GM‐CSF, IL‐5 and RANTES immunoreactivity and mRNA expression in chronic hyperplastic sinusitis with nasal polyposis (NP)

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<jats:sec><jats:title>Background</jats:title><jats:p>Eosinophils are a prominent feature of chronic hyperplastic sinusitis with nasal polyposis (CHS/NP). Our previous studies showed that their presence was associated with the expression of GM‐CSF and RANTES mRNA. In allergic NP, increased expression of IL‐5 was also found.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>We wished to examine cytokine immunoreactivity for IL‐5, GM‐CSF and RANTES mRNA in allergic and non‐allergic NP and compare immunoreactivity with expression of cytokine mRNA by <jats:italic>in situ</jats:italic> hybridization.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>NP were obtained from five allergic and eight non‐allergic subjects with CHS/NP. Middle turbinate tissue from eight normal subjects were used as controls. Cell‐associated cytokine mRNA was detected by <jats:italic>in situ</jats:italic> hybridization (ISH). Cytokine immunoreactive cells were enumerated by immunostaining. Colocalization immunostaining was also performed to identify specific cell types producing IL‐5.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Immunostaining for GM‐CSF, IL‐5 and RANTES protein was increased in both allergic and non‐allergic NP compared with control middle turbinates. Allergic polyps contained greater numbers of IL‐5 immunoreactive cells (<jats:italic>P</jats:italic> = 0.01), whereas non‐allergic polyps contained greater numbers of GM‐CSF immunoreactive cells (<jats:italic>P</jats:italic> = 0.04). Immunostaining was primarily associated with inflammatory cells, but immunostaining for RANTES and, to a lesser extent GM‐CSF, was also seen in the epithelium. The density of immunoreactive cells was variably correlated with cytokine mRNA<jats:sup>+</jats:sup> cells (GM‐CSF: R = 0.56, <jats:italic>P</jats:italic> = 0.05; IL‐5: R = 0.76, <jats:italic>P</jats:italic> = 0.003; and RANTES: R = 0.89, <jats:italic>P</jats:italic> = 0.0005). Colocalization immunostaining revealed that the majority of IL‐5 immunoreactive cells in both allergic and non‐allergic NP were T lymphocytes. However, allergic NP contained greater numbers of IL‐5<jats:sup>+</jats:sup>/CD3<jats:sup>+</jats:sup> T lymphocytes and IL‐5<jats:sup>+</jats:sup> mast cells, whereas non‐allergic NP contained greater numbers of IL‐5<jats:sup>+</jats:sup> eosinophils.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>We conclude that GM‐CSF, IL‐5 and RANTES are produced in increased amounts in both allergic and non‐allergic NP. Distinguishing features of non‐allergic NP include fewer numbers of CD3 T lymphocytes, fewer IL‐5<jats:sup>+</jats:sup>/CD3<jats:sup>+</jats:sup> T lymphocytes and greater numbers of IL‐5<jats:sup>+</jats:sup> eosinophils. These differences may suggest different mechanisms of eosinophil accumulation and activation in allergic vs non‐allergic NP.</jats:p></jats:sec>

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