Inflammatory patterns of antrochoanal polyps in the pediatric age group
Tóm tắt
The pathogenesis and etiology of antrochoanal polyps (ACPs) remains obscure. This study aimed to characterize the inflammatory profiles and investigate the effect of atopy on the pathogenesis of pediatric ACPs. Thirty-three ACP patients and ten control subjects were enrolled from January to December 2017. The severity of individual nasal symptoms was scored on a visual analogue scale (VAS). The serum total immunoglobulin E (IgE) and cytokines level was measured by multiplexed luminex assay. There was no significant difference in VAS scores and counts of inflammatory cells between atopic and nonatopic ACP. No difference in IFNγ, IL-4, IL-5, IL-13, IL-17A and IL-25 was found between control and whole ACP, nonatopic and atopic ACP. Significantly increased levels of IL-6 and IL-10 were found in ACP compared with control. For neutrophil chemotactic factor, significant increases of IL-8 and GRO were observed in ACP, but for eosinophil chemotactic factor, no difference was found in RANTES and GM-CSF. IL-6 level was positively correlated with IL-8, MCP1, and GRO level, and IL-10 level was positively correlated with IL-4 and IL-13 in ACP subjects. Nasal obstruction was the most common symptom in ACPs in children. Allergic condition may have a poor role in the pathogenesis of ACPs. IL-6 plays a crucial role in the pathogenesis of neutrophilic inflammation in patients with ACPs and may provide a new treatment strategy for ACPs in children. Treg cell associated cytokine IL-10 was involved in the inflammatory pathophysiological process of ACPs and played a certain regulatory role.
Tài liệu tham khảo
Yaman H, Yilmaz S, Karali E, Guclu E, Ozturk O. Evaluation and management of antrochoanal polyps. Clin Exp Otorhinolaryngol. 2010;3(2):110–4.
Aydin S, Taskin U, Orhan I, Altas B, Oktay MF, Toksoz M, et al. The analysis of the maxillary sinus volumes and the nasal septal deviation in patients with antrochoanal polyps. Eur Arch Otorhinolaryngol. 2015;272(11):3347–52.
El-Sharkawy AA. Endoscopic management of paediatric antrochoanal polyp: our experience. Acta Otorhinolaryngol Ital. 2013;33(2):107–11.
Galluzzi F, Pignataro L, Maddalone M, Garavello W. Recurrences of surgery for antrochoanal polyps in children: a systematic review. Int J Pediatr Otorhinolaryngol. 2018;106:26–30.
Choudhury N, Hariri A, Saleh H. Endoscopic management of antrochoanal polyps: a single UK centre’s experience. Eur Arch Otorhinolaryngol. 2015;272(9):2305–11.
Myatt HM, Cabrera M. Bilateral antrochonanal polyps in a child: a case report. J Laryngol Otol. 1996;110(3):272–4.
Yamashiro Y, Nakamura M, Huang GW, Kosugi T. Presence of urokinase-type plasminogen activator (u-PA) in tissue extracts of antrochoanal polyp. Laryngoscope. 1992;102(9):1049–52.
Al-Mazrou KA, Bukhari M, Al-Fayez AI. Characteristics of antrochoanal polyps in the pediatric age group. Ann Thorac Med. 2009;4(3):133–6.
Li CW, Zhang KK, Li TY, Lin ZB, Li YY, Curotto de Lafaille MA, et al. Expression profiles of regulatory and helper T-cell-associated genes in nasal polyposis. Allergy. 2012;67(6):732–40.
Wen W, Liu W, Zhang L, Bai J, Fan Y, Xia W, et al. Increased neutrophilia in nasal polyps reduces the response to oral corticosteroid therapy. J Allergy Clin Immunol. 2012;129(6):1522–8.
Cao PP, Zhang YN, Liao B, Ma J, Wang BF, Wang H, et al. Increased local IgE production induced by common aeroallergens and phenotypic alteration of mast cells in Chinese eosinophilic, but not non-eosinophilic, chronic rhinosinusitis with nasal polyps. Clin Exp Allergy. 2014;44(5):690–700.
Lee DH, Yoon TM, Lee JK, Lim SC. Difference of antrochoanal polyp between children and adults. Int J Pediatr Otorhinolaryngol. 2016;84:143–6.
Nikakhlagh S, Rahim F, Saki N, Mohammadi H, Maliheh YM. Antrochoanal polyps: report of 94 cases and review the literature. Niger J Med. 2012;21(2):156–9.
Yuca K, Bayram I, Kiroglu AF, Etlik O, Cankaya H, Sakin F, et al. Evaluation and treatment of antrochoanal polyps. J Otolaryngol. 2006;35(6):420–3.
Maldonado M, Martinez A, Alobid I, Mullol J. The antrochoanal polyp. Rhinology. 2004;42(4):178–82.
Yasmin T, Ghafoor F, Malik T, Khan AU. Pattern of thyroid autoimmunity in type 1 and type 2 diabetics. J Coll Physicians Surg Pak. 2006;16(12):751–4.
Wang BF, Cao PP, Long XB, Zhang XH, Xu K, Cui YH, et al. Distinct mucosal immunopathologic profiles in atopic and nonatopic chronic rhinosinusitis without nasal polyps in Central China. Int Forum Allergy Rhinol. 2016;6(10):1013–9.
Konig K, Klemens C, Haack M, Nicolo MS, Becker S, Kramer MF, et al. Cytokine patterns in nasal secretion of non-atopic patients distinguish between chronic rhinosinusitis with or without nasal polys. Allergy Asthma Clin Immunol. 2016;12:19.
Kaplan AP. Chemokines, chemokine receptors and allergy. Int Arch Allergy Immunol. 2001;124(4):423–31.
Pawankar R. Nasal polyposis: an update: editorial review. Curr Opin Allergy Clin Immunol. 2003;3(1):1–6.
Leitner G, Loidolt H, Greinix HT, Hocker P, Dettke M. Granulocyte colony-stimulating factor-induced allogeneic peripheral stem cell donation during early pregnancy. Br J Haematol. 2001;115(1):233–4.
Hirano T, Matsuda T, Turner M, Miyasaka N, Buchan G, Tang B, et al. Excessive production of interleukin 6/B cell stimulatory factor-2 in rheumatoid arthritis. Eur J Immunol. 1988;18(11):1797–801.
Houssiau FA, Devogelaer JP, Van Damme J, de Deuxchaisnes CN, Van Snick J. Interleukin-6 in synovial fluid and serum of patients with rheumatoid arthritis and other inflammatory arthritides. Arthritis Rheum. 1988;31(6):784–8.
Atreya R, Mudter J, Finotto S, Mullberg J, Jostock T, Wirtz S, et al. Blockade of interleukin 6 trans signaling suppresses T-cell resistance against apoptosis in chronic intestinal inflammation: evidence in crohn disease and experimental colitis in vivo. Nat Med. 2000;6(5):583–8.
Danielsen A, Tynning T, Brokstad KA, Olofsson J, Davidsson A. Interleukin 5, IL6, IL12, IFN-gamma, RANTES and Fractalkine in human nasal polyps, turbinate mucosa and serum. Eur Arch Otorhinolaryngol. 2006;263(3):282–9.
Palomares O, Yaman G, Azkur AK, Akkoc T, Akdis M, Akdis CA. Role of Treg in immune regulation of allergic diseases. Eur J Immunol. 2010;40(5):1232–40.
Stevens WW, Lee RJ, Schleimer RP, Cohen NA. Chronic rhinosinusitis pathogenesis. J Allergy Clin Immunol. 2015;136(6):1442–53.
Jin P, Zi X, Charn TC, Liu J, Yan Y, Shi L, et al. Histopathological features of antrochoanal polyps in Chinese patients. Rhinology. 2018;56(4):378–85.