Molecular biological analysis of eosinophilic sinusitis and otitis media

为了研究上呼吸道嗜酸性鼻窦炎和中耳炎的病理生理，我们测量了与粘膜嗜酸性粒细胞浸润相关的细胞因子或趋化因子mrna。从鼻窦炎患者的鼻息肉中提取RNA。使用BAS2000计算IL-5、IL-8、GM-CSF和Eotaxin mrna的初始量，并比较术后复发组和非复发组的mrna的初始量。与非复发组相比，复发组组织中嗜酸性粒细胞的平均浸润率有统计学意义。各细胞因子的表达率（%）分别为IL-5（100%）、IL-8（88%）、Eotaxin（53%）、GM-CSF(24%)，各组间表达率无差异。两组嗜酸性粒细胞浸润率与IL-5初始表达量有显著相关性。然而，Eotaxin或GM-CSF的表达与嗜酸性粒细胞浸润没有相关性。在复发性息肉中，嗜酸性粒细胞浸润率与初始Eotaxin量呈显著相关。此外，组内IL-5与Eotaxin mRNA表达有相关趋势。这些结果提示，IL-5和Eotaxin mrna的同时表达可能诱导上呼吸道嗜酸性粒细胞浸润数量增加，导致鼻息肉复发。接下来，我们研究了荧光三烯受体拮抗剂对嗜酸性鼻窦炎的作用。对34例常规药物治疗无效的患者使用白三烯受体拮抗剂Pranlukast 2个月。比较用药前后鼻部症状和体征。鼻漏、鼻后滴涕和易擤鼻的得分显著降低。鼻分泌物量、特征及鼻黏膜肿胀均有明显改善。这些结果提示嗜酸性粒细胞产生的白三烯可能与嗜酸性鼻窦炎的病理生理有关。少

To investigate the pathophysiology of eosinophilic sinusitis and otitis media in the upper airways, we have measured cytokine or chemokine mRNAs relevant to eosinophil infiltration in the mucosa. RNA was extracted from the nasal polyps of the subjects suffered from sinusitis. Initial amounts of mRNAs of IL-5, IL-8, GM-CSF, and Eotaxin were calculated using BAS2000 and they were comnpared between recurrent and non-recurrrent groups after surgery. An average of eosinophil infiltration rate in the tissue was statistically increased in the recurrent group compared to non-recurrent one. The expression rates of each cytokine (%) were IL-5(100%), IL-8(88%), Eotaxin(53%), and GM-CSF(24%), respectively and there were no differences in the expression rates between the groups. Eosinophil infiltration rate and initial amout of IL-5 expression showed significant correlation in both groups. However, no correlation was found between Eotaxin or GM-CSF expression and eosinophil infiltration. In recurre … More nt polyps, eosinophil infiltration rate and initial amout of Eotaxin showed significant correlation. Further, there was a trend in correlation between IL-5 and Eotaxin mRNA expressions in the group. These results suggest that the concomitant expressions of IL-5 and Eotaxin mRNAs may induce an increased number of eosinophil infiltration in the upper airways leading to the recurrence of nasal polyps.Next, we have investigated the effect of luekotriene receptor antagonist on eosinophilic sinusitis. An leukotriene receptor antagonist, Pranlukast, was administered for two months to 34 patients who did not respond routine medication. Nasal symptoms and signs were compared before and after medication. Significant reductions in scores were found in rhinorrea, postnasal drip, and easy to blow nose. Amount and character of nasal discharge, and swelling of nasal mucosa also showed significant improvement. These results indicate that leukotrienes produced from eosinophils may be relevant to pathophysiology of eosinophilic sinusitis. Less