The inflammatory pattern and the characteristics of mucous remodeling in different immune type of nasal polyps
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摘要: 目的:研究鼻息肉中免疫表型特点,比较分析TH2与TH17亚型鼻息肉的黏膜炎症模式及组织重塑特征。方法:鼻内镜手术中获取88例慢性鼻-鼻窦炎伴鼻息肉患者息肉组织,18例正常对照鼻中隔偏曲患者下鼻甲黏膜组织;ELISA法检测炎症及组织重塑相关免疫指标。免疫组织化学观察主导细胞因子蛋白表达及炎症细胞浸润状况等。结果:全部鼻息肉组织中TH效应细胞因子表达阳性IL-5占21%、IL-17占16%、IFN-γ占9%,而54%的息肉中无任何其他TH细胞关键性细胞因子的表达。其中IL-17表达阳性(TH17型)鼻息肉具有中性粒细胞炎症相关递质[主要是髓过氧化物酶(MPO),IL-1β,IL-6和IL-8]显著增高;组织学IL-17表达显著并MPO+细胞浸润明显;同时伴有组织重塑相关TGF-β1、MMP7等相对增高趋势。反之在IL-5阳性(TH2型)鼻息肉中以嗜酸性炎症相关递质升高为主(主要是IL-5,嗜酸性阳离子蛋白,TIgE和SAE-IgE);组织学IL-5表达显著并嗜酸粒细胞浸润特征;而TGF-β1与MMP7蛋白表达显著降低。结论:鼻息肉存在各种不同免疫表型并具有特殊炎症模式及组织重塑特点,即IL-5阳性鼻息肉具有嗜酸性炎症特征而组织重塑不显著; IL-17阳性息肉具有中性粒细胞炎症特征且具有组织重塑特征。Abstract: Objective:The aim of this study is to study the different immune-type of polyps and valuate mucosal inflammatory pattern and remodeling features between in IL-5 positive vs. IL-17 positive nasal polyps.Method:Nasal polyp or nasal turbinate tissue was obtained from 88 CRSwNP patients during endonasal sinus surgery or 18 non-atopic control subjects during septoplasty, respectively. Assessment of pro-inflammatory cytokines and mediators by ELISA. Additionally, the distribution of IL-5 positive or IL-17 positive cells and inflammatory cells(eosinophil, neutrophil, etc.) were examined using immunohistochemistry(IHC).Result:Overall more than half amount of polyp tissue did not express any TH cells key cytokine. However there are 21% polyp present IL-5 positive and 16% of IL-17 positive as well as 9% of IFN-γ positives. Amount of them that IL-17 positive polyps by synthesis of mediators promoting neutrophilic inflammation[myeloperoxidase(MPO), IL-1β, IL-6 and IL-8)] and staining infiltration of MPO positive with IL-17 positive cells, whereas IL-5 positive nasal polyps were characterized by synthesis of mediators promoting eosinophilic inflammation(IL-5, ECP, TIgE, and SAE-IgE) and infiltrating of eosinophils and IL-5 positive cells. Meanwhile TGF-β1 and MMP7 protein levels enhanced in IL-17 positive polyps and decreased in IL-5 positive than control.Conclusion:Nasal polyps presenting as different immune types and there were characterized with different inflammatory and remodeling patterns. Amount of them that IL-17 positive polyps presenting as a neutrophilic inflammation with remodeling biased. Whereas IL-5 positive nasal polyps were characterized by eosinophilic inflammation and absence of remodeling tendency.
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Key words:
- nasal polyps /
- eosinophils /
- interleukin-5 /
- interleukin-17 /
- neutrophils /
- T-cell subsets
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