变应性鼻炎对伴或不伴鼻息肉的慢性鼻-鼻窦炎鼻黏膜重塑的不同影响。
Different effects of allergic rhinitis on nasal mucosa remodeling in chronic rhinosinusitis with and without nasal polyps.
作者信息
Xiang Rong, Zhang Qing-Ping, Zhang Wei, Kong Yong-Gang, Tan Lu, Chen Shi-Ming, Deng Yu-Qin, Tao Ze-Zhang, Xu Yu
机构信息
Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, People's Republic of China.
Department of Otorhinolaryngology Head and Neck Surgery, Suizhou Hospital, Hubei University of Medicine, 60 Longmen Rd, Suizhou, 441300, Hubei, People's Republic of China.
出版信息
Eur Arch Otorhinolaryngol. 2019 Jan;276(1):115-130. doi: 10.1007/s00405-018-5195-x. Epub 2018 Nov 16.
BACKGROUND
Allergic rhinitis (AR) has been reported to be associated with chronic rhinosinusitis (CRS). The objective of this study was to investigate the effect of AR on nasal mucosa remodeling in CRS.
METHODS
Patients were enrolled and divided into the following groups: CRS with nasal polyps (NP) with allergic rhinitis (AR)(CRSwNPwAR; n = 20), CRS with NP without AR (CRSwNPsAR; n = 20), CRS without NP with AR (CRSsNPwAR; n = 20), CRS without NP without AR (CRSsNPsAR; n = 20), AR without CRS (AR; n = 20) and controls (n = 14). Eosinophil infiltration, mucus production, and collagen deposition were examined by hematoxylin and eosin, periodic acid schiff and masson's trichrome staining, respectively. VEGF-A and microvessel density were detected by immunohistochemistry. The expression of remodeling markers, including TGF-β1, MMP-7, MMP-9 and TIMP-1 were measured by Western blot.
RESULTS
The expression of remodeling factors, including VEGF-A, CD31, CD34 and TIMP-1 were significantly increased in CRSwAR compared to CRSsAR. Goblet cell hyperplasia, as well as VEGF-A, CD31, CD34, and MMP-9 expression were significantly higher in CRSwNPwAR compared to CRSwNPsAR. However, the expression of collagen fibers, MMP-7 and TGF-β1 were significantly higher in CRSsNPwAR compared to CRSsNPsAR.
CONCLUSIONS
AR could enhance the remodeling process in CRS. Moreover, AR had different effects on CRSwNP and CRSsNP.
背景
据报道，变应性鼻炎（AR）与慢性鼻-鼻窦炎（CRS）相关。本研究的目的是探讨AR对CRS鼻黏膜重塑的影响。
方法
招募患者并分为以下几组：伴有鼻息肉（NP）的CRS合并变应性鼻炎（CRSwNPwAR；n = 20）、伴有NP的CRS不合并AR（CRSwNPsAR；n = 20）、不伴有NP的CRS合并AR（CRSsNPwAR；n = 20）、不伴有NP的CRS不合并AR（CRSsNPsAR；n = 20）、不合并CRS的AR（AR；n = 20）和对照组（n = 14）。分别采用苏木精-伊红染色、过碘酸希夫染色和马松三色染色检测嗜酸性粒细胞浸润、黏液分泌和胶原沉积。采用免疫组织化学法检测血管内皮生长因子-A（VEGF-A）和微血管密度。通过蛋白质印迹法检测包括转化生长因子-β1（TGF-β1）、基质金属蛋白酶-7（MMP-7）、基质金属蛋白酶-9（MMP-9）和基质金属蛋白酶组织抑制因子-1（TIMP-1）在内的重塑标志物的表达。
结果
与CRSsAR相比，CRSwAR中包括VEGF-A、CD31、CD34和TIMP-1在内的重塑因子表达显著增加。与CRSwNPsAR相比，CRSwNPwAR中的杯状细胞增生以及VEGF-A、CD31、CD34和MMP-9表达显著更高。然而，与CRSsNPsAR相比，CRSsNPwAR中的胶原纤维、MMP-7和TGF-β1表达显著更高。
结论
AR可增强CRS中的重塑过程。此外，AR对CRSwNP和CRSsNP有不同影响。
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