Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
Int Forum Allergy Rhinol. 2019 Nov;9(11):1281-1288. doi: 10.1002/alr.22277. Epub 2019 Jan 8.
Odontogenic sinusitis (OS) presents more satisfactory therapeutic effect after endoscopic surgery compared with chronic rhinosinusitis (CRS) of other origin. The aim of the present study was to investigate the clinical characteristics, morphological features, and epithelial barrier function of sinus mucosa of OS and discuss the possible relationship with good prognosis.
A total of 25 subjects with OS, 7 CRS without nasal polyps (CRSsNP), 10 CRS with nasal polyps (CRSwNP), and 9 control subjects were recruited. The biopsy specimens were stained with hematoxylin and eosin for general observation of cytomorphologic features. Epithelial tight junctions (TJs) protein claudin-4 expression was determined to evaluate the epithelial barrier integrity by using immunofluorescence and Image-Pro Plus software analysis. The representative cytokine profiles regarding T helper 1 (Th1) (interferon [IFN]-γ), Th2 (interleukin [IL]-5), and Th17 (IL-17) were examined by reverse transcription-polymerase chain reaction (RT-PCR).
Extensively small papillary protrusions could be seen in the maxillary sinus mucosa of OS patients under nasal endoscopy, similar to the morphological behavior, which also presented as papillary folds in the surface of the epithelium. The epithelium in OS kept an increased claudin-4 expression compared with that seen in CRSsNP, CRSwNP, and control subjects. The inflammatory pattern analysis demonstrated that OS belonged to the lymphocyte and plasma cell-dominant cellular phenotypes, whereas IL-17 was dominant compared with IFN-γ as well as IL-5.
The odontogenic infections might induce the formation of papillary mucosa folds and enhance the epithelial TJ barrier function. OS exhibited as lymphocyte and plasma cell-dominant cellular phenotypes and Th17 cytokine profiles.
与其他来源的慢性鼻-鼻窦炎（CRS）相比，牙源性鼻窦炎（OS）经内镜手术后的治疗效果更令人满意。本研究旨在探讨 OS 鼻窦黏膜的临床特征、形态特征和上皮屏障功能，并探讨其与良好预后的可能关系。
共纳入 25 例 OS 患者、7 例无鼻息肉的 CRS（CRSsNP）患者、10 例有鼻息肉的 CRS（CRSwNP）患者和 9 例对照者。苏木精-伊红染色观察细胞形态学特征，免疫荧光染色和 Image-Pro Plus 软件分析上皮紧密连接（TJ）蛋白闭合蛋白-4 的表达，评估上皮屏障的完整性。采用逆转录-聚合酶链反应（RT-PCR）检测 Th1（干扰素-γ）、Th2（白细胞介素-5）和 Th17（白细胞介素-17）相关的代表性细胞因子谱。
鼻内镜下可见 OS 患者上颌窦黏膜有广泛的小乳头状突起，与上皮表面的乳头状皱襞形态行为相似。与 CRSsNP、CRSwNP 和对照组相比，OS 患者的上皮中闭合蛋白-4 的表达增加。炎症模式分析表明，OS 属于淋巴细胞和浆细胞占优势的细胞表型，而白细胞介素-17 与干扰素-γ和白细胞介素-5 相比更为占优势。
牙源性感染可能导致乳头状黏膜皱襞形成，并增强上皮 TJ 屏障功能。OS 表现为淋巴细胞和浆细胞占优势的细胞表型和 Th17 细胞因子谱。
