Chronic rhinosinusitis is a common disease and frequently encountered disease in otolaryngology, but the therapeutic effect is not ideal. While its pathogenesis is exploring in the continuously. Found in the recent years, Th17 cells are a new subset of T cells and closely related with inflammatory disorders, autoimmune diseases and cancer. Its differentiation, regulation and biological effects are widely noted as a hot area of research. This review explores the discovery of differentiation and regulation of Th17 cells, the relationship between related cytokines and chronic rhinosinusitis, in order to have a beteer knowledge of chronic rhinosinusitis. This review regards Th17 cells as the main clue, nevertheless, lacking consideration of the impacts of other factors on chronic rhinosinusitis.
Chronic Disease ; Humans ; Rhinitis ; immunology ; Sinusitis ; immunology ; Th17 Cells ; immunology

Since the last decade, new insights into inflammatory processes have become possible by investigating the pattern of cytokines in acute and chronic sinus diseases. This review aims to update and discuss the findings of in vitro and in vivo studies concerning the role of cytokines in sinusitis and nasal polyposis. The proinflammatory cytokines interleukin-1beta, interleukin-6 and the neutrophil-chemoattractant interleukin-8 may play a major role in acute sinusitis, as shown in viral and allergic rhinitis. In chronic sinusitis interleukin-3 dominates the cytokine profiles, giving support to a variety of inflammatory cells. Interleukin-5 is a key protein in the pathogenesis of nasal polyposis. Activation and survival of eosinophils in nasal polyps are thought to be regulated by interleukin-5. Further investigation of cytokine expression patterns in inflammatory sinus diseases will lead to a better understanding of their pathogenesis and to a development of new therapeutic modality.
Acute Disease ; Chronic Disease ; Cytokines/immunology* ; Human ; Polyps/immunology ; Rhinitis/immunology* ; Sinusitis/immunology*

Since the last decade, new insights into inflammatory processes have become possible by investigating the pattern of cytokines in acute and chronic sinus diseases. This review aims to update and discuss the findings of in vitro and in vivo studies concerning the role of cytokines in sinusitis and nasal polyposis. The proinflammatory cytokines interleukin-1beta, interleukin-6 and the neutrophil-chemoattractant interleukin-8 may play a major role in acute sinusitis, as shown in viral and allergic rhinitis. In chronic sinusitis interleukin-3 dominates the cytokine profiles, giving support to a variety of inflammatory cells. Interleukin-5 is a key protein in the pathogenesis of nasal polyposis. Activation and survival of eosinophils in nasal polyps are thought to be regulated by interleukin-5. Further investigation of cytokine expression patterns in inflammatory sinus diseases will lead to a better understanding of their pathogenesis and to a development of new therapeutic modality.
Acute Disease ; Chronic Disease ; Cytokines/immunology* ; Human ; Polyps/immunology ; Rhinitis/immunology* ; Sinusitis/immunology*

The purpose of this review is to explain the function of LL-37 in the pathogenesis of chronic sinusitis. LL-37 is the only human cathelicidin identified so far. LL-37 is an integral part of the innate immune,the role of which in chronic sinusitis is attracting more and more s attention.
Cathelicidins ; metabolism ; Chronic Disease ; Humans ; Sinusitis ; immunology ; metabolism ; pathology

China ; Chronic Disease ; Humans ; Phenotype ; Rhinitis ; genetics ; immunology ; Sinusitis ; genetics ; immunology

OBJECTIVE: To investigate the clinical relationship between allergic rhinitis and allergic factors with chronic rhinosinusitis with or without nasal polyps. METHOD: Two hundred patients were divided into A and B two groups. Group A of 110 patients was diagnosed allergic rhinitis. Group B of 90 patients was diagnosed chronic sinusitis with or without nasal polyps. Serums sIgE was detected with EUROIMMUN, and observe the recurrence rate of chronic sinusitis with or without nasal polyps patients who accept operation treatment and observe the incidence of allergic rhinitis superinduced chronic sinusitis with or without nasal polyps. RESULT: The total positive rate of group A sIgE was 89.09%. The total positive rate of group B sIgE was 74.44%. The postoperative recurrence rate of sIgE positive group was 58.21% and the postoperative recurrence rate of sIgE negative group was 8.70% in the group B. In the group A, the positive rate of serums sIgE in allergic rhinitis with chronic sinusitis with or without nasal polyps (37.27%) was 97.56%, while the positive rate of serums sIgE in allergic rhinitis without chronic sinusitis (62.73%) was 79.71%, there is a significant difference in allergic rhinitis with or without chronic sinusitis (χ2 = 6.96, P < 0.01). CONCLUSION There is a certain correlation between allergic rhinitis and allergic factors with chronic sinusitis with or without nasal polyps. Therefore, through avoiding allergen exposure, the treatment of allergic rhinitis can effectively control recurrence rate of chronic sinusitis and nasal polyp.
Adult ; Chronic Disease ; Humans ; Immunoglobulin E ; blood ; Nasal Polyps ; complications ; immunology ; Recurrence ; Rhinitis, Allergic ; complications ; immunology ; Sinusitis ; complications ; immunology

OBJECTIVETo differentiate between Aspergillus species and Mucorales of fungal sinusitis by immunohistochemistry.

METHODSFormalin-fixed paraffin-embedded tissue blocks of 66 cases of fungal sinusitis were retrieved from the archival files of Department of Pathology of Beijing Tongren Hospital during the period from 2001 to 2006. The samples included 29 cases of fungal balls, 12 cases of allergic fungal sinusitis, 24 cases of chronic invasive fungal sinusitis and 1 case of acute invasive fungal sinusitis. The types of fungi were 44 Aspergillus species (31 cases of A. fumigatus, 7 cases of A. flavus and 6 cases of A. terreus) and 22 Mucorales (14 cases of Mucor species and 8 cases of Rhizopus species). Immunohistochemistry was performed with MUC2, MUC5AC and MUC5B antibodies. The results were compared with histochemical study for periodic acid-Schiff (PAS) and Grocott methenamine silver (GMS) stains.

RESULTSImmunohistochemical study for MUC5B showed that the positive rate of Aspergillus species was 90.9%, in contrast to 4.5% in Mucorales (P < 0.001). The expression of MUC2 and MUC5AC was completely negative, whereas PAS and GMS stains were positive in all cases.

CONCLUSIONMUC5B antibody appears to be a useful immunohistochemical marker for identifying fungal types in tissue sections, especially in distinguishing between Aspergillus species and Mucorales in fungal sinusitis.

Antibodies, Fungal ; immunology ; Antibody Specificity ; immunology ; Aspergillosis ; diagnosis ; immunology ; Aspergillus flavus ; immunology ; Aspergillus fumigatus ; immunology ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; methods ; Mucin-5B ; genetics ; immunology ; Mucor ; immunology ; Mycoses ; diagnosis ; immunology ; microbiology ; Sinusitis ; diagnosis ; microbiology

OBJECTIVE: To detect the expression of Th17 nuclear factor RORC and cytokines IL-17A and IL-22 and neutrophil marker MPO and their correlations with CRSsNP. METHOD: RT-PCR was used to detect mRNA expression of RORC, IL-17A and IL-22. Immunohistochemistry was used to assess the IL-17A positive cells in CRSsNP and control. ELISA was used to detect the expression of MPO. RESULT: CRSsNP had higher mRNA expression of RORC, IL-17A and IL-22 and increased protein expression of MPO. The mRNA expression of RORC, IL-17A and IL-22 was positively correlated with each other but none of them was correlated with the expression of MPO in CRSsNP and control. CONCLUSION Both Th17 and neutrophils contribute to the pathogenesis of CRSsNP, however, the neutrophil infiltration may not be recruited by Th17 cytokines.
Adult ; Chronic Disease ; Female ; Humans ; Interleukin-17 ; immunology ; Interleukins ; immunology ; Male ; Middle Aged ; Neutrophil Infiltration ; Neutrophils ; immunology ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; immunology ; Sinusitis ; immunology ; Th17 Cells ; immunology

OBJECTIVETo develop a mouse model of bacterial rhinosinusitis superposed on allergic rhinitis (AR), and to explore whether ongoing allergic rhinitis enhance the acute sinus infection and inflammation associated with Streptococcus pneumoniae (SP).

METHODSFourty mice of C57BL6/J were randomly divided on average into 4 groups: A [ovalbumin (OVA) + SP], B [OVA + normal saline (NS)], C [phosphate buffered solution (PBS) + SP] and D (PBS + NS). (1) Group A and B were sensitized by intraperitoneal injection with 200 microl (10%) OVA on days 1 through 9, and exposed to OVA (6%) intranasally on days 10 through 17, to induce allergic inflammation. OVA was replaced with PBS in group C and D in the same way. (2) Subsequently, group A and C were inoculated with SP intranasally on day 13, and NS was used in group B and D. On the 6th day after inoculation, mice were killed. Blood was collected from the orbital venous sinus after anesthesia. The heads were embedded with paraffin and serial sections were followed and stained with hematoxylin-eosin and toluidine blue (0.5%) for histological analysis and inflammation cells count. The number of polymorphonuclear neutrophils (PMN) and eosinophils (EOS) per square millimeter of sinus mucosa were calculated by using a computer-aided special software under microscope.

RESULTSAR models were successfully established in 9 mice from group A and 8 from group B. Histologic examination of the sinus from group A and B revealed significant mucosal edema and dilated venules. The symptoms were mild in group C, and no symptom was observed in group D. PMN (x +/- s) in group A (139.3 +/- 26.5)/mm2 was significantly higher than that in group B (70.7 +/- 16.7)/mm2, C (63.0 +/- 14.7)/mm2 and D (40.2 +/- 14.1)/mm2 respectively (P < 0.01); EOS and serous IL-5 level in group A (134.6 +/- 25.5)/mm2, (48.2 +/- 13.9) pg/ml and B (116.2 +/- 25.2)/mm2, (40.8 +/- 7.8) pg/ml, were higher than that in group C (16.7 +/- 2.7)/mm2, (23.9 +/- 8.7) pg/ml (P < 0.05) and D (13.4 +/- 4.9)/mm2, (24.6 +/- 6.5) pg/ml (P < 0.05).

CONCLUSIONSThe data demonstrate that an ongoing local allergic response augments bacterial infection in mice, and allergic sensitization alone without SP does not induce the sinus infection.

Animals ; Disease Models, Animal ; Eosinophils ; immunology ; Interleukin-5 ; blood ; immunology ; Mice ; Mice, Inbred C57BL ; Neutrophils ; immunology ; Pneumococcal Infections ; Rhinitis, Allergic, Perennial ; microbiology ; Sinusitis ; microbiology

OBJECTIVE: To explore the role of the innate immune factors TLR2 and TLR4 in the pathogenesis of chronic rhinosinusitis (CRS) by detecting their expression in different clinical types of CRS and the normal control group. METHOD: Immunohistochemistry was used to detect the expression of TLR2 and TLR4 respectively in 21 cases (chronic rhinosinusitis with nasal polyps, CRSwNP) group, 15 cases (chronic rhinosinusitis without nasal polyos, CRSsNP) group, 11 cases recurrent CRSwNP group and 13 cases control group. Positive cells were counted under the microscope artificially, Mann-Whitney U analysis was applied for the ranked data, and one-way anova analysis was adopted to analyze the experimental group and control group. RESULT: (1) TLR2 and TLR4 expression had the same characteristics. Expression mainly concentrated in parts of the whole layer of epithelial basement membrane, cytoplasm of glandular cells, very few inflammatory cells such as monocytes and plasma cells in the cytoplasm, sometimes unknown cell nuclei positive expression. (2) The glandular cells were stained manual counting and color grading. TLR2 and TLR4 packet application Wilcoxon rank test Mann-Whitney U test analysis was not statistically significant (P > 0.05), measurement data within the group variance statistical difference between the groups (P < 0.05). CONCLUSION The Nasal mucosa can produce the innate immune factors TLR2 and TLR4. The different expression of TLR2 and TLR4 in the various clinical types of CRS suggests that they play the certain role in the pathogenesis of CRS.
Chronic Disease ; Epithelial Cells ; immunology ; metabolism ; Female ; Humans ; Immunohistochemistry ; Male ; Nasal Mucosa ; immunology ; metabolism ; Nasal Polyps ; immunology ; metabolism ; Rhinitis ; immunology ; metabolism ; Sinusitis ; immunology ; metabolism ; Toll-Like Receptor 2 ; metabolism ; Toll-Like Receptor 4 ; metabolism