Hua Xiaoyang, Naselsky Warren C, Jania Corey M, Chason Kelly D, Huang Julianne J, Doerschuk Claire M, Graham Scott M, Senior Brent A, Tilley Stephen L
Department Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Ann Otol Rhinol Laryngol. 2016 Apr;125(4):290-6. doi: 10.1177/0003489415610775. Epub 2015 Dec 17.
Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in adults in both developing and developed countries. The etiology and pathogenesis of CRS remain poorly understood, and the disease is refractory to therapy in many patients. Mast cell activation has been demonstrated in the sinonasal mucosa of patients with CRS; however, the specific contribution of mast cells to the development and pathogenesis of this disease has not been established.
The objective of this study was to investigate the role of mast cells in the development of CRS.
C57BL/6 wild-type and C57BL/6-Kit(W-sh/W-sh) mast cell-deficient mice were immunized by intraperitoneal allergen injection and subsequent chronic low dose intranasal allergen challenges. The sinonasal phenotypes of these groups were then evaluated and compared to saline-treated controls using radiologic, histologic, and immunologic methods.
Wild-type mice exposed to chronic intranasal allergen developed many features seen in human CRS, including mucosal thickening, cystic changes, polyp development, eosinophilia, goblet cell hyperplasia, and mast cell activation. In contrast, sinonasal pathology was significantly attenuated in mast cell-deficient mice subjected to the same chronic allergen protocol. Specifically, tissue eosinophilia and goblet cell hyperplasia were reduced by approximately 50% compared to wild-type levels. Surprisingly, none of the mast cell-deficient mice subjected to chronic allergen challenge developed cystic changes or polypoid changes in the nose or sinuses.
These data identify a critical role for mast cells in the development of many features of a mouse model of eosinophilic CRS, suggesting that therapeutic strategies targeting mast cells be examined in humans afflicted with this disease.
慢性鼻-鼻窦炎(CRS)是发展中国家和发达国家成年人中最常见的慢性疾病之一。CRS的病因和发病机制仍知之甚少,并且该疾病在许多患者中对治疗具有难治性。在CRS患者的鼻窦黏膜中已证实存在肥大细胞活化;然而,肥大细胞对该疾病发生发展和发病机制的具体作用尚未明确。
本研究的目的是探讨肥大细胞在CRS发生发展中的作用。
通过腹腔内注射变应原并随后进行慢性低剂量鼻内变应原激发,对C57BL/6野生型和C57BL/6-Kit(W-sh/W-sh)肥大细胞缺陷型小鼠进行免疫。然后使用放射学、组织学和免疫学方法评估这些组的鼻窦表型,并与盐水处理的对照组进行比较。
暴露于慢性鼻内变应原的野生型小鼠出现了许多人类CRS中可见的特征,包括黏膜增厚、囊性改变、息肉形成、嗜酸性粒细胞增多、杯状细胞增生和肥大细胞活化。相比之下,接受相同慢性变应原方案的肥大细胞缺陷型小鼠的鼻窦病理学明显减轻。具体而言,与野生型水平相比,组织嗜酸性粒细胞增多和杯状细胞增生减少了约50%。令人惊讶的是,接受慢性变应原激发的肥大细胞缺陷型小鼠中,没有一只在鼻子或鼻窦出现囊性改变或息肉样改变。
这些数据表明肥大细胞在嗜酸性CRS小鼠模型许多特征的发生发展中起关键作用,提示应对患有该疾病的人类患者研究针对肥大细胞的治疗策略。