Number Of Eosinophils In Tissue Research Articles

Abstract 5339: Establishment of a humanized IL5/IL5RA mouse model to evaluate modulators of eosinophilic inflammation in vivo

Abstract IL-5/IL-5R signaling plays a key role in the maturation, activation, survival, and recruitment of eosinophils to sites of inflammation. Targeting this pathway is an attractive therapeutic strategy for certain inflammatory diseases, such as asthma. Here, we generated a novel humanized IL5/IL5RA model (B-hIL5/hIL5RA) to examine the utility of human IL-5/IL5R-targeting therapeutic candidates. Specifically, the entire murine Il5 coding region was replaced by the corresponding human IL5 sequence, and the human IL5RA sequence coding the extracellular domain was inserted to replace the corresponding murine sequence. Successful generation of the model was confirmed by expression of human IL-5 by ELISA and IL5RA by flow cytometry. Furthermore, the proportion of eosinophils in the blood of B-hIL5/hIL5RA mice increased after stimulation with human IL5 recombinant protein, indicating that the humanized IL5RA protein is functional. Next, the ability of the humanized mice to establish asthma-like disease was tested using ovalbumin: following a 14 day sensitization period, mice were challenged with nebulized OVA daily from day 21 until the endpoint; treatment with mepolizumab or benralizumab analog was performed. Flow cytometric analysis of the bronchioalveolar fluid indicates that treatment with mepolizumab or benralizumab analog significantly lowered the number of eosinophils when compared to the isotype control in homozygous B-hIL5/hIL5RA mice. Blood counts and quantification of lung H&E sections also confirm that the treatments lowered the number of eosinophils in circulation and lung tissue, respectively. Taken together, these data indicate that B-hIL5/hIL5RA mice are a suitable preclinical model to test novel modulators of human IL-5/IL-5RA signaling. Citation Format: Suman Zhao, Shujin Zhang, Zhen Chen, Liya Yang, Mari Kuraguchi, Jiangfeng Yuan, Heiling Shen. Establishment of a humanized IL5/IL5RA mouse model to evaluate modulators of eosinophilic inflammation in vivo [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5339.

Correlation Between Nasal Allergy and the Number of Eosinophils in Adenoid Tissue.

To study adenoid tissue eosinophilia in allergic rhinitis. A single-centre clinical case-control prospective study with 66 subjects enrolled for the study after taking written informed consent from all the participants. All patients underwent adenoidectomy with histopathological evaluation of adenoid tissue samples for eosinophils. 36 patients (cases) with Symptoms for Allergic Rhinitis (SFAR) score indicative of allergic rhinitis. 30 patients (control) with SFAR scores not indicative of allergic rhinitis. All patients were evaluated for serum absolute eosinophil count and total serum immunoglobulin E (Ig-E). There was a significant relationship between allergic rhinitis and serum Ig-E levels using the Kruskal-Wallis rank sum test amongst case and control groups with a p-value of 0.031. Pathologically examined slides of adenoid tissue eosinophil count per 10 random high power fields in these patients showed significant results with a p-value of 0.002432, via the Kruskal-Wallis rank sum test. Statistical analysis, shows that adenoid tissue eosinophil count and serum Ig-E levels can somewhat predict the presence of clinical features of allergic rhinitis. Based on several similar studies with similar results, allergic rhinitis can be gauged with adenoid tissue histopathology and routine evaluation should be considered as a standard of care.

Differential expression of NEDD8 in different pathological types of chronic rhinosinusitis with nasal polyps

Objective:To analyze the differential expression of neural precursor cell-expressed developmentally downregulated 8（NEDD8） protein in nasal polyp tissues of patients with different pathological types of chronic rhinorhinosinusitis with nasal polyps（CRSwNP）. Methods:All specimens were obtained from the specimen library of Beijing Tongren Hospital, and were all patients who underwent nasal endoscopic surgery for chronic rhinosinusitis in Beijing Tongren Hospital. Hematoxylin-eosin staining（HE） was used to detect the number of eosinophils in nasal polyps, and CRSwNP patients were grouped according to the number of eosinophils in nasal polyps, immunohistochemistry was used to detect and analyze the expression level of NEDD8 protein in nasal polyps. Results:The expression level of NEDD8 protein in nasal polyps of patients with eosinophilic chronic rhinorhinosinusitis with nasal polyps was significantly higher than that of patients with non-eosinophilic chronic rhinosinusitis and nasal polyps（P<0.05）. In addition, there was a significant positive correlation between the expression level of NEDD8 protein and the number of eosinophils in nasal polyp tissue（r=0.79, P=0.02）. Conclusion:There are differences in the expression of NEDD8 protein in patients with chronic rhinosinusitis and nasal polyps of different pathological types.

Endotyping Difficult-to-Treat Chronic Rhinosinusitis with Nasal Polyps by Structured Histopathology

Introduction: This study aimed to identify the histopathologic characteristics associated with difficult-to-treat chronic rhinosinusitis with nasal polyps (CRSwNPs), enabling physicians to predict the risk of poor outcome after endoscopic sinus surgery (ESS). Methods: A prospective cohort study performed at the First Affiliated Hospital of Sun Yat-sen University between January 2015 and December 2018 with CRSwNP patients who underwent ESS. Polyp specimens were collected during surgery and were subjected to structured histopathological evaluation. Difficult-to-treat CRSwNPs were determined at 12–15 months post-operation according to the European Position Paper. Multiple logistic regression model was used to assess the association between histopathological parameters and the difficult-to-treat CRSwNP. Results: Among 174 subjects included in the analysis, 49 (28.2%) were classified with difficult-to-treat CRSwNP, which had higher numbers of total inflammatory cells, tissue eosinophils, and percentages of eosinophil aggregates and Charcot-Leyden crystals (CLC) formation but a lower number of interstitial glands than the nondifficult-to-treat CRSwNP. Inflammatory cell infiltration (adjusted OR: 1.017), tissue eosinophilia (adjusted OR: 1.005), eosinophil aggregation (adjusted OR: 3.536), and CLC formation (adjusted OR: 6.972) were independently associated with the difficult-to-treat outcome. Furthermore, patients with tissue eosinophil aggregation and CLC formation had an increasingly higher likelihood of uncontrolled disease versus those with tissue eosinophilia. Conclusion: The difficult-to-treat CRSwNP appears to be characterized by increased total inflammatory infiltrates, tissue eosinophilia, eosinophil aggregation, and CLC formation in structured histopathology.

The Tissue Lymphocyte-to-Eosinophil Ratio Predicted Long-Term Recurrence of Eosinophilic CRSwNP.

Eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP) remains a recalcitrant disease with a high recurrence rate. This study aimed to identify a predictor of long-term recurrence in patients with Eos-CRSwNP. A total of 39 Eos-CRSwNP patients who had their initial and recurrent nasal polyps surgically removed were retrospectively included in this study, with 49 Eos-CRSwNP patients without recurrence and 32 patients with non-Eos-CRSwNP matched by randomly chosen. Clinical characteristics were compared among or between groups. Spearman correlation analyses and a backward stepwise multivariate logistic regression analysis were performed to find factors associated with the recurrence and recurrence time of Eos-CRSwNP. Furthermore, a receiver operating characteristic (ROC) curve was used to determine the predictor of long-term Eos-CRSwNP recurrence. The number and ratio of tissue eosinophils were highest in Eos-CRSwNP with recurrence and lowest in non-Eos-CRSwNP. The ratio of tissue lymphocytes was highest in non-Eos-CRSwNP and lowest in Eos-CRSwNP with recurrence, with the number of tissue lymphocytes higher in Eos-CRSwNP without recurrence than the other two groups. The numbers of tissue lymphocytes in the initial nasal polyps were lower and the numbers of tissue eosinophils were higher in the group of recurrent nasal polyps that recurred at >5 years after surgery than in the nasal polyps that recurred at <5 years after surgery. The tissue lymphocyte-to-eosinophil ratio (LER) showed a significant negative correlation with the recurrence and the recurrence time of Eos-CRSwNP. A ROC curve revealed that a tissue LER value < 0.67 predicted long-term Eos-CRSwNP recurrence with 72.73% sensitivity and 82.35% specificity (area under the curve = 0.789). Tissue LER is strongly associated with Eos-CRSwNP recurrence and may play a key role in predicting long-term Eos-CRSwNP recurrence.

Calprotectin in chronic rhinosinusitis eosinophil extracellular traps.

Calprotectin is an antimicrobial peptide primarily secreted by neutrophils. Furthermore, calprotectin secretion increases in patients with chronic rhinosinusitis (CRS) with polyps (CRSwNP) and positively correlates with neutrophil markers. However, CRSwNP is known to be associated with type 2 inflammation related to tissue eosinophilia. Therefore, the authors investigated calprotectin expression in eosinophils and eosinophil extracellular traps (EETs) and explored the associations between tissue calprotectin and the clinical findings of patients with CRS. A total of 63 patients participated, and patients diagnosed with CRS were classified based on the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) score. The authors performed hematoxylin and eosin staining, immunohistochemistry, immunofluorescence with calprotectin, myeloperoxidase (MPO), major basic protein (MBP), and citrullinated histone H3 with the participant's tissues. Finally, correlations between calprotectin and the clinical data were examined. Calprotectin-positive cells are co-localized not only in MPO-positive cells but also in MBP-positive cells in human tissues. Calprotectin was also involved in EETs and neutrophil extracellular traps. The number of calprotectin-positive cells in the tissue was positively correlated with the number of tissue and blood eosinophils. In addition, calprotectin in the tissue is associated with the olfactory function, Lund-Mackay computed tomography score, and JESREC score. Calprotectin, known to be secreted by neutrophils, in CRS was also expressed in eosinophils. In addition, calprotectin, which functions as an antimicrobial peptide, may play an important role in the innate immune response based on its EET involvement. Therefore, calprotectin expression could reflect as a disease severity biomarker for CRS.

Relationship between Eosinophilic and Neutrophilic Inflammation in Chinese Chronic Rhinosinusitis with Nasal Polyps

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNPs) in China is characterized by a mixed eosinophilic-neutrophilic inflammation, linking to a more heterogeneous clinical phenotype. However, the relationship between eosinophilic and neutrophilic inflammation in Chinese patients with CRSwNP remains largely unknown. We aimed to further characterize the correlation between neutrophils with eosinophils in relation to clinical characters and disease control status after endoscopic sinus surgery (ESS). Methods: A total of 242 patients were recruited and stratified based on tissue (≥10%) eosinophilia and (≥20/per high-power field) neutrophilia. Clinical characteristics and disease control status were compared between subgroups. Associations between tissue eosinophils and neutrophils were analyzed. Results: The uncontrolled patients accounted for 41.3%, 41.3%, 17.1%, and 22.2% in subjects with concomitant tissue eosinophilia and neutrophilia (EN-high), isolated eosinophilia (E-high), isolated neutrophilia (N-high), and no eosinophilia and neutrophilia (EN-low), respectively. Positive correlations between tissue eosinophils and neutrophils were observed in patients with CRSwNP as well as in EN-high and N-high subgroups but not in E-high and EN-low subgroups. The EN-high subgroup had higher tissue eosinophil numbers than the other three subgroups. Both EN-high and E-high subgroups had higher rates of uncontrolled subjects than the N-high and EN-low subgroups; however, there was no difference in the rate of uncontrolled subjects between EN-high and E-high subgroups and between N-high and EN-low subgroups. Conclusion: Tissue neutrophils might have a potential interaction and mutual promotion effect with eosinophils in CRSwNP. However, tissue neutrophilia would not pose significant risk for poor disease control after ESS. Further larger, prospective studies are needed to confirm our findings.

Artículo traducido] Asociación entre eosinófilos de sangre periférica y cutáneos con la gravedad del penfigoide ampolloso y los resultados terapéuticos

Background and aimsA dermal inflammatory infiltrate rich in eosinophils is a prominent histological feature of bullous pemphigoid (BP) and peripheral blood eosinophilia has been documented in 50–60% of BP patients. Nevertheless, the impact of circulating and dermal infiltrate eosinophil levels on BP remains poorly understood. The main objective of this work was to investigate the association of peripheral blood and dermal infiltrate eosinophil levels with clinical and immunological characteristics of the disease. Material and methodsRetrospective cohort study including all patients diagnosed with BP between 2011 and 2020. ResultsThe study cohort included 233 patients with BP. The mean baseline peripheral blood eosinophil count was 956.3 ± 408.6 × 106/L and the mean number of tissue eosinophils at the dermal hot spot area was 30.5 ± 19.0. Patients with disseminated presentation (i.e. BSA > 50%) had significantly higher peripheral blood eosinophil counts (P = .028). Mucosal involvement was significantly associated with lower dermal eosinophil count (P = .001). Requiring inpatient care and relapsing were significantly associated with high peripheral blood eosinophil count (P = .025; P = .020, respectively). Among the 68 patients who experienced a relapse, 31 had peripheral blood eosinophilia (i.e. > 500 × 106/L) at relapse (44.2%). Peripheral blood eosinophil counts at baseline and at relapse were significantly correlated (r = 0.82, P < .001). ConclusionsPeripheral blood and cutaneous eosinophils levels may be useful biomarkers for disease activity and treatment outcomes in BP. Monitoring peripheral blood eosinophil counts may allow early detection of relapse.

Association of Peripheral Blood and Cutaneous Eosinophils With Bullous Pemphigoid Disease Severity and Treatment Outcomes

Background and aimsA dermal inflammatory infiltrate rich in eosinophils is a prominent histological feature of bullous pemphigoid (BP) and peripheral blood eosinophilia has been documented in 50–60% of BP patients. Nevertheless, the impact of circulating and dermal infiltrate eosinophil levels on BP remains poorly understood. The main objective of this work was to investigate the association of peripheral blood and dermal infiltrate eosinophil levels with clinical and immunological characteristics of the disease. Material and methodsRetrospective cohort study including all patients diagnosed with BP between 2011 and 2020. ResultsThe study cohort included 233 patients with BP. The mean baseline peripheral blood eosinophil count was 956.3±408.6×106/L and the mean number of tissue eosinophils at the dermal hot spot area was 30.5±19.0. Patients with disseminated presentation (i.e. BSA>50%) had significantly higher peripheral blood eosinophil counts (P=0.028). Mucosal involvement was significantly associated with lower dermal eosinophil count (P=0.001). Requiring inpatient care and relapsing were significantly associated with high peripheral blood eosinophil count (P=0.025; P=0.020, respectively). Among the 68 patients who experienced a relapse, 31 had peripheral blood eosinophilia (i.e. >500×106/L) at relapse (44.2%). Peripheral blood eosinophil counts at baseline and at relapse were significantly correlated (r=0.82, P<0.001). ConclusionsPeripheral blood and cutaneous eosinophils levels may be useful biomarkers for disease activity and treatment outcomes in BP. Monitoring peripheral blood eosinophil counts may allow early detection of relapse.

Meta-Analysis of Preventive and Therapeutic Effects of Ligustrazine on Airway Remodeling in Asthmatic Rats

Objective To assess the effect of ligustrazine on airway remodeling in asthmatic rats. Methods To collect studies on the effects of ligustrazine on airway remodeling in asthmatic rat models, PubMed, Embase, CBM, Cochrane, Chinese Knowledge Infrastructure (CNKI), VIP, and Wanfang data (WANFANG) were searched using a computer. Two investigators independently screened the literature, extracted the data, and assessed the methodological quality by complying with the inclusion criteria. Moreover, a meta-analysis was conducted by adopting Stata 11.0. Results On the whole, 10 articles were included. As indicated from the meta-analysis, we have the following: ① ligustrazine was capable of reducing the thickness of the airway smooth muscle and inhibiting the proliferation of smooth muscle (WMD = −5.98, 95% CI (−7.75, −4.42), P ≤ 0.001); ② ligustrazine could reduce the thickness of the airway wall and mitigate tracheal stenosis (WMD = 0.12, 95% CI (0.05, 0.20), P ≤ 0.001); ③ ligustrazine could decrease the number of eosinophils in the lung tissue and reduce airway inflammation (WMD = −14.47, 95% CI (−18.09, −10.86), P ≤ 0.001). Conclusion Ligustrazine was demonstrated to be an effective therapeutic drug in asthmatic rats by preventing and treating airway remodeling. Further high-quality experimental studies should be conducted to investigate the mechanism of ligustrazine action in depth.

Major basic protein deposited at intra mucosal epithelium with probable eosinophilic chronic rhinosinusitis.

BackgroundEosinophilic chronic rhinosinusitis (ECRS) is diagnosed by Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scoring system and histopathological eosinophil counts of dissected nasal polyps. Patients with low JESREC score and small number of tissue eosinophils are diagnosed with non-ECRS (NECRS). Due to the 2 parameters of this diagnostic system, chronic rhinosinusitis is to be divided to 4 groups and some patients fall into the 2 groups other than ECRS and NECRS: probable ECRS (pECRS) and probable non-ECRS (pNECRS). We attempted to clarify clinical and histopathological similarities and differences, especially concerning major basic protein (MBP), among those groups.MethodsOne hundred twenty-eight patients treated by endoscopic sinus surgery was included. Clinical characteristics were compared among each group, and immunohistological analysis for MBP was performed to 35 randomly selected patients. MBP deposition at intra mucosal epithelium was evaluated by semiquantificational approach.ResultsECRS patients showed significantly higher comorbidity rate with allergic rhinitis (36 patients, 78.3%), asthma (36 patients, 78.3%) compared with other groups. Also, percentage of the patients complaining olfactory dysfunction (42 patients, 91.3%) was significantly higher (p < 0.001). Lund-Mackay score (mean, 14.5; 6–24) and recurrence rate (27 patients, 61.4%) was the highest in ECRS patients. Regarding pECRS, the number of patients with olfactory dysfunction (5 patients, 55.6%) was higher than pNECRS and NECRS groups. Also, comorbidity of asthma and percentage of blood eosinophils tended to be higher than those 2 groups. MBP score of pECRS group was significantly higher than NECRS (p < 0.05), despite of smaller tissue eosinophil counts.ConclusionpECRS might share some characteristics with ECRS although tissue eosinophil count was significantly smaller compared with ECRS. The results of this study have shown that MBP score in pECRS nasal polyps was significantly higher than NECRS patients and close to ECRS. That might suggest that eosinophils have existed in the nasal polyps of pPECRS patients at some point before surgery.

Quantification of Mucosal Eosinophils for the Histopathologic Diagnosis of Eosinophilic Gastritis and Duodenitis: A Primer for Practicing Pathologists.

Eosinophilic gastrointestinal diseases, specifically eosinophilic gastritis and duodenitis, are chronic inflammatory conditions characterized by persistent gastrointestinal (GI) symptoms and elevated levels of activated eosinophils in the GI tract. Both clinical and endoscopic findings are nonspecific, no clinical or histopathologic diagnostic guidelines are published, and disease awareness is low, both among clinicians and amongst pathologists, who tend to overlook mild or moderate increases in the density of eosinophils in GI biopsy specimens. Yet, evaluating and, at times, counting eosinophils in GI biopsies may have important clinical implications: the numbers of tissue eosinophils correlate with clinical manifestations, can be used as determinants of effective management, and are used to assess the effects of treatment. A most persuasive argument for providing a count rather than a value judgment is that patients read reports, understand numbers, and use them to help to understand the course of their disease. The objective of this primer is to provide pathologists with the tools to incorporate a quantitative assessment of eosinophilia in the diagnosis of gastric and duodenal biopsy specimens and to develop a systematic approach to their evaluation, counting, and reporting. To achieve this aim, we present our general approach to the biopsy (where to count), followed by details on the characteristics of a countable eosinophil (what to count), and provide with a set of suggestions on the counting methods (how to count). We conclude with suggestions on how to report GI tissue eosinophilia in a manner that alerts clinicians and prompts pertinent management steps.

The protective effects of human milk components, 2′-fucosyllactose and osteopontin, against 2,4-dinitrochlorobenzene-induced atopic dermatitis in mice

Atopic dermatitis (AD) is a chronic inflammatory skin disease with high morbidity in infants. Several bioactive components of human milk, such as 2′-fucosyllactose (2′-FL) and osteopontin (OPN), are reported to exhibit anti-inflammatory properties. This study determined that oral administration of 2′-FL and OPN significantly attenuated the 2,4-dinitrochlorobenzene (DNCB)-induced AD symptoms in BALB/c mice. 2′-FL and OPN treatment markedly downregulated the serum IgE level and decreased the numbers of mast cells and eosinophils in the dermal tissues from DNCB-sensitized mice. Interestingly, we found that the combination of OPN with 2′-FL produced a great therapeutic effect on AD in mice. Additionally, the result showed that the components suppressed Th2 response, resulting in an attenuated cutaneous inflammatory response. Furthermore, in vitro study validated that 2′-FL and OPN inhibited Th2 cells differentiation. Together, we conclude that 2′-FL and OPN ameliorates DNCB-induced AD-like skin inflammation, and its supplement might help to prevent AD in infants.

Association Between Serum Amyloid A Expression and Disease Control after Endoscopic Sinus Surgery in Patients With Chronic Rhinosinusitis With Nasal Polyps.

Our previous study revealed that serum amyloid A (SAA) levels in polyp tissues could serve as a biomarker for the prediction of corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). However, their association with disease control status in the patients after endoscopic sinus surgery remains to be assessed. Polyp tissues and control uncinate process mucosa were collected from 48 patients with CRSwNP and 10 healthy control subjects. SAA expression was examined using immunohistochemistry and enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curves were performed to determine the predictive value of SAA in nasal polyps. The clinical characteristics of 2 CRSwNP subtypes (SAAhigh and SAAlow) were evaluated. The SAA expression levels in polyp tissues were significantly elevated both in non-eosinophilic and eosinophilic CRSwNP as compared to the healthy controls. In patients with CRSwNP, the tissue SAA level was significantly higher in the disease-controlled patients than those of the partly controlled and uncontrolled. ROC curve analysis revealed that a cut-off value of 114.9ng/mL for the tissue SAA level predicted the patients with disease-controlled status with 93.33% sensitivity and 63.64% specificity (AUC = .8727, P < .001). Furthermore, The SAAhigh subgroup showed higher tissue eosinophil numbers and percentage of the disease-controlled patients compared to the SAAlow subgroup. Our findings suggest that measurements of SAA in polyp tissues may provide useful information for evaluating CRSwNP conditions, especially identifying the CRSwNP patients with disease-controlled status after endoscopic sinus surgery.

Concordant systemic and local eosinophilia relates to poorer disease control in patients with nasal polyps

Objective: To explore whether blood and polyp tissue eosinophil numbers are independent risk factors for poor disease control in patients with nasal polyp. Methods: By using the electronic medical records database and manual evaluation, 183 nasal polyp patients who had undergone endoscopic sinus surgery at least one year prior to the study with complete data of tissue specimens, baseline blood routine test, nasal endoscopy and sinus computed tomography, were identified and recruited to assess disease control based on the criteria of a European Position Paper on Rhinosinusitis and Nasal Polyps 2012 (EPOS 2012). Multiple logistic regression model was used to determine the association between blood and tissue eosinophil numbers and risk of poor disease control by adjusting for demographics and comorbidities. Results: We broke down the cohort into 4 groups according to blood (0.3×109/L) and tissue (10%) eosinophils. The patients without eosinophilic inflammation represented the largest group (41.5%). The group with concordant blood and tissue eosinophilia represented the second largest (31.2%), and the patients with isolated tissue (15.3%) or blood (12.0%) eosinophilia were relatively rare. Multiple logistic regression models found blood eosinophil count and tissue eosinophil percentage were independently associated with increased risk for poor disease control after adjustments for covariates related to poor treatment outcome. Furthermore, subjects with concordant blood and tissue eosinophilia had a higher risk for poor disease control than those with isolated blood or tissue eosinophilia. Conclusion: Concordant blood and tissue eosinophilia relates to a higher likelihood of poor disease control than isolated blood or tissue eosinophilia after adjustment of potential confounders in nasal polyp patients.

Tissue Cytokine Adenoid Experssion in Hypertrophic Adenoid Gland in Children with Allergic Rhinitis.

To investigate the inflammatory pattern in terms of inflammatory cells and cytokines expression in children with adenoid hypertrophy (AH) and coexistent allergic rhinitis (AR). A cross-sectional analytical study. Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong P. R. China, from October 2018 to August 2020. A sample of 102 children with AH, who underwent adenoidectomy were enrolled. They were divided into two groups of AH, alone and AH with AR (AH+AR). A routine complete blood count, and the number of eosinophils in adenoid tissue was measured using hematoxylin-eosin staining. The tissue expression of cytokines was carried out using real-time quantitative PCR. Forty-eight children (47%) were diagnosed with AR. The number and percentage of eosinophils in peripheral blood and adenoid tissue were statistically (p <0.05) higher in the group of AH+AR than AH alone. Furthermore, in patients with AH+AR, the mRNA expression levels of IL-12 and IFN-γ decreased, while IL-4, IL-8, IL-18, IL-33, H2R, LTR1, LTR2 and GCR all increased in adenoid tissue. The pathological mechanism underlying adenoid hypertrophy in children with comorbid allergic rhinitis can be involved with predominant tissue eosinophilia and type 2 (or Th 2) inflammation. Key Words: Adenoid hypertrophy, Allergic rhinitis, Inflammatory features, Cytokines, Eosinophils.

What does elevated TARC/CCL17 expression tell us about eosinophilic disorders?

Eosinophilic disorders encompass a large spectrum of heterogeneous diseases sharing the presence of elevated numbers of eosinophils in blood and/or tissues. Among these disorders, the role of eosinophils can vary widely, ranging from a modest participation in the disease process to the predominant perpetrator of tissue damage. In many cases, eosinophilic expansion is polyclonal, driven by enhanced production of interleukin-5, mainly by type 2 helper cells (Th2 cells) with a possible contribution of type 2 innate lymphoid cells (ILC2s). Among the key steps implicated in the establishment of type 2 immune responses, leukocyte recruitment toward inflamed tissues is particularly relevant. Herein, the contribution of the chemo-attractant molecule thymus and activation-regulated chemokine (TARC/CCL17) to type 2 immunity will be reviewed. The clinical relevance of this chemokine and its target, C-C chemokine receptor 4 (CCR4), will be illustrated in the setting of various eosinophilic disorders. Special emphasis will be put on the potential diagnostic, prognostic, and therapeutic implications related to activation of the TARC/CCL17-CCR4 axis.

Clinical characteristics and cytokine profiles of central-compartment-type chronic rhinosinusitis.

The clinical characteristics of central-compartment-type chronic rhinosinusitis (CRS) in East Asian individuals are not clear. We sought to investigate the clinical features and the cytokine profiles of central-compartment-type CRS in our patient group. Adult patients diagnosed with bilateral CRS were recruited, and patients who had previously undergone sinus surgery and pansinusitis (Lund-Mackay scores >23) were excluded. Central-compartment-type CRS was defined by both endoscopic and radiological features. The symptoms, inhalant allergen sensitization status, endoscopic findings, and radiological assessments were recorded and compared between patients with central-compartment-type CRS and other types of CRS. We also examined the extent of tissue eosinophilia and specific cytokine protein levels (eosinophil cationic protein [ECP], myeloperoxidase [MPO], immunoglobulin E [IgE], interleukin [IL]-4, IL-5, and IL-13) in the sinonasal tissues. Central-compartment-type CRS was found in 16 (23.9%) patients, and non-central-compartment-type CRS was found in 51 (76.1%) patients. Hyposmia or anosmia as the major symptom was more common in the central-compartment-type CRS group. The numbers of eosinophils in tissue and serum were significantly higher in the central-compartment-type CRS patients. The presence of allergen sensitization was not significantly different between groups. The levels of IL-5 and IL-13 were increased in middle turbinate tissues of patients with central-compartment-type CRS. Central-compartment-type CRS was associated with hyposmia or anosmia, eosinophilic subtypes, and elevated levels of IL-5 and IL-13 in middle turbinate tissues but not necessarily correlated with allergic disease in our patients.

Tissue eosinophils in different grades of oral squamous cell carcinoma – A special stain (carbol chromotrope) study

Background: In recent days, tissue eosinophils are considered to have more impetus role in the biological behavior of various tumors. Compared to routine hematoxylin and eosin stain, the special stains such as carbol chromotrope for eosinophils are considered to be more specific and definitive for its evaluation in routine histopathology. Aim: This study aims to evaluate and compare the infiltration of tissue eosinophils in different grades of oral squamous cell carcinoma (OSCC) using a special stain – carbol chromotrope and to investigate the prognostic role of tissue eosinophils in OSCC. Methodology: The study was carried out with the sample size of fifty histopathologically diagnosed cases of OSCC, of which twenty cases were well differentiated, twenty cases were moderately differentiated, and ten cases were poorly differentiated, and comparison of infiltration of tissue eosinophils in the different grades of OSCC was done using special stain. The tissue sections were stained with carbol chromotrope special stain. Results: In the present study, more number of tissue eosinophils were seen in well-differentiated OSCC cases than the moderately and poorly differentiated OSCC cases, and the analysis of variance test showed P

Mast Cell and Eosinophil Counts in Gastric and Duodenal Biopsy Specimens From Patients With and Without Eosinophilic Gastroenteritis

Mast cells are believed to contribute to the development of eosinophilic gastrointestinal disorders (EGIDs). We quantified mast cells and eosinophils in biopsy specimens from patients with EGIDs and without known esophageal or gastrointestinal disease to investigate associations between these cell types and EGID and its features. We conducted a retrospective study of patients with EGID (n= 52) and of children and adults who underwent upper endoscopy and were found to have no evidence of gastrointestinal or systemic conditions (n= 123). We re-reviewed archived gastric and duodenal biopsy specimens to quantify mast cells (by tryptase immunohistochemistry) and eosinophils. We calculated the specificity of cell count thresholds for identification of patients with EGIDs and evaluated the correlation between mast cell and eosinophil counts and clinical and endoscopic features. In the gastric biopsy specimens from patients without esophageal or gastrointestinal diseases, the mean mast cell count was 18.1 ± 7.2 cells per high-power field (hpf), and the peak mast cell count was 21.9 ± 8.2 cells/hpf. In the duodenal biopsy specimens from patients without esophageal or gastrointestinal diseases, the mean mast cell count was 23.6 ± 8.1 cells/hpf and the peak mast cell count was 28.1 ± 9.3 cells/hpf. The mean and peak eosinophil counts in gastric biopsy specimens from patients without disease were 3.8 ± 3.6 eosinophils/hpf and 5.8 ± 5.0 eosinophils/hpf; the mean and peak eosinophil counts in duodenal biopsy specimens were 14.6 ± 8.9 eosinophils/hpf and 19.5 ± 11.0 eosinophils/hpf. A mean count of 20 eosinophils/hpf in gastric biopsy specimens or 30 eosinophils/hpf in duodenal biopsy specimens identified patients with EGIDs with high specificity. Gastric and duodenal biopsy specimens from patients with EGIDs had significant increases in mean mast cell counts compared with biopsy specimens from patients without EGIDs. There was a correlation between mean mast cell and eosinophil counts in duodenal biopsy specimens (R= 0.47; P= .01). The mean mast cell and eosinophil counts did not correlate with symptoms or endoscopic features of EGIDs. We identified thresholds for each cell type that identified patients with EGIDs with 100% specificity. The increased numbers of mast cells and eosinophils in gastric and duodenal tissues from patients with EGIDs supports the concept that these cell types are involved in pathogenesis. However, cell counts are not associated with symptoms or endoscopic features of EGIDs.