Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Tao-Yuan, Taiwan.
Am J Otolaryngol. 2012 Jan-Feb;33(1):14-9. doi: 10.1016/j.amjoto.2010.12.001. Epub 2011 Mar 4.
Nasal polyps (NP) are regulated by proinflammatory transcription factors such as activator protein-1 (AP-1), which comprises members of the proto-oncogene Jun and Fos protein families. The binding of AP-1 proteins to the 12-O-tetradecanoylphorbol-13-acetate (TPA)-response element can activate target genes and regulate many critical cellular processes. The proliferating cell nuclear antigen (PCNA) gene contains AP-1 sites, and its expression is regulated by AP-1 activity. In this study, NP and inferior turbinate (IT) were evaluated, compared with normal mucosa, to see if diffuse inflammation and active cellular proliferation exist.
A diseased group of 20 subjects and control group of 20 subjects were enrolled in this study. NP and IT were evaluated with expression of phospho-c-Jun, c-Fos, PCNA, major basic protein by immunohistochemistry, and eosinophil numbers by cell counts.
The expression of phospho-c-Jun, c-Fos, PCNA, major basic protein, and eosinophil numbers showed no significant difference in IT and NP of the same patients, but all were significantly higher in IT and NP compared with normal mucosa (P < .05).
Our result demonstrated strong evidence that diffuse mucosal inflammation and active cellular proliferation do exist in rhinosinusitis with nasal polyposis. As the degree of the disease severity increases, the difference of eosinophilic infiltration and cellular proliferation activity between NP and its adjacent mucosa decreases. An integrated anti-inflammatory treatment may be more important than surgical intervention.
鼻息肉（NP）受促炎转录因子如激活蛋白-1（AP-1）调节，AP-1 由原癌基因 Jun 和 Fos 蛋白家族成员组成。AP-1 蛋白与 12-O-十四烷酰佛波醇-13-醋酸酯（TPA）反应元件的结合可以激活靶基因并调节许多关键的细胞过程。增殖细胞核抗原（PCNA）基因含有 AP-1 位点，其表达受 AP-1 活性调节。在这项研究中，NP 和下鼻甲（IT）与正常黏膜进行了比较评估，以观察是否存在弥漫性炎症和活跃的细胞增殖。
本研究纳入了 20 名患者的病变组和 20 名患者的对照组。通过免疫组织化学评估磷酸化 c-Jun、c-Fos、PCNA、主要碱性蛋白的表达，并通过细胞计数评估嗜酸性粒细胞数量。
同一患者的 IT 和 NP 中磷酸化 c-Jun、c-Fos、PCNA、主要碱性蛋白和嗜酸性粒细胞数量的表达无显著差异，但 IT 和 NP 均显著高于正常黏膜（P<.05）。
我们的结果有力地证明了在伴有鼻息肉的鼻窦炎中确实存在弥漫性黏膜炎症和活跃的细胞增殖。随着疾病严重程度的增加，NP 与其相邻黏膜之间嗜酸性粒细胞浸润和细胞增殖活性的差异减小。综合抗炎治疗可能比手术干预更为重要。
