Dimić Aleksandar, Perić Aleksandar, Grgurević Uglješa, Sotirović Jelena, Labus Milica, Baletić Nenad, Milojević Milanko, Stanojević Ivan, Vojvodić Danilo
Department of Otorhinolaryngology Military Medical Academy Belgrade Serbia.
Department of Otorhinolaryngology, Faculty of Medicine of the Military Medical Academy University of Defence Belgrade Serbia.
Laryngoscope Investig Otolaryngol. 2022 Apr 13;7(3):671-678. doi: 10.1002/lio2.794. eCollection 2022 Jun.
Biomarker levels in nasal secretions can reflect the inflammatory status of nasal mucosa and evolution of sinus disease. The aim of this study was to evaluate the relationship between local inflammatory mediator production and clinical characteristics of patients with nasal polyposis (NP).
Thirty-one nonaeroallergen sensitized patients with NP (NANP), 29 aeroallergen sensitized patients with NP (ANP), and 30 subjects without inflammation of nasal mucosa as controls (C) entered this prospective, cross-sectional study. Clinical parameters (symptoms, endoscopic, and radiological findings) were assessed. The concentrations of heat shock protein 70 (HSP70), eosinophil cationic protein (ECP), tryptase, substance P and Clara cell protein 16 (CC16) were measured in the nasal secretion samples of all participants by ELISA method.
Our results showed higher concentrations of HSP70, ECP, and tryptase in ANP than in NANP and C ( < .001 for all markers). On the other hand, levels of CC16 were significantly higher in C than in NANP and ANP groups ( < .001; < .001, respectively). We found positive correlations between HSP70, ECP, tryptase, and substance P levels and nasal symptom score in patients with NP. Also, HSP70, ECP, tryptase, and substance P showed different levels of positive correlation among themselves, with HSP70 showing highest positive correlation with ECP. Finally, relatively strong negative correlations were found between the levels of CC16 and nasal symptoms, as well as between the CC16 levels and levels of other four mediators in nasal fluid.
HSP70, ECP, tryptase, and substance P might play a role in the pathogenesis of NP. The results suggest that chronic inflammation in NP involves a self-sustaining local release of HSP70, ECP, and tryptase, independent of aeroallergen stimulation of the mucosal layer, although the production of these mediators is higher in aeroallergen sensitized NP patients.
鼻分泌物中的生物标志物水平可反映鼻黏膜的炎症状态及鼻窦疾病的进展。本研究旨在评估鼻息肉（NP）患者局部炎症介质产生与临床特征之间的关系。
31例非变应原致敏的NP患者（NANP）、29例变应原致敏的NP患者（ANP）以及30例无鼻黏膜炎症的受试者作为对照（C）进入这项前瞻性横断面研究。评估临床参数（症状、内镜及影像学检查结果）。采用酶联免疫吸附测定法（ELISA）检测所有参与者鼻分泌物样本中热休克蛋白70（HSP70）、嗜酸性粒细胞阳离子蛋白（ECP）、类胰蛋白酶、P物质和克拉拉细胞蛋白16（CC16）的浓度。
我们的结果显示，ANP组中HSP70、ECP和类胰蛋白酶的浓度高于NANP组和C组（所有标志物均P<0.001）。另一方面，C组中CC16的水平显著高于NANP组和ANP组（分别为P<0.001；P<0.001）。我们发现NP患者中HSP70、ECP、类胰蛋白酶和P物质水平与鼻症状评分呈正相关。此外，HSP70、ECP、类胰蛋白酶和P物质之间呈现出不同程度的正相关，其中HSP70与ECP的正相关性最高。最后，发现CC16水平与鼻症状之间以及CC16水平与鼻分泌物中其他四种介质水平之间存在较强的负相关。
HSP70、ECP、类胰蛋白酶和P物质可能在NP的发病机制中起作用。结果表明，NP中的慢性炎症涉及HSP70、ECP和类胰蛋白酶的局部持续释放，独立于黏膜层的变应原刺激，尽管这些介质在变应原致敏的NP患者中产生量更高。
