Department of Otolaryngology, Head and Neck Surgery, 13010Osaka Medical College, Osaka, Japan.
Department of Animal Radiology and Graduate School of Agriculture and Life Sciences, 13143The University of Tokyo, Tokyo, Japan.
Ear Nose Throat J. 2021 Sep;100(5_suppl):738S-745S. doi: 10.1177/0145561320902858. Epub 2020 Feb 20.
Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic rhinosinusitis, nasal polyposis, aspirin sensitivity, and asthma. This study aims to identify a mechanism to target for the future treatment of AERD via the elucidation of the effect of systemic steroids on the expression of hematopoietic prostaglandin D synthase (HPGDS) and chemotaxic prostaglandin D (DP2) receptor relative to eosinophil activation in the nasal polyps of patients with AERD.
Among 37 patients undergoing endoscopic sinus surgery, 28 received systemic steroids preoperatively. Nasal polyps were harvested from all 37 patients. After routine processing of paraffin sections, immunohistochemistry was performed using specific antibodies for HPGDS, eosinophil peroxidase (EPX), and DP2.
Expression of HPGDS, DP2, and EPX by eosinophils was higher and more frequent in patients with non-preoperative steroid therapy. Likewise, HPGDS and DP2 were highly expressed in activated eosinophils in the nasal polyps, but not in normal eosinophils.
This study provides clear evidence that systemic steroid therapy inhibits eosinophil activation and decreases HPGDS and DP2 expression in patients with AERD, indicating a reduction in prostaglandin D production and hence control hyperplasia of nasal polyps.
阿司匹林加重性呼吸系统疾病（AERD）的特征是嗜酸性鼻窦炎、鼻息肉、阿司匹林敏感性和哮喘。本研究旨在通过阐明全身类固醇对嗜酸性粒细胞活化相关的造血前列腺素 D 合酶（HPGDS）和趋化性前列腺素 D（DP2）受体表达的影响，确定针对 AERD 的未来治疗靶点。
在 37 例行内镜鼻窦手术的患者中，28 例患者术前接受了全身类固醇治疗。从所有 37 例患者中采集鼻息肉。对石蜡切片进行常规处理后，使用针对 HPGDS、嗜酸性过氧化物酶（EPX）和 DP2 的特异性抗体进行免疫组织化学染色。
未接受术前类固醇治疗的患者的 HPGDS、DP2 和 EPX 表达更高且更频繁。同样，HPGDS 和 DP2 在鼻息肉中活化的嗜酸性粒细胞中高表达，但在正常嗜酸性粒细胞中不表达。
本研究提供了明确的证据，表明全身类固醇治疗可抑制 AERD 患者嗜酸性粒细胞的活化，并降低 HPGDS 和 DP2 的表达，表明前列腺素 D 生成减少，从而控制鼻息肉的增生。
