Hamilos D L, Leung D Y, Wood R, Meyers A, Stephens J K, Barkans J, Meng Q, Cunningham L, Bean D K, Kay A B
Department of Medicine, National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206.
J Allergy Clin Immunol. 1993 Jul;92(1 Pt 1):39-48. doi: 10.1016/0091-6749(93)90035-e.
We investigated the association among tissue eosinophilia, cellular infiltration, and cytokine mRNA expression in chronic hyperplastic sinusitis (CHS).
Percutaneous biopsies of the maxillary sinuses and nasal polyps were performed in 12 adult patients (six men and six women) of whom seven were nonallergic and 11 were asthmatic. Tissues were compared with biopsy specimens from the inferior and middle turbinates of normal control subjects.
Histologically, an eosinophil-predominant inflammatory infiltrate was seen in 10 of 12 patients, whereas a mild to moderate neutrophilic infiltrate was seen in 4 of 12 patients. As determined by immunocytochemistry, diseased tissues and normal control tissues differed significantly in terms of the number of activated (EG2+) eosinophils (p = 0.005) but not in terms of CD3+ or CD4+ T lymphocytes, elastase-positive neutrophils or CD68+ macrophages. The number of eosinophils did not correlate with that of any other cell type. By in situ hybridization, CHS tissues showed significantly higher numbers of granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin (IL)-3 mRNA-positive cells than normal control tissues (p = 0.002 and 0.0005, respectively) per high-powered field. There was a significant correlation between the number of infiltrating EG2+ eosinophils and cells that expressed mRNA for GM-CSF (r = 0.60, p = 0.041) or IL-3 (r = 0.69, p = 0.013). Furthermore, epithelial cells did not show detectable mRNA expression for GM-CSF or IL-3. No significant correlation was found between IL-5 mRNA expression and infiltrating EG2+ eosinophils in diseased tissues. However, the IL-5 density was significantly higher in the five patients with CHS who had positive allergy skin test results than in the seven patients with negative skin test results (p = 0.017) or in normal control subjects.
Our data support a role for GM-CSF and IL-3 in the eosinophilia characteristic of CHS and show that IL-5 mRNA expression is not a prominent feature of nonallergic inflammation. The cellular sources of GM-CSF and IL-3 in CHS remain to be definitely determined.
我们研究了慢性增生性鼻窦炎（CHS）中组织嗜酸性粒细胞增多、细胞浸润和细胞因子mRNA表达之间的关联。
对12例成年患者（6名男性和6名女性）进行上颌窦和鼻息肉的经皮活检，其中7例为非过敏性患者，11例为哮喘患者。将这些组织与正常对照受试者下鼻甲和中鼻甲的活检标本进行比较。
组织学上，12例患者中有10例可见以嗜酸性粒细胞为主的炎性浸润，而12例患者中有4例可见轻度至中度的中性粒细胞浸润。通过免疫细胞化学测定，病变组织和正常对照组织在活化（EG2 +）嗜酸性粒细胞数量方面存在显著差异（p = 0.005），但在CD3 +或CD4 + T淋巴细胞、弹性蛋白酶阳性中性粒细胞或CD68 +巨噬细胞数量方面无显著差异。嗜酸性粒细胞数量与其他任何细胞类型的数量均无相关性。通过原位杂交，CHS组织每高倍视野中粒细胞 - 巨噬细胞集落刺激因子（GM - CSF）和白细胞介素（IL）-3 mRNA阳性细胞的数量显著高于正常对照组织（分别为p = 0.002和0.0005）。浸润的EG2 +嗜酸性粒细胞数量与表达GM - CSF mRNA的细胞（r = 0.60，p = 0.041）或IL - 3 mRNA的细胞（r = 0.69，p = 0.013）之间存在显著相关性。此外，上皮细胞未显示出可检测到的GM - CSF或IL - 3 mRNA表达。在病变组织中，IL - 5 mRNA表达与浸润的EG2 +嗜酸性粒细胞之间未发现显著相关性。然而，5例皮肤过敏试验结果阳性的CHS患者的IL - 5密度显著高于7例皮肤试验结果阴性的患者（p = 0.017）或正常对照受试者。
我们的数据支持GM - CSF和IL - 3在CHS嗜酸性粒细胞增多中起作用，并表明IL - 5 mRNA表达不是非过敏性炎症的突出特征。CHS中GM - CSF和IL - 3的细胞来源仍有待明确确定。
