this work was to optimize a thermosensitive in situ gelling formulation to improve intranasal and nose-to-brain delivery of the antiepileptic drug carbamazepine (CBZ). A preliminary procedure of vehicles obtained just mixing different fractions of poloxamer 407 (P407) and poloxamer 188 (P188) revealed preparations with phase transition temperatures, times to gelation and pH values suitable for nasal delivery. Subsequently, the mucoadhesive properties of the most promising formulations were tuned by adding hydroxypropylmethylcellulose types of different viscosity grades, and the effect of the adhesive polymers was evaluated by testing in vitro time and strength of mucoadhesion on specimens of sheep nasal mucosa. The formulation that showed the greatest mucoadhesive potential in vitro, with a time and force of mucoadhesion equal to 1746,75 s and 3.66 × 10-4 N, respectively, was that composed of 22% P407, 5% P188 and 0.8% HPMC low-viscous and it was further investigated for its ability to increase drug solubility and to control the release of the drug. Lastly, the capability of the candidate vehicle to ensure drug permeation across the biomimetic membrane Permeapad®, an artificial phospholipid-based barrier with a stratified architecture, and the same barrier enriched with a mucin layer was verified. The final formulation was characterized by a pH value of 6.0, underwent gelation at 32.33°C in 37.85 s, thus showing all the features required by in situ gelling thermosensitive preparations designed for nasal delivery and, more notably, it conserved the ability to favor drug permeation in the presence of mucin. These findings suggest that the optimized gelling system could be a promising and easy to realize strategy to improve CBZ delivery to the brain exploiting both a direct and indirect pathway.

Establishment of a patient-derived organoid model and living biobank for nasopharyngeal carcinoma

Background Recurrent nasopharyngeal carcinoma (NPC) remains a major challenge for clinicians and scientists. Tumor organoid is a revelational disease model that highly resembled the heterogeneity and histopathological characteristics of original tumors. This study aimed to optimize the modeling process of patient-derived NPC organoids (NPCOs), and establish a living-biobank of NPCs to study the mechanism and explore the more effective treatment of the disease.MethodsSixty-two fresh NPC tissue samples and 15 normal mucosa samples were collected for 3-dimensional (3D) organoid culture. The organoids were confirmed using hematoxylin and eosin assays. The expression levels of CD133, CD44, BMI-1, and Epstein-Barr virus (EBV)-encoded small RNAs (EBERs) were detected by immunohistochemistry (IHC) and in situ hybridization (ISH). Recurrent NPCOs were frozen in liquid nitrogen for 6 months and then resuscitated and passaged.ResultsWe identified a novel two-step enzymatic strategy for the treatment of NPC and nasal mucosa specimens and an optimal medium for culturing NPCOs and nasal mucosa organoids (NMOs). Organoid cultures were generated from 34 primary NPC samples, 28 recurrent NPC samples, and 15 normal mucosa samples. The success rates for primary NPCO, recurrent NPCO, and NMO formation were 47.06%, 81.25%, and 86.5%, respectively. All the NPCOs were EBER positive and CK7 negative. Recurrent NPCOs had higher expressions of stem cell markers, including BMI-1, CD44, and CD133. Additionally, recurrent NPCOs could be cultured to passage 4 and frozen and revived repeatedly, while primary NPCOs were challenging to culture.Conclusions In summary, we successfully established a living biobank using the NPCO model, which has enormous potential in basic and clinical research on NPC.

Transcriptomic and Lipidomic Profiles in Nasal Polyps of Glucocorticoid Responders and Non-Responders: Before and After Treatment.

Background: The pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) and mechanisms underlying different responses to systemic glucocorticoids (GC) remain unclear. The major aim of this study was to explore the transcriptomic and oxidative lipidomic signatures and the effects of GC in patients with different clinical responses. Methods: Nasal polyp biopsies were obtained before and after 14-day oral GC treatment from 16 patients with CRSwNP, and normal nasal mucosa specimens were collected from 12 control subjects. RNA sequencing and oxidative lipidomics were performed, and differential gene expression analysis was conducted in the Responder and Non-responder groups at baseline and after treatment. Results: In the Responder group, GC significantly improved clinical symptoms and reduced tissue eosinophil infiltration. Meanwhile, GC led to a pronounced transcriptomic reversion with robust suppression of inflammatory responses and abnormal metabolism of extracellular matrix, as well as restoration of cilia function. However, non-responders were mainly characterized by epithelial hyperplasia and keratinization, with much less transcriptomic improvement after GC treatment. Higher expression of type 2 inflammatory molecules (CCL13, IGHE, CCL18, CCL23, CCR3, and CLC) with lower levels of LACRT, PPDPFL, DES, C6, MUC5B, and SCGB3A1 were related to a stronger clinical response to GC. Besides decreased prostaglandins and increased leukotrienes, increased dysregulation in other oxylipid mediators derived from polyunsaturated fatty acids was determined in nasal polyps, which was ameliorated by GC treatment. Conclusion: Systemic GC exert anti-inflammatory effects, improve tissue remodeling, restore cilia function, and ameliorate dysregulation of oxylipid mediator pathway in CRSwNP. GC-responders exhibited different transcriptomic signatures from non-responders.

Detection of persistent SARS-CoV-2 IgG antibodies in oral mucosal fluid and upper respiratory tract specimens following COVID-19 mRNA vaccination

COVID-19 mRNA vaccines are highly effective at preventing COVID-19. Prior studies have found detectable SARS-CoV-2 IgG antibodies in oral mucosal specimens of participants with history of COVID-19. To assess the development of oral SARS-CoV-2 IgG antibodies among people who received either the Moderna or Pfizer/BioNTech COVID-19 vaccination series, we developed a novel SARS-CoV-2 IgG enzyme-linked immunosorbent assay (ELISA) to quantify the concentrations of oral and nasal mucosal SARS-CoV-2 IgG levels. We enrolled 52 participants who received the Moderna vaccine and 80 participants who received the Pfizer/BioNTech vaccine. Oral mucosal specimens were self-collected by participants prior to or on the day of vaccination, and on days 5, 10, 15, and 20 following each vaccination dose and 30, 60, and 90 days following the second vaccination dose. A subset of the cohort provided additional nasal mucosal specimens at every time point. All participants developed detectable oral mucosal SARS-CoV-2 IgG antibodies by 15 days after the first vaccination dose. There were no significant differences in oral mucosal antibody concentrations once participants were fully vaccinated in the Moderna and Pfizer/BioNTech vaccines. Oral or nasal mucosal antibody testing could be an inexpensive and less invasive alternative to serum antibody testing. Further research is needed to understand the duration of detectable oral or nasal mucosal antibodies and how antibody concentrations change with time.

Comparative analysis of ACE2 protein expression in rodent, non-human primate, and human respiratory tract at baseline and after injury: A conundrum for COVID-19 pathogenesis.

Angiotensin converting enzyme 2 (ACE2) is the putative functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Current literature on the abundance and distribution of ACE2 protein in the human respiratory tract is controversial. We examined the effect of age and lung injury on ACE2 protein expression in rodent and non-human primate (NHP) models. We also examined ACE2 expression in human tissues with and without coronavirus disease 19 (COVID-19). ACE2 expression was detected at very low levels in preterm, but was absent in full-term and adult NHP lung homogenates. This pattern of ACE2 expression contrasted with that of transmembrane protease serine type 2 (TMPRSS2), which was significantly increased in full-term newborn and adult NHP lungs compared to preterm NHP lungs. ACE2 expression was not detected in NHP lungs with cigarette smoke-induced airway disease or bronchopulmonary dysplasia. Murine lungs lacked basal ACE2 immunoreactivity, but responded to hyperoxia, bacterial infection, and allergen exposure with new ACE2 expression in bronchial epithelial cells. In human specimens, robust ACE2 immunoreactivity was detected in ciliated epithelial cells in paranasal sinus specimens, while ACE2 expression was detected only in rare type 2 alveolar epithelial cells in control lungs. In autopsy specimens from patients with COVID-19 pneumonia, ACE2 was detected in rare ciliated epithelial and endothelial cells in the trachea, but not in the lung. There was robust expression of ACE2 expression in F344/N rat nasal mucosa and lung specimens, which authentically recapitulated the ACE2 expression pattern in human paranasal sinus specimens. Thus, ACE2 protein expression demonstrates a significant gradient between upper and lower respiratory tract in humans and is scarce in the lung. This pattern of ACE2 expression supports the notion of sinonasal epithelium being the main entry site for SARS-CoV-2 but raises further questions on the pathogenesis and cellular targets of SARS-CoV-2 in COVID-19 pneumonia.

Expression of Sp100 Protein in Human Papillomavirus-Associated Sinonasal Inverted Papilloma.

Sinonasal inverted papilloma (SNIP) is a benign tumor characterized by an aggressive growth, a tendency to recur, and an association with malignancy. However, the precise etiology of SNIP is still unknown. The objective of this study was to identify the expression pattern of speckled protein 100 (Sp100) in the malignant transformation (MT) of SNIP and its correlation with human papillomavirus (HPV)-16 and HPV-18 infections and other clinical features. This would further help in understanding the possible mechanisms for the development of SNIP. Individual nasal mucosa specimens from 40 patients (25 males and 15 females) and 10 inferior turbinate specimens as controls were included in the present study. The samples were divided into several sections for histopathological examination, HPV DNA detection, and immunohistochemical staining. We observed that as SNIP progressed, the Sp100 protein expression was gradually downregulated, and SP100 localization changed from nucleus to the cytoplasm. Positive rate of HPV infection in the SNIP with MT group was higher than that in the other groups, and Sp100 expression was correlated to HPV infections and SNIP with MT. However, no correlation was observed between Sp100 expression and clinical features, such as age, gender, and smoking. Positive rate of HPV infection is high in the SNIP with MT and has a correlation with Sp100 expression. In addition, the expression of Sp100 is downregulated in SNIP with MT, and Sp100 may play a role in the progression of SNIP.

Influence of fibrosis mediators on the outcomes of endoscopic endonasal dacryocystorhinostomy

Fibrosis is the most important pathologic condition involved in undesirable outcomes of dacryocystorhinostomy. A number of biochemical factors are currently known to have an effect on wound healing by promoting excessive scarring. Isoforms of transforming growth factor β (TGF-β1) are considered the 'main' pro-fibrotic factor, but wound healing is also affected by other cytokines such as connective tissue growth factor (CTGF), which stimulates fibrosis, and fibroblast growth factor (FGF-2), which acts as antagonist to it. To investigate correlations between endoscopic endonasal dacryocystorhinostomy outcomes and certain mediators of fibrosis. The study included 45 cases of endoscopic endonasal dacryocystorhinostomy. The patients were grouped according to surgery outcome: patients with unsuccessful surgical treatment were assigned to group 1 (n=10); patients with successful surgical treatment - to group 2 (n=34). One patient was excluded from the study. Full-layer biopsy specimen were taken from patients' nasal mucosa before the surgery. TGF-β1, TGF-β2, TGF-β3, CTGF, FGF-2 concentrations were evaluated using ELISA and normalized by total protein concentration. Surgical failure was observed in 10 cases (22.72%). CTGF concentration was significantly correlated with negative outcome (p<0.05) and was elevated in most specimen obtained from group 1. No significant correlation was noted between the concentrations of other evaluated cytokines in nasal mucosa specimens and the surgical outcome. The study found a correlation between CTGF concentration in nasal mucosa and dacryocystorhinostomy outcome, which supports the hypothesis suggested by several authors linking dacryocystorhinostomy failure with chronic inflammation in nasal mucosa.

TGFβ mediates collagen production in human CRSsNP nasal mucosa-derived fibroblasts through Smad2/3-dependent pathway and CTGF induction and secretion.

Chronic rhinosinusitis without nasal polyp (CRSsNP) is characterized by tissue remodeling and fibrosis. Transforming growth factor-β (TGF-β) is considered a master switch in the induction of the profibrotic program which can induce fibroblasts to synthesize and contract extracellular matrix (ECM) proteins. A previous study has shown TGF-β1 signaling and collagen overproduction in the CRSsNP, but the responsible cells and mechanism of action remain unclear. Therefore, this study was aimed to investigate the relationship between TGF-β1 stimulation and collagen expression and to explore the role of connective tissue growth factor (CTGF) during the remodeling process using human CRSsNP nasal mucosa tissues and mucosa-derived fibroblasts as main materials. We found that TGF-β1 and its isoforms could promote collagen protein expression. Concomitantly, TGF-β1 caused CTGF expression and secretion. An addition of exogenous CTGF to fibroblasts also caused collagen expression. In accordance with these observations, TGF-β1, CTGF, and collagen were highly expressed in the subepithelial stroma region of CRSsNP nasal mucosa, as determined by immunohistochemistry. The TGF-β1-mediated collagen expression could be blocked by actinomycin D and SIS3, suggesting that the induction was through transcriptional regulation and Smad2/3-dependent pathway. Finally, we demonstrated that CTGF small interfering RNA knockdown led to a substantial decrease in TGF-β1-mediated collagen expression. Collectively, our results provide first and further evidence that TGF-β1 mediates collagen expression-production through a canonical Smad2/3-dependent pathway and CTGF induction and secretion in human nasal fibroblasts. Moreover, TGF-β1, CTGF, and collagen are highly expressed in human CRSsNP nasal mucosa specimens, suggesting their roles in tissue remodeling during CRSsNP progression.

Investigation on the expression of microvessel pericyte coverage index and lymph vessel density in nasal polyps

Objective: To investigate the role of lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) in the pathogenesis of nasal polyps. Methods: Using immunohistochemistry and immunofluorescence double staining method, the expressions of albumin, D2-40 and CD34-α-SMA in 11 specimens of normal nasal mucosa, 26 specimens of nasal polyp and 26 specimens of inferior turbinate tissue from patients with nasal polyps were investigated. The counts of microvessel density (MVD), lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) were compared. SPSS 17.0 software was used to analyze the data. Results: The nasal polyp group(0.269±0.096) had more albumin than inferior turbinate tissue group(0.159±0.078) and normal nasal mucosa group(0.138±0.045), the differences were significant (q value was 4.873, 4.446, both P<0.05). The counts of MVD in nasal polyp group (30.52±4.42) were not significantly higher than those in inferior turbinate tissue group (30.33±6.03) and normal nasal mucosa group(28.21±6.84), the differences were not significant (q value was 0.130, 1.147, both P>0.05). The MPI in nasal polyp group (0.291±0.096) was significantly lower than those in inferior turbinate tissue group(0.432±0.101) and normal nasal mucosa group(0.416±0.071), the difference was significant (q value was 5.399, 3.680, both P<0.05). The counts of LVD in the nasal polyp group(0.245±0.073) were significantly lower than those in inferior turbinate tissue group (0.431±0.054) and normal nasal mucosa group(0.470±0.078), the difference was significant (q value was 10.004, 9.328, both P<0.05). MPI expression in the nasal polyp group was negetively correlated to albumin expression(r=-0.889, P<0.05). The LVD expression in the nasal polyp group was negetively correlated to albumin expression(r=-0.901, P<0.05). Conclusion: Different LVD and MIP in nasal polyp tissues and normal nasal mucosa tissues imply that microcirculatory dysfunction plays a crucial role in the pathogenesis of nasal polyps.

Increased number of IgG4-positive plasma cells in chronic rhinosinusitis

Conclusion: High levels of IgG4-positive plasma cells were observed in tissue samples from ∼30% of patients with chronic rhinosinusitis who satisfied the comprehensive diagnostic criteria for IgG4-related disease. Detection of increased numbers of IgG4-positive plasma cells in the nasal cavity or paranasal sinuses might not be sufficient to make a diagnosis of IgG4-related rhinosinusitis, and a comprehensive evaluation is required.Objectives: This study aimed to clarify the clinicopathological characteristics of IgG4-positive plasma cells in patients with chronic rhinosinusitis.Method: This study examined nasal mucosal specimens from 35 patients and assigned them to high-IgG4 and low-IgG4 groups based on infiltration of IgG4-positive plasma cells. It compared the pathological characteristics of the two groups, including the presence of fibrosis, phlebitis, hyperplasia of the nasal glands and infiltration of inflammatory cells.Results: No cases of chronic rhinosinusitis showed storiform fibrosis or obliterative phlebitis. The mean number of IgG4-positive plasma cells in samples from all patients was 29.8 ± 40.3/high-power field. Eleven of the 35 cases (31.4%) were classified as high-IgG4. Hyperplasia of the nasal glands was observed significantly more frequently in the high-IgG4 group than in the low-IgG4 group (p = .03).

The expression of cancerous inhibitor protein phosphatase 2A in chronic rhinosinusitis with nasal polyps

Conclusion: The study suggests that cancerous inhibitor of protein phosphatase 2A (CIP2A) expression and eosinophilia associate with chronic rhinosinusitis with nasal polyps with aspirin exacerbated respiratory disease (CRSwNP + AERD). Further studies with a larger sample size are needed to evaluate further the role of CIP2A and related pathways in CRSwNP + AERD.Objectives: Low prostaglandin E2 levels putatively associate with CRSwNP + AERD and decreased c-Myc levels. The aim of this study was to evaluate the expression and revision-predictive role of oncoprotein CIP2A, another c-Myc modulator, in CRSwNP with/without AERD, and in antrochoanal polyps.Method: Ninety retrospective archival objective glasses of nasal polyp tissue from CRSwNP or ACP patients were used for assessing mucosal eosinophilia. Of this population, 90 archival nasal polyp specimens were available for immunohistochemical staining with a polyclonal anti-CIP2A antibody, together with 19 control nasal mucosa specimens. CIP2A staining intensity and tissue eosinophilia were assessed by two blinded observers with a light microscope. Subject characteristics from 90 patients and 19 controls were obtained from patient records and additionally by a questionnaire from controls. The follow-up data was available from patient records of 84 patients and 16 controls.Results: The expression of epithelial CIP2A was detected both in control inferior turbinate mucosa and nasal polyps. The expression was significantly lower in the CRSwNP + AERD group compared to controls and CRSwNP without AERD (p < 0.01). High mucosal eosinophilia associated with CRSwNP (p < 0.01). Neither CIP2A nor eosinophilia predicted the need for revision surgery (p > 0.05), whereas previous surgery, allergic rhinitis, and use of corticosteroids did predict the need for revision surgery (p < 0.05).

Cytologic and functional alterations of nasal mucosa in smokers: temporary or permanent damage?

Tobacco smoke is a significant risk factor for respiratory diseases. The purpose of this study is to analyze the cytologic and functional features of nasal mucosa in smokers, nonsmokers, and ex-smokers to evaluate if nasal alterations in smokers are permanent or reversible conditions after smoking cessation. Case series with planned data collection. University medical center. Ninety healthy volunteers recruited from the staff of Alfredo Fiorini Hospital, Sapienza University of Rome, were enrolled in this prospective study from October to November 2013. We divided the cases according to smoking habits (smokers, nonsmokers, ex-smokers). Each group was composed of 30 subjects. Cytologic features of nasal mucosa and effectiveness of nasal mucociliary clearance were studied, focusing on 4 parameters: (1) nasal mucociliary clearance, assessed by saccharin nasal transit time; (2) ratio between the number of ciliated cells and goblet cells, analyzed by microscopic observation of cytologic specimens of nasal mucosa that had undergone May Grunwald Giemsa staining; (3) evaluation of ciliary motility; and (4) time of ciliary movement of ciliated cells analyzed by phase-contrast microscopy. All parameters were significantly reduced in the smokers compared to the nonsmokers. There were no statistically significant differences between the nonsmoker and ex-smoker groups. Cigarette smoking causes cytologic modifications of nasal mucosa that influence the effectiveness of mucociliary clearance. Our preliminary study suggests that these changes are not permanent and that nasal mucosa of ex-smokers recovers normal cytologic and functional features.

The prevalence of Epstein-Barr Virus-positive lymphoid cells in nasal mucosa: an extremely rare event.

The prevalence of EBV (Epstein-Barr virus)-positive lymphoid cells is unknown. Because EBV is implicated in the etiology of extranodal NK/T-cell lymphoma, nasal type (nasal ENKL), the presence of EBV-positive lymphoid cells (EPLs) in nasal mucosa specimens is expected. This study evaluated the presence of EBV-positive lymphoid cells in the nasal mucosa of 420 patients who had undergone surgical resection of lesions of the nasal cavity due to nasal septal deviation, chronic paranasal rhinosinusitis, chronic hypertrophic rhinosinusitis, nasal polyps, allergic rhinitis, papillomas, and cysts. Three representative 1.0-mm-diameter core biopsies were taken from one paraffin-embedded donor tissue block per case and subsequently arranged in new recipient paraffin blocks with a trephine. EBV in situ hybridization study was performed to detect EPLs. None of the cases demonstrated EPLs. The presence of EPLs in the nasal mucosa is an extremely rare event in immunocompetent individuals. Therefore, the detection of EPLs in nasal biopsy specimens should prompt the pathologist to perform further testing to exclude the possibility of nasal ENKL.

Role of IL‐5 and IL‐8 in the Pathogenesis of Nasal Polyps

Objectives: (1) Evaluate the histopathological and immunohistochemical characteristics of different types of nasal polyps. (2) Quantify the expression of IL-5 and IL-8 in 2 different histotypes of nasal polyps in order to evaluate the role of these cytokines in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) . Methods: This retrospective study was conducted on 44 specimens collected from nasal cavities of 44 patients with nasal polyposis who underwent functional endoscopic sinus surgery at the ENT University Unit of the A. Fiorini Hospital, Sapienza University of Rome, from January 2009 to January 2011. The specimens were analyzed at the histopathology unit of the university and divided into 2 groups according to their dominant histological features: Group A (polypoid mucosa and eosinophilia, 34 subjects) and Group B (polypoid mucosa associated with glandular hyperplasia, 10 subjects). Expression of IL-5 and IL-8 were analyzed on the specimens using immunohistochemical techniques. The same tests were run on nasal mucosa specimens drawn from 10 patients without sinusitis (control group). Results: IL-5 expression was significantly more expressed in Group A than in Group B ( P &lt; .05). Both IL-5 and IL-8 expressions were significantly more expressed in Groups A and B compared to the control group ( P &lt; .05). No significant difference was found in the expression of IL-8 between the 2 groups. Conclusions: The outcomes of this preliminary study suggest that IL-8 may play a role in the pathogenesis of both histological subtypes of nasal polyps, whereas IL-5 predominates in the eosinophilic subtype.

Nasal carriage rate of Staphylococcus aureus among patients with systemic lupus erythematosus and its correlation with disease relapse

IntroductionSystemic lupus erythematosus (SLE) is an autoimmune disease with unknown origin. The disease causes a broad spectrum of signs and symptoms in a majority of body organs. Due to several factors like damage to mucosal surfaces and defect in complement systems, these patients are at a great risk of infections with opportunistic pathogens. Aim of the workTo evaluate the nasal carriage of Staphylococcus aureus, rate of Methicillin-resistant S. aureus (MRSA) and its correlation with relapse in lupus patients. Patients and methodsIn an analytical-descriptive study, 80 patients (65 female and 15 male) with SLE attending the rheumatology clinics of Tabriz University of medical sciences were selected. Nasal mucosa specimens of the patients were taken and incubated in appropriate culture environment. All of the patients were followed for 1year and the relapse of the disease was evaluated. ResultsThe mean age of the patients was 25.35±5.87years. The mean disease duration was 3.66±2.27years and the mean SLE disease activity index (SLEDAI) was 6.40±2.84. Thirty-nine out of 80 patients (48.75%) were positive for S. aureus in the nasal mucosa. Although no significant difference in SLEDAI was observed between the patients with nasal carriage of S. aureus and those without, the two groups were significantly different in the relapse and complement levels. ConclusionThese results indicate that relapse of SLE in patients having S. aureus in their nasal mucosa is higher than in patients without.

Upregulation of inflammatory genes in the nasal mucosa of patients undergoing endonasal dacryocystorhinostomy.

BackgroundEpiphora is a common complaint of nasolacrimal duct obstruction (NLDO) in adults. The precise pathogenesis of NLDO is still unknown, but inflammatory processes are believed to be predisposing factors. Endoscopic dacryocystorhinostomy (EN-DCR) is an effective surgical technique for treating symptomatic NLDO. The purpose of the procedure is to relieve the patient’s symptoms by creating an opening, ie, a rhinostoma, between the lacrimal sac and the nasal cavity. Although the success rates after EN-DCR are high, the procedure sometimes fails due to onset of a fibrotic process at the rhinostomy site. The aim of this prospective comparative study was to investigate inflammation-related gene expression in the nasal mucosa at the rhinostomy site.MethodsTen participants were consecutively recruited from eligible adult patients who underwent primary powered EN-DCR (five patients) or septoplasty (five controls). Nasal mucosa specimens were taken from the rhinostomy site at the beginning of surgery for analysis of gene expression. Specimens were taken from the same site on the lateral nasal wall for controls. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed for the inflammatory genes interleukin (IL)-6, IL-1β, and CCL2, and because of a clear trend of increased inflammation in the EN-DCR samples, a wider PCR array was performed to compare inflammation-related gene expression in EN-DCR subjects and corresponding controls.ResultsOur qRT-PCR results revealed a clear trend of increased transcription of IL-6, IL-1β, and CCL2 (P=0.03). The same trend was also evident in the PCR array, which additionally revealed notable differences between EN-DCR subjects and controls with regard to expression of several other inflammation-related mediators. At 6-month follow-up, the success rate after primary EN-DCR was 60%, ie, in three of five patients.ConclusionThe present study demonstrates that there is an intense inflammation gene expression response in the nasal mucosa of patients undergoing EN-DCR.

The prevalence of Epstein-Barr Virus-positive lymphoid cells in nasal mucosa: an extremely rare event

The prevalence of EBV (Epstein-Barr virus)-positive lymphoid cells is unknown. Because EBV is implicated in the etiology of extranodal NK/T-cell lymphoma, nasal type (nasal ENKL), the presence of EBV-positive lymphoid cells (EPLs) in nasal mucosa specimens is expected. This study evaluated the presence of EBV-positive lymphoid cells in the nasal mucosa of 420 patients who had undergone surgical resection of lesions of the nasal cavity due to nasal septal deviation, chronic paranasal rhinosinusitis, chronic hypertrophic rhinosinusitis, nasal polyps, allergic rhinitis, papillomas, and cysts. Three representative 1.0-mm-diameter core biopsies were taken from one paraffin-embedded donor tissue block per case and subsequently arranged in new recipient paraffin blocks with a trephine. EBV in situ hybridization study was performed to detect EPLs. None of the cases demonstrated EPLs. The presence of EPLs in the nasal mucosa is an extremely rare event in immunocompetent individuals. Therefore, the detection of EPLs in nasal biopsy specimens should prompt the pathologist to perform further testing to exclude the possibility of nasal ENKL.

Effects of topical nasal steroids and diclofenac on the nasal mucosa during hyperbaric oxygen therapy: a double-blind experimental study

We aimed to evaluate nasal mucosal changes and efficiency of nasal steroids and diclofenac on nasal mucosa during hyperbaric oxygen (HBO) treatment. Forty adult Albino-Wistar rats were randomized into four groups. Group 1 (control group) (n = 10) not exposed to hyperbaric or enhanced oxygen concentrations; group 2 (HBO group) (n = 10) underwent only HBO treatment; group 3 (n = 10) received HBO and intranasal mometasone furoate (10 μl/day); group 4 (n = 10) treated with HBO and diclofenac sodium (10 mg/kg/day ip). Specimens of nasal mucosa were collected after sacrificing and dissection of animals. The specimens were processed for light microscopic evaluation, and then evaluated histopathologically for fibroblastic proliferation and inflammation. Regarding the scores of inflammation, the level of inflammation in the control group was significantly less severe than the other groups (p < 0.05). Evaluation of the fibrosis scores showed that the scores of both groups 2 and 4 were significantly increased (p < 0.05). There were no statistically significant differences between groups 2, 3, and 4 as for fibrosis and inflammation (p > 0.05). Chronic HBO treatment induced mild inflammation of the nasal mucosa. These effects cannot be prevented adequately by administration of nasal steroids and diclofenac.