Morphological assessment of the nasal mucosa in patients with chronic rhinosinusitis with nasal polyps

Chronic rhinosinusitis of the nasal mucosa is an inflammatory disease of paranasal sinuses, which causes rhinorrhea, nasal congestion, and hyposmia, and in some cases, it can result in the development of nasal polyposis. Nasal polyps are benign lobular-shaped growths that project in the nasal cavities; they originate from inflammation in the paranasal mucous membrane and are associated with a high expression of interleukins (IL)-4, IL-5, IL-13, and IgE. Polyps derive from the epithelial–mesenchymal transition of the nasal epithelium resulting in a nasal tissue remodeling. Nasal polyps from three patients with chronic rhinosinusitis as well as control non-polyp nasal mucosa were used to isolate and cultivate mesenchymal stem cells characterized as CD73+, CD90+, CD105+/CD14−, CD34−, and CD45−. Mesenchymal stem cells (MSCs) cultures were induced to differentiate toward adipocytes, where lipid droplets and adipocyte genes PPARγ2, ADIPO-Q, and FABP4 were observed in control non-polyp nasal mucosa-derived mesenchymal cells but were scarcely present in the cultures derived from the nasal polyps, where apoptosis was evident. The modulation of the response to adipogenic stimulus in polyps represents a change in the molecular response that controls the cascade required for differentiation as well as possible means to specifically target these cells, sparing the normal mucosa of the nasal sinuses.

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Different effects of allergic rhinitis on nasal mucosa remodeling in chronic rhinosinusitis with and without nasal polyps

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-018-5195-x ◽

2018 ◽

Vol 276 (1) ◽

pp. 115-130 ◽

Cited By ~ 2

Author(s):

Rong Xiang ◽

Qing-ping Zhang ◽

Wei Zhang ◽

Yong-gang Kong ◽

Lu Tan ◽

...

Keyword(s):

Allergic Rhinitis ◽

Chronic Rhinosinusitis ◽

Nasal Mucosa ◽

Nasal Polyps

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Respiratory Nasal Mucosa in Chronic Rhinosinusitis with Nasal Polyps versus COVID-19: Histopathology, Electron Microscopy Analysis and Assessing of Tissue Interleukin-33

Journal of Clinical Medicine ◽

10.3390/jcm10184110 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4110

Author(s):

Ionuț Isaia Jeican ◽

Dan Gheban ◽

Lucian Barbu-Tudoran ◽

Patricia Inișca ◽

Camelia Albu ◽

...

Keyword(s):

Electron Microscopy ◽

Transmission Electron Microscopy ◽

Chronic Rhinosinusitis ◽

Nasal Mucosa ◽

Total Protein ◽

Nasal Polyps ◽

Mucous Cell ◽

Cell Hyperplasia ◽

Transmission Electron ◽

Inflammatory Pattern

(1) Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is one of the most studied rhinological disorders. Modifications of the respiratory nasal mucosa in COVID-19 patients are so far unknown. This paper presents a comparative morphological characterization of the respiratory nasal mucosa in CRSwNP versus COVID-19 and tissue interleukin (IL)-33 concentration. (2) Methods: We analyzed CRSwNP and COVID-19 samples through histopathology, scanning and transmission electron microscopy and performed proteomic determination of IL-33. (3) Results: Histopathologically, stromal edema (p < 0.0001) and basal membrane thickening (p = 0.0768) were found more frequently in CRSwNP than in COVID-19. Inflammatory infiltrate was mainly eosinophil-dominant in CRSwNP and lymphocyte-dominant in COVID-19 (p = 0.3666). A viral cytopathic effect was identified in COVID-19. Scanning electron microscopy detected biofilms only in CRSwNP, while most COVID-19 samples showed microbial aggregates (p = 0.0148) and immune cells (p = 0.1452). Transmission electron microscopy of CRSwNP samples identified biofilms, mucous cell hyperplasia (p = 0.0011), eosinophils, fibrocytes, mastocytes, and collagen fibers. Extracellular suggestive structures for SARS-CoV-2 and multiple Golgi apparatus in epithelial cells were detected in COVID-19 samples. The tissue IL-33 concentration in CRSwNP (210.0 pg/7 μg total protein) was higher than in COVID-19 (52.77 pg/7 μg total protein) (p < 0.0001), also suggesting a different inflammatory pattern. (4) Conclusions: The inflammatory pattern is different in each of these disorders. Results suggested the presence of nasal dysbiosis in both conditions, which could be a determining factor in CRSwNP and a secondary factor in COVID-19.

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Inflammatory markers in the nasal mucosa and polyp-modified tissues in chronic rhinosinusitis with nasal polyps

CLINICAL AND EXPERIMENTAL MORPHOLOGY ◽

10.31088/cem2021.10.3.29-38 ◽

2021 ◽

Vol 10 (3) ◽

pp. 29-38

Author(s):

D.G. Pavlush ◽

◽

I.V. Dyuizen ◽

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Mucosa ◽

Inflammatory Markers ◽

Nasal Polyps ◽

Chemical Structure ◽

Comparison Group ◽

Pathological Process ◽

Molecular Rearrangement ◽

Clinical Prognosis ◽

Neurokinin Receptors

Introduction. To date, chronic rhinosinusitis with nasal polyps (CRSwNP) has not yet been extensively studied: the molecular factors and mechanisms involved in the initiation of polypous transformations in nasal mucosa (NM) and sustaining their recurrence probability are still to be determined. Simultaneously, it is necessary to understand the molecular rearrangement in NM tissues to make clinical prognosis and choose an adequate therapeutic or surgical strategy for CRSwNP treatment. The aim of the study was to identify the features of how inflammatory markers localize and are distributed in the NM and polyps in various morphological CRSwNP types. Materials and methods. We studied morphological and chemical structure of nasal polyps and mucosa of the inferior turbinates. The material was obtained during surgical management of patients diagnosed with CRSwNP. The comparison group involved the patients with a deviated septum who underwent septorhi-noplasty and had neither polyposis nor concomitant inflammatory/allergic pathology. The NM removed in surgeries was used to compare morphological and chemical changes. Immunohistochemistry was applied to determine the localization and distribution of SP, NK1, nNOS, iNOS, and IL1b in the tissues. Results. The formation of nasal polyps was found to be accompanied by morphological and chemical altera-tions in the mucous membrane of the inferior turbinates. In polyps of different morphological types, the changes in the activity of inflammatory markers were specific. Conclusion. The data obtained indicate that changes in the NM of the inferior turbinates, which accompany polyposis development, give certain pathological causes that induce and maintain the pathological process. We have revealed the features of the specific signaling microenvironment in the nasal cavity, which provide special conditions for the formation of polyps of various types. The specificity of the activity and distribu-tion of inflammatory markers in the polyps of different morphological types may serve as a prerequisite for the development of personalized therapy for the disease. Keywords: chronic rhinosinusitis with nasal polyps, inflammation, neurokinin receptors, substance P, nitric oxide

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Fascin overexpression in nasal mucosa in patients with chronic rhinosinusitis with and without nasal polyps

Jornal Brasileiro de Patologia e Medicina Laboratorial ◽

10.5935/1676-2444.20200007 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Anton S. Tkachenko ◽

Galina I. Gubina-Vakulyck ◽

Anatolii I. Onishchenko ◽

Iulii M. Kalashnyk ◽

Yaroslava O. Butko ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Mucosa ◽

Nasal Polyps

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Long-lasting clinical, radiological and immunological remission of severe nasal polyposis by means of ‘reboot’ surgery

BMJ Case Reports ◽

10.1136/bcr-2019-233726 ◽

2020 ◽

Vol 13 (4) ◽

pp. e233726

Author(s):

Luca Malvezzi ◽

Francesca Pirola ◽

Armando De Virgilio ◽

Enrico Heffler

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Mucosa ◽

Nasal Polyps ◽

Nasal Polyposis ◽

Surgical Techniques ◽

Remarkable Improvement ◽

History Of ◽

Mucosal Oedema ◽

Effective Instrument ◽

Nasal Biopsy

A 68-year-old woman with a long history of relapsing chronic rhinosinusitis with nasal polyps (CRSwNP) underwent a complete reboot surgery and nasal biopsy prior to and after surgery. Remarkable improvement of symptoms and no signs of mucosal oedema and no complaints of initially worsening nasal functions were still present 12 months after reboot surgery. Biopsy demonstrated an outstanding reduction in eosinophilic infiltration and re-epithelisation of nasal mucosa with normal features after reboot approach compared with previous surgeries. Therefore, reboot approach may become an effective instrument in plurioperated patients with CRSwNP who suffer from a nasal condition that is recalcitrant to pharmacological therapies and is unsatisfactorily treated by standard surgical techniques.

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Vimentin Expression in Nasal Mucosa of Patients with Exacerbated Chronic Rhinosinusitis Without Nasal Polyps

Acta Medica Bulgarica ◽

10.2478/amb-2019-0007 ◽

2019 ◽

Vol 46 (1) ◽

pp. 39-42

Author(s):

A. I. Onishchenko ◽

A. S. Tkachenko ◽

I. M. Kalashnyk ◽

V. L. Tkachenko ◽

O. A. Nakonechna ◽

...

Keyword(s):

Blood Serum ◽

Chronic Rhinosinusitis ◽

Nasal Mucosa ◽

Nasal Polyps ◽

Epithelial To Mesenchymal Transition ◽

Serum Levels ◽

Immunohistochemical Method ◽

Control Group ◽

Vimentin Expression ◽

Mesenchymal Transition

Abstract Objective. The aim of the study was to evaluate vimentin expression in inflamed nasal mucosa of patients with chronic rhinosinusitis without nasal polyps (CRSsNP) and serum levels of matrix metalloproteinase-9 (MMP-9). Material and Methods. We measured concentrations of MMP-9 in blood serum of twenty patients with CRSsNP using ELISA and compared them with the control group composed of twenty healthy subjects. Vimentin expression in nasal mucosa was studied by an immunohistochemical method. Results. Blood serum levels of MMP-9 were found to be elevated in patients with CRSsNP. The disease was also associated with the upregulation of vimentin expression both in the lamina propria and nasal epithelial layer. Conclusion. CRSsNP is accompanied by a higher number of vimentin-expressing cells in the nasal epithelium, which may indicate their epithelial-to-mesenchymal transition (EMT). We speculate that MMP-9 may contribute to the increased rate of EMT of nasal epithelial cells in CRSsNP.

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