Armengot Miguel, Garín Luis, Carda Carmen
Ear, Nose, and Throat Department, Valencia University General Hospital and Medical School, Valencia, Spain.
Am J Rhinol Allergy. 2009 Sep-Oct;23(5):466-70. doi: 10.2500/ajra.2009.23.3357.
Eosinophils are possibly the most important inflammatory cells in the pathogenesis of rhinosinusitis with nasal polyposis. Eosinophil degranulation is the mechanism by which these cells exert their inflammatory action. Knowledge of eosinophil state and degranulation mode therefore may help us to better understand this disease. A study is made of eosinophil state and degranulation mode using transmission electron microscopy (TEM), attempting to establish correlations with certain clinical variables considered to be of importance in patients with nasal polyposis.
A prospective TEM study was made to examine 582 eosinophils under 5000x magnification, classifying them according to their state and degranulation mode. The cells originated from 36 cases of nasal polyposis and were catalogued according to the clinical-radiological presentation of the disorder, the presence of asthmatic disease, or acetilsalicilic acid (ASA) triad syndrome (nasal polyposis, asthma, and nonsteroidal anti-inflammatory drug intolerance), and the degree of nasal tissue eosinophilia of the case of origin.
A total of 30.75% of the eosinophils were inactive, 41.75% exhibited piecemeal degranulation (PMD), 27.5% exhibited cytolysis, and 0.34% were in apoptosis. The degranulation mode was significantly correlated to the clinical and histological parameters studied. Thus, cytolysis tended to be less pronounced and PMD greater, in the cells from cases with intense eosinophilia or severe polyposis (high clinical stage and ASA triad).
Cytolysis and PMD are the principal degranulation modes of eosinophils in nasal polyposis-apoptosis being very infrequent. Nasal polyposis shows a correlation between eosinophil degranulation mode and the clinical and radiological stage and the degree of tissue eosinophilia of the case of origin.
嗜酸性粒细胞可能是鼻息肉伴鼻窦炎发病机制中最重要的炎症细胞。嗜酸性粒细胞脱颗粒是这些细胞发挥炎症作用的机制。因此，了解嗜酸性粒细胞状态和脱颗粒模式可能有助于我们更好地理解这种疾病。本研究采用透射电子显微镜（TEM）对嗜酸性粒细胞状态和脱颗粒模式进行研究，试图建立与鼻息肉患者某些重要临床变量的相关性。
进行一项前瞻性TEM研究，在5000倍放大倍数下检查582个嗜酸性粒细胞，根据其状态和脱颗粒模式进行分类。这些细胞来自36例鼻息肉患者，并根据疾病的临床-放射学表现、哮喘疾病的存在情况、或阿司匹林（ASA）三联征综合征（鼻息肉、哮喘和非甾体抗炎药不耐受）以及原始病例的鼻组织嗜酸性粒细胞程度进行分类。
共有30.75%的嗜酸性粒细胞无活性，41.75%表现为颗粒逐片脱失（PMD），27.5%表现为细胞溶解，0.34%处于凋亡状态。脱颗粒模式与所研究的临床和组织学参数显著相关。因此，在嗜酸性粒细胞增多或息肉严重（临床分期高和ASA三联征）的病例的细胞中，细胞溶解往往不太明显，而PMD更明显。
细胞溶解和PMD是鼻息肉中嗜酸性粒细胞的主要脱颗粒模式——凋亡非常罕见。鼻息肉显示嗜酸性粒细胞脱颗粒模式与临床和放射学分期以及原始病例的组织嗜酸性粒细胞程度之间存在相关性。
