Department of Otolaryngology, UNICAMP Campinas, Sao Paulo, Brazil.
Am J Rhinol Allergy. 2011 Sep-Oct;25(5):e191-5. doi: 10.2500/ajra.2011.25.3644.
Immunosuppression is the leading cause of recurrent sinus infections after hematopoietic stem cell transplant (HSCT), with increased incidence of sinusitis in patients with chronic graft versus host disease (GVHD). Histological descriptions of the oral mucosa, lung ciliary epithelium, and intestinal mucosa related to HSCT have been described. However, few have described the nasal mucosa. We, therefore, sought to elucidate the histological and ultrastructural features of the nasal mucosa in patients after HSCT to better understand the pathophysiology of the immune response.
Uncinate processes from 24 HSCT patients and 12 immunocompetent patients were subjected to histological analyses via light and transmission electron microscopy (TEM).
TEM revealed aberrant cilia structure, altered mitochondria quantity, microvilli, and cytoplasm vacuolization. All HSCT patients with rhinosinusitis had significant loss or absence of cilia (p = 0.018). Apoptotic bodies were increased and Goblet cells decreased in nasal epithelium from patients with chronic GVHD (p = 0.04).
This tissue destruction likely enhances pathogen penetration resulting in recurrent infection.
免疫抑制是造血干细胞移植（HSCT）后复发性鼻窦感染的主要原因，慢性移植物抗宿主病（GVHD）患者的鼻窦炎发病率增加。已经描述了与 HSCT 相关的口腔黏膜、肺纤毛上皮和肠黏膜的组织学描述。然而，很少有描述鼻腔黏膜的。因此，我们试图阐明 HSCT 后患者鼻腔黏膜的组织学和超微结构特征，以更好地了解免疫反应的病理生理学。
通过光镜和透射电子显微镜（TEM）对 24 例 HSCT 患者和 12 例免疫功能正常患者的鼻甲进行组织学分析。
TEM 显示纤毛结构异常、线粒体数量改变、微绒毛和细胞质空泡化。所有患有鼻-鼻窦炎的 HSCT 患者的纤毛均显著缺失或缺失（p = 0.018）。慢性 GVHD 患者的鼻上皮中凋亡小体增加，杯状细胞减少（p = 0.04）。
这种组织破坏可能增强了病原体的穿透，导致反复感染。
