OBJECTIVETo detect the changing profiles of three factors in nasal fluid before and after endoscopic sinus surgery (ESS), including platelet derived growth factor (PDGF), tumour necrosis factor-alpha (TNF-alpha) and hyaluronic acid (HA), to investigate the predictive factor of healing quality after sinus surgery.

METHODSNasal secretions were obtained from 22 patients with nasal polyp before ESS and at 1, 4, 8, 12 weeks after ESS compared to 22 controls. Nasal fluid was analyzed by enzyme-linked immunosorbent assay (ELISA) for PDGF, TNF-alpha and HA. The healing quality was evaluated at 1, 4, 8, 12 weeks postoperatively for every one. Finally, we performed a multiple logistic regression model to assess whether the healing quality was associated with age, gender, body mass, preoperative stage, and concentrations of PDGF, TNF-alpha, HA before ESS.

RESULTS1. Each factor before surgery showed different level when compared to controls, PDGF was constant, TNF-alpha was high (P = 0.034), and HA was low (P = 0.003). Comparing patients at 1 week after surgery with control subjects, a significant increase in the concentrations of PDGF, TNF-alpha, HA in nasal secretions could be demonstrated (compared to controls, P = 0.000, 0.020, 0.038, respectively). After that, decreasing amounts of these factors were found, reaching normal conditions at 12 weeks for PDGF (compared to controls, P = 0.087), 8 weeks for TNF-alpha (compared to controls, P =0.104), 4 weeks for HA (compared to controls, P = 0.304). There was another peak for TNF-alpha at 12 weeks (compared to controls, P = 0.002). 2. The percentage of good healing at 1, 4, 8, 12 week postoperatively was 0, 4.5%, 36.4%, 81.8%, respectively. The healing quality after ESS was significantly and independently correlated to the age of patient and preoperative PDGF concentrations in nasal secretions. The younger, the better healing. The lower PDGF concentration, the better healing.

CONCLUSIONSDuring the wound healing of nasal mucosa, the levels of PDGF, TNF-alpha, HA were different at each postoperative stage. Age and PDGF concentrations preoperatively were suitable factors to predict the healing quality after ESS.

Adolescent ; Adult ; Aged ; Body Fluids ; secretion ; Case-Control Studies ; Endoscopy ; Female ; Humans ; Hyaluronic Acid ; secretion ; Male ; Middle Aged ; Nasal Mucosa ; metabolism ; secretion ; Nasal Polyps ; metabolism ; surgery ; Platelet-Derived Growth Factor ; secretion ; Tumor Necrosis Factor-alpha ; secretion ; Young Adult

Since the early part of the twentieth century, many authors have claimed that eosinophilia is found in the nasal secretions and blood of patients with allergic diseases. This observation has now become an established fact, and recent evidence based on extensive investigation, suggests that the eosinophil may play an active role in allergic disease. Thus, we report changes in nasal eosinophils in a group of nasal allergy patients treated by specific hyposensitization. The following results were obtained; 1. Eosinophilia was noted in 52.8 percent of untreated nasal allergy patients. 2. The eosinophilic count was gradually decreased with increasing S.D.V.(specific desensitizing vaccine) hyposensitization.
Eosinophils* ; Hay Fever/pathology* ; Human ; Leukocyte Count ; Mucus/cytology ; Nasal Mucosa/secretion*

PURPOSE: The nasal mucosa is the first site to encounter pathogens, and it forms continuous barriers to various stimuli. This barrier function is very important in the innate defense mechanism. Additionally, inflammation of the nasal sinus is known to be a hypoxic condition. Here, we studied the effect of hypoxia on barrier function in normal human nasal epithelial (NHNE) cells. MATERIALS AND METHODS: The expression levels of various junction complex proteins were assessed in hypoxia-stimulated NHNE cells and human nasal mucosal tissues. We performed real-time polymerase chain reaction analysis, western blotting, and immunofluorescence assays to examine differences in the mRNA and protein expression of ZO-1, a tight junction protein, and E-cadherin in NHNE cells. Moreover, we evaluated the trans-epithelial resistance (TER) of NHNE cells under hypoxic conditions to check for changes in permeability. The expression of ZO-1 and E-cadherin was measured in human nasal mucosa samples by western blotting. RESULTS: Hypoxia time-dependently decreased the expression of ZO-1 and E-cadherin at the gene and protein levels. In addition, hypoxia decreased the TER of NHNE cells, which indicates increased permeability. Human nasal mucosa samples, which are supposed to be hypoxic, showed significantly decreased levels of ZO-1 and E-cadherin expression compared with control. CONCLUSION: Our results demonstrate that hypoxia altered the expression of junction complex molecules and increased epithelial permeability in human nasal epithelia. This suggests that hypoxia causes barrier dysfunction. Furthermore, it may be associated with innate immune dysfunction after encountering pathogens.
Anoxia/etiology/*metabolism ; Blotting, Western ; Cadherins/*analysis/genetics ; Epithelium/chemistry/pathology ; Humans ; Membrane Proteins/*analysis ; Nasal Mucosa/*chemistry/pathology/*secretion ; Permeability/*radiation effects ; RNA, Messenger/genetics/metabolism ; Real-Time Polymerase Chain Reaction ; Tight Junctions/*metabolism ; Zonula Occludens-1 Protein