Epidemiological and immunological study of nasal polyposis among allergic patients in Babylon province: Cross-sectional study (original) (raw)
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Nasal Polyposis and Allergy: Is There a Correlation?
American Journal of Rhinology, 2001
Nasal polyposis (NP) is a chronic inflammatory disease of the nasal mucosa. The etiology and formation of NP are still not elucidated and have been debated for many years. The objective of the present study was to investigate the role of nasal allergy in the development of NP. The following aspects were analyzed: age, sex, and patient's symptoms; correlation between asthma, aspirin intolerance, and NP; serum immunoglobulin levels and eosinophil; and concentration of interleukins 1β, 3, and 4 in NP. Thirty-nine patients with NP were selected, 13 of them allergic and 26 non-allergic. A control group of 11 individuals was also studied. The concentrations of interleukins 1β, 3, and 4 were measured by enzyme-linked immunosorbent assay (ELISA). There was a higher incidence of NP after the fourth decade of life and among men. We found no correlation of asthma or aspirin intolerance with the presence or absence of allergy. Serum levels of IgE and eosinophils were significantly higher in...
Airway inflammation in nasal polyposis: immunopathological aspects of relation to asthma
Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 2005
Background Nasal polyposis (NP) is a chronic inflammatory disorder of the upper respiratory tract, which is often coexist with asthma. However, the pathogenesis of especially in patients with NP is still a matter of debate. Objective To better understand the immunopathologic mechanism involved in this relationship, we investigated the inflammatory cell profiles in bronchial and nasal tissues of patients with NP alone and with concomitant asthma. Methods Seventeen patients with NP (six male, 11 female, age range: 19-63, mean age: 38.29 AE 13.27 years) were selected for the study. Subjects were divided into two groups based on the presence of asthma or bronchial hyper-responsiveness (BHR). NP without BHR (Group 1) (n 5 8), NP and asthma or BHR (Group 2) (n 5 9). All patients underwent atopy evaluation including detailed history, skin prick test (SPT), total and specific IgE determination in sera. None of the subjects had taken inhaled, nasal or oral corticosteroids for at least 1 month before the study. Respiratory symptoms of asthmatic patients were controlled with only short acting b 2 -agonist inhaler drugs as needed. NP tissue, nasal and bronchial mucosa biopsies were taken from all patients using fiberoptic endoscopy. CD3, CD8, CD16, CD68, AA1 (mast cell tryptase), human leucocyte antigen-DR (HLA-DR) and eosinophil peroxidase (EPO) expressing cells in specimens were determined by immunohistochemical methods. Positively staining inflammatory cell types were counted. Subepithelial lamina propria and periglandular areas were separately evaluated. Results No significant difference was found in polyp tissue, nasal and bronchial CD3 1 , CD8 1 , CD16 1 , CD68 1 , AA1 1 , HLA-DR 1 and EPO 1 positive cells between groups. There were significantly higher numbers of CD8 1 , CD16 1 , HLA-DR 1 , EPO 1 cells in the polyp tissue and nasal mucosa vs. the bronchial mucosa in all groups (Po0.05). However, CD8 1 cells were significantly increased in the polyp tissue and bronchial mucosa of patients with NP alone when compared with the patients with both asthma and NP (Po0.05). CD3 1 , CD68 1 and CD16 1 cell counts were tended to be higher within the nasal polyp tissue of patients with isolated NP compared with counts within nasal and bronchial mucosa of patients with NP and asthma. Also, patients with isolated NP showed more HLA-DR 1 cells in the nasal polyp tissue and nasal mucosa than those of patients with NP and asthma. Immunoreactivity for EPO 1 eosinophils within the nasal and bronchial mucosa was more prominent in patients with NP and asthma compared with patients with NP alone. The number of EPO 1 eosinophils within the polyp tissue, nasal and bronchial mucosa was higher in the skin prick test negative (SPT À ve) group than the SPT positive (SPT 1ve) ones. Conclusions Our results demonstrate that infiltration of inflammatory cells in the nasal and the lower airways do not remarkably differ between patients with NP alone who has no evidence of BHR and asthmatic patients with NP. However, patients with SPT À ve NP reveal more intense eosinophilic inflammation in the entire respiratory mucosa.
Allergenic Profi le of Nasal Polyposis
2000
■ Abstract Background: Nasal polyposis is highly prevalent in the general population. Its exact origin is unknown, although several factors are involved in the etiology and development of this condition. Clinical patterns, a history of atopy, environmental exposure, eosinophil-mediated infl ammation, the presence of infl ammatory mediators, and sensitization to some allergens indicate that nasal polyposis is associated with allergic
American Journal of Rhinology, 2006
Background It is considered that allergy, at least in some cases, is associated with nasal polyps and affects recurrence rate. Our purpose was to determine the effects of aeroallergen hypersensitization on therapeutic response of eosinophil- and noneosinophil-dominated inflammation. Methods Sixty-eight patients were enrolled. Histopathological investigation and a skin-prick test were done and categorized as eosinophil-dominated inflammation with positive (ESPT+) or negative skin test (ESPT-) and nonesoinophil-dominated inflammation with positive (NESPT+) or negative skin test (NESPT-). Patients were treated over 6 weeks with budesonide nasal spray, 400 μg/day. At 0, 3, and 6 weeks after treatment, nasal symptoms, polyp size, nasal and oral peak expiratory flow (PEF) index and overall assessment within and between groups were evaluated and compared. Results At 3 and 6 weeks after treatment, the ESPT- group showed the most, and the NESPT+ group showed the least therapeutic improvement...
Inflammatory mediators and eosinophilia in atopic and non-atopic patients with nasal polyposis
Biomedicine & Pharmacotherapy, 2005
Nasal polyps are characterized by eosinophilic infiltration and presence of inflammatory mediators, such as total IgE, eosinophil cationic protein (ECP) and cytokines. The role of atopy in nasal polyp pathogenesis is still unclear. Therefore, we evaluated serum IgE levels, nasal mucus concentrations of ECP and cytokines and the number of infiltrating eosinophils in nasal tissue of polyps from atopic and non-atopic patients. Samples were obtained from a randomized population of 31 patients with nasal polyposis having endonasal sinus surgery and of 13 control subjects undergone corrective surgery of the nasal septum. On the basis of medical history of allergy, positive skin-prick tests and total IgE levels, patients with polyposis were divided in atopic (n = 13) and non-atopic (n = 18) patients. We determined levels of IgE in blood, ECP and cytokines (IL-4, IL-6, IL-8, IFN-c and IL-2) in nasal mucus, and number of infiltrating eosinophils in nasal tissue. The concentrations of total IgE, ECP, IL-4 and IL-8 and eosinophilia were significantly higher in all patients with nasal polyps compared with controls. Inside, all patients with nasal polyposis showed lower levels of IL-6, IFN-c and IL-2 compared with controls. The atopic patients showed significant differences when compared with non-atopic patients for the higher concentrations of total IgE (698.80 ± 322.24 vs. 279.63 ± 234.11; P < 0.0001) and IL-8 (1437.2 pg/ml ± 1250.7 vs. 605.5 pg/ml ± 481.1; P < 0.015). These findings suggest that inflammation still remains the major factor in the etiology of nasal polyposis and show different levels of inflammatory mediators into atopic and non-atopic patients.
Eosinophilic Inflammation in Allergic Rhinitis and Nasal Polyposis
Archives of Industrial Hygiene and Toxicology, 2000
On histopathological examination, nasal polyps and nasal mucosa in allergic rhinitis show different forms of pseudostratifi ed respiratory epithelium, whereas the dominant characteristic of lamina propria is an eosinophilic infi ltration. The aim of this study was to compare interleukin (IL)-5 and eosinophilic cationic protein (ECP) levels in the nasal fl uid of 42 patients: 12 with allergic rhinitis and nasal septal deviation, 17 non-atopic patients with nasal polyposis, and 13 atopic nasal polyp patients were enrolled in this crosssectional study. Nasal secretion samples were collected a few days before surgery. The levels of IL-5 were measured using fl ow cytometry and the ECP using a commercial ELISA kit. In addition, we counted eosinophils in hematoxylin-and-eosin-stained sections of all nasal polyp and all nasal mucosa samples taken from the inferior nasal turbinates during septoplasty. A signifi cantly higher concentration of IL-5 was found in the nasal fl uid of atopic patients with nasal polyposis than in non-atopic nasal polyp patients (p=0.025) and patients with allergic rhinitis (p=0.05). ECP was higher in atopic nasal polyp patients than in patients with allergic rhinitis (p<0.0001) and than in non-atopic nasal polyp patients (p<0.0001). Polyp eosinophils were higher in atopic' than in non-atopic patients (p<0.0001) and higher than in the mucosa of patients with allergic rhinitis (p<0.0001). These however had signifi cantly more mucosal eosinophils than was found in the polyps of non-atopic patients' (p=0.025). ECP levels in nasal fl uid and eosinophil counts in tissue specimens correlated well in all three groups of patients. Our study has shown that atopic nasal polyp patients have a higher level of eosinophilic infl ammation than non-atopic patients with nasal polyps and patients with allergic rhinitis. KEY WORDS: eosinophilic cationic protein, eosinophils, epithelium, interleukin-5, nasal fl uid Perić A, et al. INFLAMMATORY MEDIATORS IN ALLERGIC RHINITIS AND NASAL POLYPOSIS Arh Hig Rada Tokiskol 2011;62:341-348 KLJUČNE RIJEČI: eozinofi li, eozinofi lni kationski protein, epitel, interleukin 5, nosni sekret
Allergologia et Immunopathologia, 2011
Background/Aims: Concentrations of mediators in nasal secretions could reflect the inflammatory status of the nasal mucosa and evolution of sinus disease. So, the aim of our study was to evaluate local immune reaction by measuring crucial Th1, Th2 and inflammatory cytokines in nasal fluid samples of patients with nasal polyps (NP), and to correlate them to clinical, radiological findings and to the degree of eosinophil infiltration of polyp tissue. Therefore, in our study we compared the cytokine levels in nasal fluid of asthmatic and non-asthmatic patients with nasal polyposis, the eosinophil counts in NP tissues of these patients, and we correlated cytokine levels with eosinophil counts in NP tissue specimens. Material and methods: Thirty patients with nasal polyposis (NP) (15 asthmatic and 15 nonasthmatic) were included in this prospective study. Nasal secretion samples were collected from nasal cavities of all subjects. The levels of 11 cytokines (TNF-␣, TNF-, IL-1, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, and IFN-␥) were measured using commercial flow cytometric kit. Eosinophils were counted in haematoxylin-and-eosin-stained NP sections. Results: The concentrations of Th2 cytokines IL-5, IL-6, IL-10, and Th1 cytokine IFN-␥ were significantly higher in patients with NP and asthma compared with non-asthmatic subjects. A positive correlation was found between IL-6 and TNF-␣ levels in nasal fluid and eosinophil counts in polyp tissue in non-asthmatic subjects. In asthmatic NP patients, we found positive correlation between level of IL-6 and eosinophil counts and negative correlation between IFN-␥ level and number of eosinophils in NP tissue specimens. Conclusion: Our results showed that these patients with similar clinical findings had significantly different mediator profiles in their nasal secretions, implying clear differences in pathogenesis of their NP.