J Rhinol.  2015 May;22(1):18-27. 10.18787/jr.2015.22.1.18.

Clinical Characteristics and Expression Pattern of IL-33 and IL-25 According to Histologic Classification in Chronic Rhinosinusitis with Nasal Polyposis

• Kim SH
• Mo JH
• Chung YJ
• Xu J
• Park SJ
• Rha KS
• Kim YM

• KMID: 2297550
• DOI: http://doi.org/10.18787/jr.2015.22.1.18

Abstract

BACKGROUND AND OBJECTIVES
Many kinds of inflammatory cells and cytokines are suggested to be related to the pathophysiology of chronic rhinosinusitis with nasal polyposis (CRSwNP), but not yet fully understood. The objectives of this study were to classify CRSwNP patients according to histologic features and to reveal the roles of IL-33 and IL-25, on the pathophysiology of CRSwNP. MATERIALS AND METHOD: CRSwNP patients (n=122) were divided into 3 groups according to the type of nasal polyp; eosinophilic polyp (EP, n=38), neutrophilic polyp (NeuP, n=15) and non-eosinophilic non-neutrophilic polyp (NENN, n=63) groups. Clinical features and the expressions of IL-25 and IL-33 were evaluated among the groups.
RESULTS
The EP group showed many clinical features that were different from the other groups: increased prevalence of asthma and olfactory dysfunction, increased percentage of blood eosinophils, increased E/M ratio, and poor postoperative outcomes such as recurrent polyposis and the need for frequent use of oral steroids. Numbers of IL-33 and IL-25 positive cells were significantly higher in the EP group compared with the other groups in the lamina propria (p=0.001).
CONCLUSION
These results suggest that patients with an eosinophilic polyp are clinically and pathogenetically different from patients with other types of polyps, and IL-25 and IL-33 are associated with the pathogenesis of chronic rhinosinusitis with eosinophilic polyps.

Keyword

Nasal polyps; Sinusitis; Eosinophil; IL-25; IL-33

MeSH Terms

Asthma
Classification*
Cytokines
Eosinophils
Humans
Mucous Membrane
Nasal Polyps
Neutrophils
Polyps
Prevalence
Sinusitis
Steroids
Cytokines
Steroids

Figure

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  Fig. 1. Representative CT findings of ethmoid sinus domiant & maxillary sinus dominant CRSwNP.

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  Fig. 2. Classification of patients with chronic rhinosinusitis with nasal polyposis according to the histopathologic feature of the nasal polyp. A: Control. B: EP. C: NP. D: NENP. H&E stain (×400). Scale bar: 20 µm. EP: eosinophilic polyp. NP: neutrophilic polyp. NENP: non-eosinophilic & non-neutrophilic polyp.

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  Fig. 3. Correlation of blood eosinophil differential count and infiltrated eosinophil number of nasal polyps (A) and Relationship of infiltrated eosinophil number of nasal polyp and Lund-MacK-ay score (B) in patients with eosinophilic nasal polyp.

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  Fig. 4. Expression patterns of IL-33 among the groups. Immunohistochemical stain was performed to detect of IL-33 expression in the tissues. A: Isotype control. B: Control group. C: EP. D: NP. E: NENP. IL-33 positive cells were count in the epithelium (F) and subepithelium (G). Immunohistochemical staining (×400). Scale bar: 20 µm. *: p＜0.05 compared with other groups, †: p＜0.05 compared with contol group. EP: eosinophilic polyp. NP: neutrophilic polyp. NENP: non-eosinophilic, & non-neutrophilic polyp.

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  Fig. 5. Expression patterns of IL-25 among the groups. Immunohistochemical stain was performed to detect of IL-25 expression in the tissues. A: Isotype control. B: Control group. C: EP. D: NP. E: NENP. IL-25 positive cells were count in the epithelium (F) and subepithelium (G). Immunohistochemical staining (×400). Scale bar: 20 µm. *: p＜0.05 compared with other groups, †: p＜0.05 compared with contol group. EP: eosinophilic polyp, NP: neutrophilic polyp, NENP: non-osinophilic & non-neutrophilic polyp.

Reference

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