Nasal Polyps Group Research Articles

Comparison of Proliferating Cell Nuclear Antigen (PCNA) Expression among Nasal Polyp and Chronic Rhinosinusitis

Background and objectiveChronic rhinosinusitis is a common inflammatory disorder in sinonasal mucosa that could be developed with or without nasal polyps. Cellular proliferation is suggested as a possible mechanism of nasal polyp development. However, conducted studies in this context are limited. So, the present study's aim is the comparison of proliferating cell nuclear antigen (PCNA) expression in nasal polyps and chronic rhinosinusitis. Materials and methodsIn this cross-sectional study, 70 nasal polyp and 60 chronic rhinosinusitis samples from patients referred to Mostafa Khomeini Hospital, Tehran from 2017 to 2022 were immunohistochemically stained by PCNA marker. The percentage of PCNA nuclear expression was determined in two groups and its association with the type of pathological lesion and the patient's age and sex was analyzed by SPSS statistic software version 24 statistical software (IBM Statistics, USA). ResultsThe mean percentage expression of PCNA in nasal polyp and chronic rhinosinusitis samples was 16.55 ± 13.66 and 17.58 ± 12.68 respectively (ranging from 0 to 57 in both groups) however, there was no significant statistical difference between the two groups (p = 0.479). No relationship was found between PCNA expression with age and sex in none of the chronic rhinosinusitis and nasal polyp groups. ConclusionProliferative activity of the nasal epithelial cell is similar in chronic rhinosinusitis with and without nasal polyps and it is considered that the increase of epithelial cell proliferative activity probably has no role in nasal polyp development in patients with chronic rhinosinusitis.

Comparison of Proliferating Cell Nuclear Antigen (PCNA) Expression among Nasal Polyp and Chronic Rhinosinusitis

Background and objectiveChronic rhinosinusitis is a common inflammatory disorder in sinonasal mucosa that could be developed with or without nasal polyps. Cellular proliferation is suggested as a possible mechanism of nasal polyp development. However, conducted studies in this context are limited. So, the present study's aim is the comparison of proliferating cell nuclear antigen (PCNA) expression in nasal polyps and chronic rhinosinusitis. Materials and methodsIn this cross-sectional study, 70 nasal polyp and 60 chronic rhinosinusitis samples from patients referred to Mostafa Khomeini Hospital, Tehran from 2017 to 2022 were immunohistochemically stained by PCNA marker. The percentage of PCNA nuclear expression was determined in two groups and its association with the type of pathological lesion and the patient's age and sex was analyzed by SPSS statistic software version 24 statistical software (IBM Statistics, USA). ResultsThe mean percentage expression of PCNA in nasal polyp and chronic rhinosinusitis samples was 16.55 ± 13.66 and 17.58 ± 12.68 respectively (ranging from 0 to 57 in both groups) however, there was no significant statistical difference between the two groups (p = 0.479). No relationship was found between PCNA expression with age and sex in none of the chronic rhinosinusitis and nasal polyp groups. ConclusionProliferative activity of the nasal epithelial cell is similar in chronic rhinosinusitis with and without nasal polyps and it is considered that the increase of epithelial cell proliferative activity probably has no role in nasal polyp development in patients with chronic rhinosinusitis.

E3 ubiquitin ligase NEDD4L inhibits epithelial-mesenchymal transition by suppressing the β-catenin/HIF-1α positive feedback loop in chronic rhinosinusitis with nasal polyps.

Chronic rhinosinusitis with nasal polyp (CRSwNP) is a refractory inflammatory disease with epithelial-mesenchymal transition (EMT) as one of the key features. Since ubiquitin modification has been shown to regulate the EMT process in other diseases, targeting ubiquitin ligases may be a potential strategy for the treatment of CRSwNP. In this study we investigated whether certain E3 ubiquitin ligases could regulate the EMT process in CRSwNP, and whether these regulations could be the potential drug targets as well as the underlying mechanisms. After screening the potential drug target by bioinformatic analyses, the expression levels of three potential E3 ubiquitin ligases were compared among the control, eosinophilic nasal polyp (ENP) and non-eosinophilic nasal polyp (NENP) group in clinical samples, and the significant decrement of the expression level of NEDD4L was found. Then, IP-MS, bioinformatics and immunohistochemistry studies suggested that low NEDD4L expression may be associated with the EMT process. In human nasal epithelial cells (hNECs) and human nasal epithelial cell line RPMI 2650, knockdown of NEDD4L promoted EMT, while upregulating NEDD4L reversed this effect, suggesting that NEDD4L inhibited EMT in nasal epithelial cells. IP-MS and Co-IP studies revealed that NEDD4L mediated the degradation of DDR1. We demonstrated that NEDD4Linhibitedthe β-catenin/HIF-1α positive feedback loop either directly(degrading β-catenin and HIF-1α) or indirectly (mediatingDDR1 degradation).These results were confirmed in a murine NP model in vivo. This study for the first time reveals the regulatory role of ubiquitin in the EMT process of nasal epithelial cells, and identifies a novel drug target NEDD4L, which has promising efficacy against both ENP and NENP by suppressing β-catenin/HIF-1α positive feedback loop.

Bacteriology of Different Phenotypes of Chronic Rhinosinusitis.

Chronic rhinosinusitis (CRS) reduces the health-related quality of life and subsequently causes a tremendous socio-economic impact. Although many studies have been conducted, few have identified a relationship between bacteriological characteristics and different phenotypes or endotypes. Therefore, this study aimed to elucidate the recent trends in bacterial cultures from different types of CRS in the Asian population. This retrospective case-control study recruited patients diagnosed with CRS who underwent functional endoscopic sinus surgery (FESS) at a tertiary hospital in Taiwan. The patients were classified into those with chronic rhinosinusitis with nasal polyps (CRSwNP)/chronic rhinosinusitis without nasal polyps (CRSsNP), eosinophilic chronic rhinosinusitis (eCRS)/non-eosinophilic chronic rhinosinusitis (NECRS), and central compartment atopic disease (CCAD)/lateral-dominant nasal polyp (LDNP) groups. The demographic data and bacteriological characteristics of the groups were analyzed. We included 503 patients, identifying no significant difference between CRSwNP and CRSsNP for several common bacteria in CRS. The number of Staphylococcus epidermidis isolates in culture was significantly higher in the NECRS group (50.46% vs. 32.56%, p = 0.0003) than that in the eCRS group. The number of methicillin-resistant Staphylococcus aureus (MRSA; 8.51% vs. 2.35%, p = 0.0221) positive isolates was significantly higher in the CCAD group than that in the LDNP group. This was the first study in Asia to analyze the relationship between bacteriological characteristics and CCAD. MRSA is significantly higher in the CCAD group than that in the LDNP group. Recognizing the unique microbiology of CRSwNP, eCRS, and CCAD is crucial when selecting antimicrobial therapy to lessen the socio-economic impact. 3 Laryngoscope, 134:1071-1076, 2024.

Association between Helicobacter pylori Infection and Nasal Polyps: A Systematic Review and Meta-Analysis.

Helicobacter pylori (H. pylori) has definite or possible associations with multiple local and distant manifestations. H. pylori has been isolated from multiple sites throughout the body, including the nose. Clinical non-randomized studies with H. pylori report discrepant data regarding the association between H. pylori infection and nasal polyps. The aim of this first systematic review and meta-analysis was the assessment of the strength of the association between H. pylori infection and incidence of nasal polyps. We performed an electronic search in the three major medical databases, namely PubMed, EMBASE and Cochrane, to extract and analyze data as per PRISMA guidelines. Out of 57 articles, 12 studies were graded as good quality for analysis. Male-to-female ratio was 2:1, and age ranged between 17-78 years. The cumulative pooled rate of H. pylori infection in the nasal polyp group was 32.3% (controls 17.8%). The comparison between the two groups revealed a more significant incidence of H. pylori infection among the nasal polyp group (OR 4.12), though with high heterogeneity I2 = 66%. Subgroup analysis demonstrated that in European studies, the prevalence of H. pylori infection among the nasal polyp group was significantly higher than in controls, yielding null heterogeneity. Subgroup analysis based on immunohistochemistry resulted in null heterogeneity with preserving a statistically significant difference in H. pylori infection prevalence between the groups. The present study revealed a positive association between H. pylori infection and nasal polyps.

Association between Social Determinants of Health and Allergic Fungal Rhinosinusitis: A Systematic Review and Meta-analysis.

Some previous studies have shown an increased prevalence of allergic fungal rhinosinusitis (AFRS) among young, black patients with poor access to health care; however, results have been mixed. The purpose of this study was to investigate the relationship between social determinants of health and AFRS. PubMed, Scopus, CINAHL. A systematic review was performed searching for articles published from date of inception to September 29, 2022. English language articles describing the relationship between social determinants of health (i.e., race, insurance status) and AFRS as compared to chronic rhinosinusitis (CRS) were selected for inclusion. A Meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted. A total of 21 articles with 1605 patients were selected for inclusion. The proportion of black patients among AFRS, chronic rhinosinusitis with nasal polyps (CRSwNP), and chronic rhinosinusitis without nasal polyps (CRSsNP) groups was 58.0% [45.3%-70.1%], 23.8% [14.1%-35.2%], and 13.0% [5.1%-24.0%], respectively. This was significantly higher among the AFRS population compared to both the CRSwNP population (Δ34.2% [28.4%-39.6%], p < .0001) and the CRSsNP population (Δ44.9% [38.4%-50.6%], p < .0001). The proportion of patients who were either uninsured or covered by Medicaid among the AFRS, CRSwNP, and CRSsNP populations was 31.5% [25.4%-38.1%], 8.6% [0.7%-23.8%], and 5.0% [0.3%-14.8%], respectively. This was significantly higher among the AFRS group than the CRSwNP group (Δ22.9% [15.3%-31.1%], p < .0001) and the CRSsNP group (Δ26.5% [19.1%-33.4%], p < .0001). This study confirms that AFRS patients are more likely to be Black and either uninsured or on subsidized insurance than their CRS counterparts.

Peripheric and central smell regions in patients with chronic rhinosinusitis with nasal polyps: An MRI evaluation

Abstract OBJECTIVE. We evaluated the effect of olfactory deficiency caused by sinonasal polyposis using a magnetic resonance imaging (MRI) evaluation. MATERIAL AND METHODS. In this retrospective study, 33 adult patients with bilateral chronic rhinosinusitis with nasal polyps (CRSwNP) (Group 1) and 30 healthy subjects without nasal polyps (Control, Group 2) were included. On coronal T2 weighted SPIR images of the MRI, the olfactory bulb (OB) volume and the olfactory sulcus (OS) depth were measured; the same action was performed on the axial T1 weighted images, for the corpus amygdala and insular gyrus areas. RESULTS. OB volume, insular gyrus and corpus amygdala areas of the CRSwNP group were significantly lower than those in the control group (p&lt;0.05). In the CRSwNP group, there were positive correlations between OB volumes, OS depths, and insular gyrus areas and corpus amygdala areas bilaterally (p&lt;0.05). In females, bilateral insular gyrus areas decreased compared to the males (p&lt;0.05). When polyp duration got longer, the right corpus amygdala area decreased (p&lt;0.05). In older patients with a CRSwNP, the left corpus amygdala area decreased (p&lt;0.05). CONCLUSION. OB volume was found to be smaller in the CRSwNP group. We think that the OB volume has decreased primarily due to decreased transfer of odor particles (sensory input) related to nasal obstruction and inflammation in the presence of nasal polyps. After OB volume shrinkage, the insular gyrus and corpus amygdala areas shrink due to the decreased data transfer to the central odor system. In patients with nasal polyps, olfactory functions may improve after endoscopic sinus surgery.

Expression Levels of Glutathione S-Transferase and Cytochrome P450 Isoenzymes in Nasal Polyp Tissue.

Nasal polyps are benign sinonasal masses composed of eosinophils and extracellular edema. Pathogenesis of the polyp formation is unclear but several studies strongly suggest a correlation with infection, inflammation and allergy conditions. Our aim is to investigate the potential link between allergy and nasal polyp in tissue level. Nasal polyp group included 60 patients whose diagnosis was confirmed with biopsy and the control group included 38 healthy patients. Tissue sample of the control group was taken from inferior turbinate mucosa under local anesthesia and nasal polyp tissue was collected from functional endoscopic sinus surgery. The glutathione S-transferase (GST) and cytochrome P450 (CYP) isoenzyme expressions of the tissue samples were investigated under light microscopy and graded by a senior pathologist. GSTP1 protein expression was significantly higher in tissue samples from nasal polyp group compared to that of control group (p < 0.05). However, CYP1A1, GSTM1 and GSTA1 isoenzymes were not different between the two groups (p > 0.05). We have found that GSTP1 isoenzyme was elevated in nasal polyp tissue compared to the control. The increase in protein expression of GSTP1 might have occured as a tissue response to the increased oxidative stress thus suggesting a role of GSTP1 in polyp formation.

The Effect of Bevacizumab and Propranolol on Nasal Polyposis.

Objective This study aims to evaluate the effects of bevacizumab and propranolol from the point of view of a possible antiangiogenic effect in a model of primary nasal polyp (NP) tissue culture. Methods NP samples of 21 patients and normal healthy nasal mucosa samples of 7 patients were cultured. Samples were divided into four groups as follows (healthy nasal mucosa, NP without any treatment, NP treated with propranolol, NP treated with bevacizumab). Cultured tissues were formalin fixed and paraffin embedded. Tissue sections and immunohistochemical VEGF-A, angiopoietin-1 (Ang-1), and angiopoietin-2 (Ang-2) expressions were evaluated. ELISA was also performed for each one of them. Results Both propranolol and bevacizumab significantly decreased the expressions of VEGF-A and Ang-1, and they significantly increased the expression of Ang-2 in comparison to the control NP group. In the healthy nasal mucosa group, no significant expression of VEGF-A was seen, a slight (+) Ang-1 expression, and a high (+++) Ang-2 expression were observed. Conclusion Bevacizumab and propranolol exert an antiangiogenic effect on NP tissues, mainly by decreasing VEGF-A and Ang-1 expression, increasing Ang-2 expression.

Alterations in innate immune responses of patients with chronic rhinosinusitis related to cystic fibrosis.

The role of phagocytes of children with cystic fibrosis (CF) associated with different phenotypes of chronic rhinosinusitis (CRS) is unclear. The aim of this study was to evaluate the phagocytic capacity of blood neutrophils and monocytes and production of superoxide anion by phagocytes in patients with CF with or without chronic rhinosinusitis and with or without nasal polyps (NP). This cross-sectional study was established in 2015-2017 in a tertiary reference center to the CF treatment, Brasilia, Brazil. Sample included 30 children volunteers with CRS related to CF (n = 16) and control subjects (n = 14). Epidemiological and clinical data were compared. Collection of 15 mL of peripheral blood and nasal endoscopy to identify the presence or absence of nasal polyps (NP) were performed. Phagocytosis of Saccharomyces cerevisiae by pathogen-associated molecular pattern receptors and opsonin receptors was assessed. Superoxide anion production was evaluated. The control group showed a higher phagocytic index to monocytes and neutrophils than to the CF or CF+CRS with NP groups [Kruskal-Wallis p = 0.0025] when phagocytosis were evaluated by pathogen-associated molecular pattern receptors (5 yeasts/cell). The phagocytic index of the CF+CRS without NP group was higher than in the CF+CRS with NP group (Kruskal-Wallis p = 0.0168). In the control group, the percentage of phagocytes involved in phagocytosis and superoxide anion production (74.0 ± 9.6%) were higher in all CF groups (p < 0,0001). The innate immune response, represented by phagocytic activity and superoxide anion production by monocytes and neutrophils was more impaired in patients with CF related or not related to CRS than in the control group. However, the phagocytic function of patients without NP showed less impairment.

Analysis of serum Vitamin C expression level and its correlation with immune function in adult patients with chronic sinusitis

Objective:To investigate the expression of Vitamin C in adult patients with chronic rhinosinusitis（CRS） and its correlation with immune function. Methods:A total of 315 patients who underwent nasal endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery and undergoing nasal endoscopic surgery were collected from Renmin Hospital of Wuhan University from May 2018 to June 2020, including 207 CRS patients, who were divided into CRS without nasal polyps（CRSsNP） group（110 cases） and CRS with nasal polyps（CRSwNP） group（97 cases）; 108 patients with nasal septum correction were selected as the control group. All patients underwent serum Vitamin A, C, D, and E tests. Among them, 107 patients（39 in the control group, 35 in the CRSsNP group, and 33 in the CRSwNP group） were treated with serum IL-2, TNF-α, IFN-γ, IL-4, IL-5, IL-6, IL-10, etc. Detection of cytokines and immune protein levels such as IgA, IgM, IgG, C3, and C4. Results:The serum levels of Vitamin C and IL-10 in the CRSwNP group were significantly lower than those in the control group（P<0.05）, and the serum C4 level was significantly higher（P<0.05）; the serum Vitamin C level decreased with the level of IL-10, the decline is positively correlated, while negatively correlated with C4 levels; CRSsNP patients also had lower Vitamin C levels and higher C3 and C4 levels. Conclusion:The Vitamin C level in adult patients with CRS is lower than that in the normal population, and the level of C4 is higher; the level of IL-10 in patients with CRSwNP is lower; Vitamin C affects the immune balance and antioxidant level of patients, and in the pathogenesis of CRS and nasal polyps play a certain role.

A comparison of central compartment atopic disease and lateral dominant nasal polyps.

The characteristics and surgical outcomes of central compartment atopic disease (CCAD) vary by region and race. Therefore, we aimed to identify the risk factors, symptom severity, and prognosis of CCAD in the Asian population. This case-control study recruited patients diagnosed with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery (FESS) at a tertiary hospital in Taiwan. Patients were classified into CCAD and lateral-dominant nasal polyp (LDNP) groups based on endoscopic and computed tomography imaging findings. The demographic data, symptom severity scores, and surgical outcomes of the 2 groups were analyzed. Our study included 442 patients (CCAD group: n = 51; LDNP group: n = 391). We found that CCAD was strongly related to both asthma (9.8% vs 3.5%, p = 0.04) and allergic rhinitis symptoms (43.3% vs 26.6%, p = 0.01). Higher eosinophil counts were detected in blood serum (5.8% vs 2.8%, p < 0.01) and histopathologic profiles (57.0 vs 17.3, p < 0.01) among patients with CCAD. Improvements in 22-item Sino-Nasal Outcome Test (SNOT-22) score and mucociliary clearance time (MCT) after surgical intervention revealed that the CCAD group had a better response to FESS (SNOT-22 score: -31.82 vs -22.66, p < 0.01; MCT: -233.06 vs -191.93 seconds, p = 0.03). The revision FESS rate was not different between the 2 groups. Polyps originating from the central compartment were found to be related to asthma and allergic rhinitis in Taiwanese patients. A higher eosinophil count was suggested in both serum and local nasal tissue from patients with CCAD. FESS serves as an effective treatment for symptom relief in patients with CCAD.

The Evaluation of The Relation Between Nasal Polyp Etiopathogenesis and the Amount of Biofilm

Objective: To evaluate the effect of biofilm layer on polyp formation in nasal polyposis by comparing the amount of biofilm layer on polyp tissue and the normal mucosa. Material and Methods: This study is a prospective study. 14 patients who underwent functional endoscopic sinus surgery (FESS) for nasal polyposis were evaluated. Patients were had no history of previous FESS. Tissue samples were obtained from lower turbinate (Group 1 n:14) and from nasal polyp (Group 2, n:14) of the same nasal cavity. Biofilm presence was identified using scanning electron microscopic (SEM) morphological findings. In biofilm positive samples, the presence of biofilm in less than 25% of the surface area was classified as (+), between 25-50% as (++) , and over 50% as (+++). Results: In Group 2, with SEM imaging, (+++) biofilm presence was detected in 9 patients and (++) biofilm was detected in 5 patients. In Group 1, no biofilm was detected 8 patients, while; (+++), (++), and (+) biofilm presence was detected in 1, 2, and 3 patients respectively. Significant difference was found between group 1 and group 2 with respect to the amount of biofilm according to SEM (p =0.000). Conclusion: In samples, statistically significant difference was found between polyp tissue and normal mucosa in terms of the amount of biofilm. However, further studies with larger patient series are required in order to reach a definitive conclusion on the effect of biofilm on pathogenesis of polyp.

IL-1β Expression of Patients with Chronic Rhinosinusitis is negatively correlated with Lund-Mackay score

Introduction: IL-1β is one of the proinflammatory cytokines which is commonly found in various diseases, including Chronic Rhinosinusitis (CRS). It has been widely targeted as a therapeutic approach for inflammatory diseases. However, study of IL-1β expression and its correlation with CT-Scan grading scores in CRS is still scarce. Objective: To investigate IL-1β expression based on immunohistochemical examination and analyse its correlation with Lund-Mackay score in CRS with and without polyps. Method: This analytic observational study was done on 50 patients: 25 subjects in the CRS with Nasal Polyps (CRSwNP) group and 25 subjects in the CRS without Nasal Polyps (CRSsNP) group. The uncinate process was taken for immunohistochemical examination of IL-1β. Lund-Mackay score was calculated based on CT-Scan of the paranasal sinus. Result: IL-1β expression in CRSsNP (mean=36.38) was significantly higher than that in the CRSwNP (mean=14.62) with p&lt;0.001. Lund-Mackay score in CRSwNP was higher (mean=35.22) compared to CRSnNP group (mean=15.78) with p&lt;0.001. There was a moderate negative correlation (-0.403) between IL-1β expression and Lund-Mackay score (p&lt;0.05). Conclusion: There was a moderate negative correlation between IL-1β expression and Lund-Mackay score. The IL-1β and the Lund-Mackay score in CRSwNP were lower and higher, respectively, than in CRSsNP

Is there a relationship between Lund-Mackay scale, olfactory bulb depth and width, and Keros classification in patients with nasal polyps?

Abstract OBJECTIVE. We investigated the relationship between Lund-Mackay scale, olfactory bulb depth and width, and Keros classification in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). MATERIAL AND METHODS. In this retrospective study, paranasal sinus computed tomography (PNSCT) images of 47 patients with CRSwNP and 47 healthy subjects (control) were evaluated. In the CRSwNP group, PNSCT scans were assessed based on Lund-Mackay scale. In both groups, olfactory fossae (OF) depth and width, and Keros classification were evaluated. RESULTS. The total Lund-Mackay score was 17.1±5.9. There were no significant differences between OF depth and width values of the nasal polyps group and control group. For both groups, Type II Keros was the most detected type; secondly, Keros type I and rarely Keros type III were detected. There was no significant correlation between Lund-Mackay score (All items and total score) and OF depth and width, and Keros type. There were negative correlations between ipsilateral OF depth and width (p&lt;0.05), whereas there were positive correlations between contralateral OF depth and width (p&gt;0.05). Keros type was positively correlated between ipsilateral and contralateral OF depth and Keros type (p&lt;0.05). In older patients, left OF depth and Keros type decreased (p&lt;0.05). CONCLUSION. As a conclusion, there was no correlation between Lund-Mackay score and olfactory fossa dimensions (depth and width). When considering age, one could notice that Keros type decreased in older patients.

The expression and significance of TRPM8 among chronic rhinosinusitis with nasal polyps

Objective: To compare the expression and difference of melastatin-related transient receptor potential 8(TRPM8) among chronic rhinosinusitis, nasal polyps and normal mucosa tissues. And to explore the significant expression of TRPM8 among CRSwNP. Methods: Fifty-one patients underwent endoscopic sinus surgery in the Department of Otorhinolaryngology Head and Neck Surgery of Renmin Hospital of Wuhan University from February 2019 to January 2020 were recruited, including 33 males and 18 females, aged from 14 to 65 years old (34.55±1.689).Immunohistochemistry was used to detected the expression of TRPM8 protein among CRSsNP(17),CRSwNP (17) and control tissuses(17). In addition, the correlation between the expression of TRPM8 protein in CRSwNP patients and preoperative CT Lund-Mackay scores and preoperative VAS scores and sinonasal outcome test-20 scores was analyzed, respectively. The primary human nasal epithelial cells were cultured in vitro and the expression of TRPM8 was detected by quantitative real-time PCR and western blotting. The tissue in control group, chronic rhinosinusitis without nasal polyps (CRSsNP) group and the CRSwNP group were collected and grinded into tissue homogenized. The expression of TRPM8 protein was detected by western blotting after 24 h stimulation after homogenate was added into the medium of RPMI 2650 and primary nasal epithelial cells. Results: Compared with the control, the expression of TRPM8 was significantly up-regulated in nasal polyps (t=6.852, P<0.05). TRPM8 was mainly expressed in epithelial cells. The expression of TRPM8 in the epithelial cells of CRSsNP had no difference with the control group (t=1.980, P>0.05). In addition, the expression of TRPM8 in CRSwNP patients was positively correlated with the preoperative CT Lund-Mackay scores and VAS scores and SNOT-20 scores (r=0.512, P<0.05;r=0.853, P<0.01;r=0.814, P<0.01). After cultured primary epithelial cells in vitro, the expression level of TRPM8 in epithelial cells derived from nasal polyp was significantly higher than that in control group (t=8.845, P<0.05). By adding the homogenization of control and CRSsNP and CRSwNP tissues, the expression of TRPM8 in RPMI 2650 cells and primary nasal epithelial cells was changed and that was significantly increased after adding the homogenization of the group of CRSwNP. Conclusion: TRPM8 is highly expressed in nasal polyps epithelial cells, suggesting that TRPM8 may be involved in the pathogenesis of nasal polyps regulated by nasal epithelial cells.

Evaluation of peripheral blood cell levels in nasal polyposis, anthrochoanal polip and inverted papillom patients

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Nasal polyps, antrochoanal polyps and Inverted papilloma are nasal masses. The aim of this study the levels and rates of peripheral blood cells are examined in patients with nasal polyps, antrochoanal polyps, and inverted papilloma, and it is investigated whether peripheral blood elements can be used as a marker in the differential diagnosis of these three pathologies&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The files of 70 patients were retrospectively analyzed between January 2015 and December 2018. Patient were divided into three groups as inverted papilloma, nasal polyposis and antrochoanal polyp. Neutrophil, lymphocyte, eosinophil, monocyte and platelet counts, NLR, ELO, MLO, BLO and TLO values of each of these three groups were compared statistically separately.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 70 patients, including 24 nasal polyps, 26 antrochoanal polyps, and 20 inverted papillomas, were included in the study. There was no statistical difference between the groups in terms of NLR, BLO, MLO, TLO (p=0.479). Only ELO value was higher in the nasal polyp group (p=0.035).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; As in many areas, easier and cheaper diagnostic methods and markers are needed in nasal cavity masses. In our study, we found no evidence that peripheral blood cells could be used to guide the diagnosis and treatment plan of the most common mass lesions of the nasal cavity. Broader and more comprehensive studies are needed for definitive results. &lt;/p&gt;

Eosinophils Correlate with Epithelial-Mesenchymal Transition in Chronic Rhinosinusitis with Nasal Polyps

Introduction: Chronic inflammation and tissue remodeling always occur together in chronic rhinosinusitis (CRS). Epithelial-mesenchymal transition (EMT) plays a critical role in airway remodeling. Objective: Changes of epithelial cells in sinus mucosa in different subtypes of CRS, especially in eosinophilic chronic rhinosinusitis with nasal polyps, and the role of EMT and eosinophils (EOS) in airway remodeling are still unknown. Methods: We included 85 patients in this study. They were divided into 4 groups: a normal control (NC) group, a chronic rhinosinusitis without nasal polyps (CRSsNP) group, an eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) group, and a noneosinophilic chronic rhinosinusitis with nasal polyps (non-ECRSwNP) group. Clinical data were all collected and analyzed. Standard hematoxylin and eosin staining, immunohistochemical staining, and 2-color immunofluorescence staining were performed. Biomarkers of EMT, epithelial cadherin, and vimentin were labeled. The immunohistochemistry results of each group were counted and statistically analyzed. Results and Conclusion: E-cadherin was downregulated, and vimentin was upregulated in epithelial tissue from the ECRSwNP group, compared with that from the control group and the other groups. The number of vimentin-expressing epithelial cells correlated with sinus CT imaging Lund-Mackay scores (r = 0.560, p < 0.001). Moreover, expression levels of vimentin in the epithelium were associated with numbers of infiltrating EOS in tissues (r = 0.710, p < 0.001) and the peripheral blood EOS ratio (r = 0.594, p < 0.001). EMT occurred in patients with CRSwNP, especially in those with ECRSwNP. Epithelial reprogramming correlates with eosinophil infiltration and disease severity. Eosinophils contributed to impairment of epithelial function and promoted EMT in CRSwNP.

MicroRNA Expression in Extracellular Vesicles from Nasal Lavage Fluid in Chronic Rhinosinusitis.

Extracellular vesicles (EVs) are nanovesicles of endocytic origin released by cells and found in human bodily fluids. EVs contain both mRNA and microRNA (miRNA), which can be shuttled between cells, indicating their role in cell communication. This study investigated whether nasal secretions contain EVs and whether these EVs contain RNA. EVs were isolated from nasal lavage fluid (NLF) using sequential centrifugation. EVs were characterized and EV sizes were identified by transmission electron microscopy (TEM). In addition, EV miRNA expression was different in the chronic rhinosinusitis without nasal polyp (CRSsNP) and chronic rhinosinusitis with nasal polyp (CRSwNP) groups. The Kyoto encyclopedia gene and genome database (KEGG) database was used to identify pathways associated with changed miRNAs in each analysis group. Twelve miRNAs were differentially expressed in NLF-EVs of CRS patients versus HCs. In addition, eight miRNAs were differentially expressed in NLF-EVs of CRSwNP versus CRSsNP patients. The mucin-type O-glycan biosynthesis was a high-ranked predicted pathway in CRS patients versus healthy controls (HCs), and the Transforming growth factor beta (TGF-β) signaling pathway was a high-ranked predicted pathway in CRSwNP versus CRSsNP patients. We demonstrated the presence of and differences in NLF-EV miRNAs between CRS patients and HCs. These findings open up a broad and novel area of research on CRS pathophysiology as driven by miRNA cell communication.

Abnormal Expression of YAP Is Associated With Proliferation, Differentiation, Neutrophil Infiltration, and Adverse Outcome in Patients With Nasal Inverted Papilloma.

BackgroundNasal inverted papilloma (NIP) is a common benign tumor. Yes-associated protein (YAP) is the core effector molecule of the Hippo pathway, which regulates the proliferation and differentiation of airway epithelium. While its role in proliferation may be connected to NIP formation, no definitive association has been made between them.MethodsWe compared the difference of YAP expression and proliferation level between the control inferior turbinate, NP (nasal polyps), and NIP groups. In addition, we further used PCR, immunofluorescence, and immunohistochemistry to investigate YAP’s role in the proliferation and differentiation of the nasal epithelium and inflammatory cell infiltration, correlating them with different grades of epithelial remodeling. We further used an IL-13 remodeling condition to investigate YAP’s role in differentiation in an in vitro air-liquid interface (ALI) human nasal epithelial cell (hNECs) model. Finally, we also explored the correlation between YAP expression and clinical indicators of NIP.ResultsThe expression of YAP/active YAP in the NIP group was significantly higher than that in the NP group and control group. Moreover, within the NIP group, the higher grade of epithelial remodeling was associated with higher YAP induced proliferation, leading to reduced ciliated cells and goblet cells. The finding was further verified using an IL-13 remodeling condition in differentiating ALI hNECs. Furthermore, YAP expression was positively correlated with proliferation and neutrophil infiltration in NIP. YAP expression was also significantly increased in NIP patients with adverse outcomes.ConclusionAbnormal expression of YAP/active YAP is associated with proliferation, differentiation, neutrophil infiltration, and adverse outcome in NIP and may present a novel target for diagnosis and intervention in NIP.