Huriyati Effy, Darwin Eryati, Yanwirasti Yanwirasti, Wahid Irza
Postgraduate Biomedical Science, Faculty of Medicine, Andalas University, Padang, Indonesia.
Department of Histology, Faculty of Medicine, Andalas University, Padang, Indonesia.
Open Access Maced J Med Sci. 2019 May 31;7(11):1733-1738. doi: 10.3889/oamjms.2019.341. eCollection 2019 Jun 15.
Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical entity with its propensity for recurrence. This disease decreases the patients' quality of life and creates a high economic burden. An effort to investigate the aetiology of recurrent polyps has to be more alert.
This study aims to prove the differences in expression of IL-5, IL-8, IL-17A and TGF-β1 in mucosal and polyp tissue between CRSwNP and recurrent CRSwNP and also to determine which expression of cytokines that have the main role in mucosal and polyp tissue in recurrent CRSwNP.
An observational study was conducted with a comparative cross-sectional design of CRS patients with 15 recurrent CRSwNP and CRSwNP who had never undergone surgery for as many as 15 polyps. Mucosal specimens of nasal polyps are taken by brushing, and polyp tissue specimens are taken during surgical removal of nasal polyps. Specimens from the polyp mucosa were examined by ELISA while the polyp tissue specimens were carried out immunohistochemistry (IHC).
The result showed that there is a significant difference in IL-5 expression in the polyp mucosal between CRSwNP with recurrent CRSwNP, where expression is higher in recurrent CRSwNP. The expression of IL-8, IL-17 and TGF-β1 were lower in recurrent CRSwNP, but the difference was not significant. In nasal polyp tissue, there is a significant difference in TGF-β1 and IL-8 expression between CRSwNP and recurrent CRSwNP, where the expression of both cytokines is lower in recurrent CRSwNP. Interleukin-5 expression was higher in recurrent CRSwNP than CRSwNP, but the difference was not significant. In the polyps mucosal, IL-5 has the main role in recurrent CRSwNP polyp, whereas TGF-β has the main role in polyp tissue.
This study concluded that the expression of IL-5 in the mucosa could be examined with simple techniques like brushing before polypectomy or FESS was performed to determine the possibility of polyps recurrencies.
伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）仍是一个具有复发倾向的具有挑战性的临床实体。这种疾病降低了患者的生活质量，并造成了高昂的经济负担。对复发性息肉病因的研究必须更加警惕。
本研究旨在证明CRSwNP与复发性CRSwNP在黏膜和息肉组织中IL-5、IL-8、IL-17A和TGF-β1表达的差异，并确定在复发性CRSwNP的黏膜和息肉组织中起主要作用的细胞因子表达情况。
采用观察性研究，对15例复发性CRSwNP患者和15例从未接受过手术的CRSwNP患者进行比较横断面设计。鼻息肉黏膜标本通过刷取获得，息肉组织标本在鼻息肉手术切除时获取。息肉黏膜标本采用酶联免疫吸附测定（ELISA）检测，息肉组织标本进行免疫组织化学（IHC）检测。
结果显示，CRSwNP与复发性CRSwNP的息肉黏膜中IL-5表达存在显著差异，复发性CRSwNP中的表达更高。复发性CRSwNP中IL-8、IL-17和TGF-β1的表达较低，但差异不显著。在鼻息肉组织中，CRSwNP与复发性CRSwNP之间TGF-β1和IL-8表达存在显著差异，复发性CRSwNP中这两种细胞因子的表达均较低。复发性CRSwNP中白细胞介素-5的表达高于CRSwNP，但差异不显著。在息肉黏膜中，IL-5在复发性CRSwNP息肉中起主要作用，而TGF-β在息肉组织中起主要作用。
本研究得出结论，在进行息肉切除术或功能性内镜鼻窦手术（FESS）之前，可通过如刷取等简单技术检测黏膜中IL-5的表达，以确定息肉复发的可能性。
