摘要
目的 探究2型和非2型慢性鼻窦炎不伴鼻息肉(chronic rhinosinusitis without nasal polyps,CRSsNP)患者的临床特征及组织重塑差异。方法 收集26例CRSsNP患者鼻窦黏膜组织和临床资料,回访患者复发情况。根据组织内白细胞介素5(IL-5)表达将CRSsNP分为2型和非2型两组。天狼猩红染色检测CRSsNP组织的胶原沉积情况。RT-qPCR和Luminex检测转化生长因子β1(TGF-β1)、TGF-β2和TGF-β3的mRNA和蛋白表达情况,明确IL-5与CRSsNP组织重塑的相关性。结果 与非2型CRSsNP相比,2型CRSsNP合并过敏的比例(21.05% vs 71.43% P=0.061)、术前Lund-Mackay CT评分(13.00±4.40 vs 8.50±4.19,P<0.05)、组织内IL-5[(120.23±83.93)pg/ml vs(4.95±2.75)pg/ml,P<0.001]、TGF-β3[(315.0±304.7)pg/ml vs(93.93±132.4)pg/ml,P<0.05]显著升高。活化的TGF-β3与IL-5表达水平呈正相关(r=0.6813,P<0.05)。此外,2型CRSsNP总胶原沉积程度更高,Ⅰ型、Ⅲ型胶原纤维表达面积百分比较非2型CRSsNP均增加。结论 与非2型CRSsNP患者相比,2型CRSsNP患者临床症状和组织重塑更严重,组织重塑与2型炎症反应呈正相关,揭示以2型炎症为靶点的治疗方案可适用于2型CRSsNP患者。
OBJECTIVE To explore the clinical features and tissue remodeling differences between type 2 and non-type 2 chronic rhinosinusitis without nasal polyps(CRSsNP) patients.METHODS We collected sinus mucosa tissue and clinical features of twenty-six CRSsNP patients,and recalled the patients after surgery.The patients were divided into type 2 CRSsNP and non-type 2 CRSsNP according to IL-5 expression in nasal sinus tissue.Sirius red solution was used to detect the collagen deposition in CRSsNP sinus mucosa tissue.Further,the mRNA and protein levels of the tissue remodeling cytokines transforming growth factor-β1 (TGF-β1),TGF-β2 and TGF-β3 were measured by RT-qPCR and Luminex.Finally,the correlation between IL-5 and CRSsNP tissue remodeling cytokine was clarified.RESULTSCompared with non-type 2 CRSsNP patients,the allergy comorbidity rate(21.05% vs 71.43% P=0.061),Lund-Mackay CT score(13.00±4.40 vs 8.50±4.19,P<0.05),the protein level of IL-5[(120.23±83.93)pg/ml vs (4.95±2.75)pg/ml,P<0.001]and active TGF-β3[(315.0±304.7)pg/ml vs (93.93±132.4)pg/ml,P<0.05]were significantly higher in nasal mucosa tissue of type 2 CRSsNP patients.And the expression of active TGF-β3 was positively correlated to IL-5 in CRSsNP nasal mucosa(r=0.6813,P<0.05).In addition,the degree of total collagen deposition in type 2 CRSsNP was higher than that in non-type 2 CRSsNP and the elvated percentage of type I collagen fibers and type Ⅲ collagen fibers positive area was noticed in type 2 CRSsNP in comparison to non-type 2 CRSsNP.CONCLUSION Compared to non-type 2 CRSsNP patients,type 2 CRSsNP patients have more severe clinical symptoms and tissue remodeling.Tissue remodeling,especially collagen deposition,is positively correlated with type 2 inflammation,which reveals that a treatment plan targeting type 2 inflammation might be also applied to type 2 CRSsNP patients.
作者
蓝凤
赵丽敏
杨萌哲
张宇玲
王麒淇
王向东
张罗
LAN Feng;ZHAO Limin;YANG Mengzhe;ZHANG Yuling;WANG Qiqi;WANG Xiangdong;ZHANG Luo(Beijing Key Laboratory of Nasal Diseases,Beijing Institute of Otolaryngology,Beijing,100005,China;Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100730,China;Department of Allergy,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2022年第5期304-308,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
北京市医院管理局“青苗”人才培养计划(QML20180201)
北京市科技新星计划(Z191100001119117)
北京市优秀人才青年拔尖(2018000021223ZK12)
北京市科技计划首都健康保障培育研究项目(Z181100001618002)。
关键词
鼻窦炎
炎症
转化生长因子Β3
组织重塑
Sinusitis
Inflammation
Transforming Growth Factor beta3
tissue remodeling
