Ebenezer J A, Christensen J M, Oliver B G, Oliver R A, Tjin G, Ho J, Habib A R, Rimmer J, Sacks R, Harvey R J
Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, UNSW, Sydney, Australia.
Woolcock Institute, University of Sydney, Sydney, Australia.
Rhinology. 2017 Sep 1;55(3):234-241. doi: 10.4193/Rhino16.215.
Although extracellular matrix (ECM) proteins are associated with irreversible lower airway changes, the relationship with upper airway remodelling which occurs during chronic rhinosinusitis (CRS) is poorly understood. This study assessed the expression of ECM proteins periostin, fibulin-1, fibronectin and collagenIV in nasal mucosa of patients with and without histologic features of remodelling.
A cross-sectional study of sinonasal mucosal biopsies taken from patients, undergoing surgery for CRS was performed, where patients were grouped according to remodelling, defined by basement membrane thickening (BMT over 7.5 micrometer) and subepithelial fibrosis. An overall view and three random fields of immunostained tissue sections that included epithelium, basement membrane and submucosa, were imaged using Zeiss Zen software. The area and intensity of positive staining were scored by two blinded observers, using a 12-point ordinal scale of weak to strong.
65 patients (47.6 +/- 13.4years, 44.6% female) were assessed. Patients were grouped as controls 26.2%, BMT/no fibrosis 38.5% or BMT and fibrosis 33.8%. Stronger grade of periostin expression was associated with remodelling changes and tissue eosinophilia over 10/HPF. Fibulin-1, fibronectin and collagenIV did not differ.
Periostin expression was associated with the presence of BMT, fibrosis and tissue eosinophilia and may identify patients undergoing remodelling changes.
尽管细胞外基质（ECM）蛋白与不可逆的下呼吸道改变有关，但与慢性鼻-鼻窦炎（CRS）期间发生的上呼吸道重塑之间的关系却知之甚少。本研究评估了有无重塑组织学特征的患者鼻黏膜中ECM蛋白骨膜蛋白、纤连蛋白-1、纤连蛋白和IV型胶原的表达。
对接受CRS手术患者的鼻窦黏膜活检进行横断面研究，根据基底膜增厚（BMT超过7.5微米）和上皮下纤维化定义的重塑对患者进行分组。使用蔡司Zen软件对包括上皮、基底膜和黏膜下层的免疫染色组织切片的整体视图和三个随机视野进行成像。由两名盲法观察者使用从弱到强的12分有序量表对阳性染色的面积和强度进行评分。
评估了65例患者（47.6±13.4岁，44.6%为女性）。患者分为对照组（26.2%）、BMT/无纤维化组（38.5%）或BMT和纤维化组（33.8%）。骨膜蛋白表达的更高等级与重塑改变和每高倍视野超过10个的组织嗜酸性粒细胞增多有关。纤连蛋白-1、纤连蛋白和IV型胶原无差异。
骨膜蛋白表达与BMT、纤维化和组织嗜酸性粒细胞增多有关，可能有助于识别正在发生重塑改变的患者。
