Jiang Lijie, Zeng Yinhui, Huang Zhaoqi, Tang Yiquan, Zeng Qingxiang, Liu Wenlong, Shi Jianbo
Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
Department of Otolaryngology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
World Allergy Organ J. 2021 Dec 5;14(12):100616. doi: 10.1016/j.waojou.2021.100616. eCollection 2021 Dec.
The histopathology of pediatric chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) is rarely reported due to low prevalence or the unavailability of tissue samples. Hence, we aimed to characterize and compare the histologic features and protein expression of Th1/Th2/Th17-related cytokines in pediatric CRSsNP and CRSwNP.
The histologic characteristics of 15 children with CRSsNP, 52 children with CRSwNP, and 12 control participants were analyzed using hematoxylin and eosin staining. The expression of Th1/Th2/Th17-related cytokines were examined using immunohistochemistry and the enzyme-linked immunosorbent assay.
Pediatric subjects with CRSwNP had more intact epithelium and less submucosal mucous glands compared to those with CRSsNP. Tissue eosinophils were more prevalent in the younger CRSwNP group compared to the older CRSwNP or the CRSsNP groups. The protein concentrations of Th2 cytokines were significantly higher in the CRSwNP group than the CRSsNP group or the control group. Moreover, the protein concentrations of Th17 cytokines were significantly higher in the younger CRSwNP group than the older CRSwNP group or the CRSsNP and control groups. The protein concentrations of Th1 and Th17 cytokines were also significantly higher in the CRSsNP group than the control group. Compared with non-eosinophilic CRSwNP, eosinophilic CRSwNP presented with elevated protein concentrations of Th1 and Th17 cytokines.
For the first time, we showed that pediatric CRSwNP presents as eosinophilic with Th2/Th17 inflammation, whereas CRSsNP presents as Th1/Th17 inflammation. Our study may provide a theoretical basis for the precise treatment of pediatric CRS in the future.
由于小儿慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）和不伴鼻息肉（CRSsNP）的患病率较低或难以获取组织样本，其组织病理学情况鲜有报道。因此，我们旨在描述和比较小儿CRSsNP和CRSwNP的组织学特征以及Th1/Th2/Th17相关细胞因子的蛋白表达。
采用苏木精-伊红染色分析15例CRSsNP患儿、52例CRSwNP患儿及12例对照参与者的组织学特征。采用免疫组织化学和酶联免疫吸附测定法检测Th1/Th2/Th17相关细胞因子的表达。
与CRSsNP患儿相比，CRSwNP患儿的上皮更完整，黏膜下黏液腺更少。与年龄较大的CRSwNP组或CRSsNP组相比，年龄较小的CRSwNP组组织嗜酸性粒细胞更为常见。CRSwNP组Th2细胞因子的蛋白浓度显著高于CRSsNP组或对照组。此外，年龄较小的CRSwNP组Th17细胞因子的蛋白浓度显著高于年龄较大的CRSwNP组、CRSsNP组及对照组。CRSsNP组Th1和Th17细胞因子的蛋白浓度也显著高于对照组。与非嗜酸性CRSwNP相比，嗜酸性CRSwNP的Th1和Th17细胞因子蛋白浓度升高。
我们首次表明，小儿CRSwNP表现为嗜酸性伴Th2/Th17炎症，而CRSsNP表现为Th1/Th17炎症。我们的研究可能为未来小儿CRS的精准治疗提供理论依据。
