OBJECTIVE To establish a reliable mouse eosinophilic chronic rhinosinusitis model,study the histological and immunological effects of glucocorticoids on type 2 inflammatory cells and factors in nasal mucosa,and provide an animal model basis for the biological treatment of CRS and related research of resistance to glucocorticoids in vivo.METHODS The CRS model group was treated with ovalbumin and Staphylococcal enterotoxins B.The dexamethasone intervention group received an additional weekly intraperitoneal injection of dexamethasone for 8 weeks.The expression of type-2 innate lymphoid cell(ILC2)in the nasal mucosa was detected with immunofluorescence and the expression of tryptase+mast cells,eosinophil cationic protein(ECP),IL-5,IL-25,and IL-33 in the nasal mucosa was detected with immunohistochemical.RESULTS The nasal mucosa eosinophils in the dexamethasone intervention group was lower than in the CRS model group(P<0.05).Thy-1+ST2+ILC2 cells in the dexamethasone intervention group were less than those of the CRS model group,and Thy-1+ST2+ILC2 cells were rare in the control group.Tryptase+mast cells were moderately positive in the CRS model group and weakly positive in the control group and in the dexamethasone intervention group.ECP and IL-5 were strongly positive in the CRS model group and weakly positive in the control group and the dexamethasone intervention group.IL-25 was moderately positive in the control group,strongly positive in the CRS model group,and weakly positive in the dexamethasone intervention group.IL-33 was weakly positive in the control group,while the CRS model group and the dexamethasone intervention group were strongly positive.CONCLUSION Intraperitoneal injection of dexamethasone reduce the number of eosinophils,Thy-1+ST2+ILC2 cells and tryptase+mast cells in the nasal mucosa of the mouse CRS model.It can also down-regulate the expression of ECP,IL-5,and IL-25 in tissues,but it does not have a significant effect on the expression of IL-33 in tissues.

Objective: To investigate the type 2 innate lymphoid cells (ILC2s) in eosinophilic nasal polyps, non-eosinophilic nasal polyps and controls, and to compare the characteristics of ILC2s indifferent types of nasal polyp. Methods: Flow cytometric analysis was used to quantify the ILC2s and Th2 cells in tissues from 19 patients with chronic rhinosinusitis with nasal polyp (CRSwNP) and 6 controls. The patients were classified into two groups as eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and non-eosinophilic chronic rhinosinusitis with nasal polyps (non-ECRSwNP) based on eosinophil counts under hematoxylin-eosin staining. ILC2 and Th2 cell frenquencies, measured as a percentage of CD45⁺ cells, were compared among ECRSwNP group (n=9), non-ECRSwNP group (n=10) and control group (n=6) using Mann-Whitney U test .The correlation between ILC2, Th2 cell frequencies and eosinophil count in tissues was analyzed using Pearson correlation coefficient. Results: ILC2 frequencies in ECRSwNP group were significantly higher than non-ECRSwNP group and controls ((0.051±0.025) vs (0.011±0.017), (0.051±0.025) vs (0.004±0.004), Z value was -3.185, -3.186, respectively, both P<0.05). There was no significant difference between ILC2 frequencies in non-ECRSwNP and controls ((0.011±0.017) vs (0.004±0.004), Z=-0.712, P=0.492). Th2 cell frequencies in ECRSwNP and non-ECRSwNP group were significantly higher than controls ((0.500±0.437) vs (0.106±0.102), (0.275±0.170) vs (0.106±0.102), Z value was -2.946, -2.278, respectively, both P<0.05). There was no significant difference between Th2 frequencies in non-ECRSwNP group and ECRSwNP group ((0.275±0.170) vs (0.500±0.437), Z=-1.306, P=0.211). ILC2 frequencies significantly correlated with Th2 cell frequencies (r=0.571, P=0.011) and tissue eosinophilia (r=0.579, P=0.009). Th2 cell frequencies significantly correlated with tissue eosinophilia (r=0.844, P=0.001). There was no significant association between ILC2 and allergic status. Conclusion ILC2s are elevated in ECRSwNP, and not influenced by allergic status, suggesting that ILC2s play an important role in ECRSwNP without allergic diseases.

Objective: To investigate the effect of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: From March 2011 to March 2016, 72 cases with CRSwNP were treated by endoscopic sinus surgery in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People′s Hospital. The clinical records were retrospectively reviewed, and the cases were divided into eosinophilia elevated and non-elevated group according to blood eosinophils, and nasal polyps were evaluated for histopathology eosinophil count. Statistical analysis was performed to compare two groups′ pre- and post-operative symptoms of VAS score, sinus computed tomography (CT) scans scores according to the Lund-Mackay system and the outcome of surgery. Both groups′ factors that might have affected their outcome were analyzed by t-test, Chi square, Pearson Correlation Coefficient and Willcoxon rank sum test. Results: Seventy two cases were followed up from 24 to 78 months.The average follow-up time was 56 months. The VAS score in the eosinophilia elevated group (n=16) was higher than that in the non-elevated group(n=56), and the difference was statistically significant (11.44±7.13 vs 4.98±5.64, t=3.726, P<0.05). The control of symptoms in the peripheral blood eosinophilia elevated group was less than that in the non-elevated group, and the difference was statistically significant (Z=-1.979, P<0.05). There was a positive correlation between eosinophil counts in peripheral blood and tissues of 72 cases (r=0.429, P<0.05). Conclusion There is a significant correlation between tissue and blood eosinophil counts, and eosinophilia group has poorer outcomes.

Objective To analyze the subjective and objective results and the correlation of nasal obstruction because of nasal structural variation pre and post operation,and to provide clinical evidence for surgery and curative effect.Methods Three groups were included in this study:group 1 were 78 patients with structural rhinitis,group 2 were 72 patients with chronic sinusitis (without nasal polyp) and group 3 were healthy controls of 75 cases.Assessment of nasal obstruction was achieved by visual analog scale (VAS),and objective measurement was achieved by rhinomanometry and acoustic rhinometry.The first two minimum cross-sectional area of nasal cavity (MCA1,MCA2),their distances from the nostrils (MD1,MD2) and the nasal volume of 5 cm depth from the nostril (NV5) were recorded.The ratio of the parameters of the two sides of the nasal cavity was calculated respectively.Nasal resistance total (RT) and calculated right-left nasal resistance ratio (Rlr) were recorded.Patients of group 1 and group 2 accepted endoscopic surgery and received the above evaluation again at three months after surgery.Three groups were compared with statistical test.Results The preoperative values of three groups (MCA1,MD1,MCA2,MD2,NV5,RT) showed no statistical significance (F value was 0.945,0.245,1.380,0.036,0.866,1.651,respectively;all P ＞ 0.05),while their ratio had statistical differences except MD1 (F value was 5.242,1.726,4.882,4.005,5.066,5.316;P =0.013,0.199,0.019,0.024,0.018,0.011,respectively).Statistical results between the ratio of values (MCA1,MD1,MCA2,MD2,NV5,RT) and VAS of nasal obstruction of group 1 and group 2 showed significant positive correlations pre operation (r of group 1 value was 0.471,0.418,0.260,0.324,0.305,0.459,respectively;r of group 2 value was 0.373,0.403,0.288,0.366,0.402,0.249,respectively;all P ＜ 0.05).VAS scores pre and post operation of group 1 had statistically difference (t =35.122,P ＜0.05).Postoperative value of MD1,MD2 and RT among three groups had no statistical difference (F value was 0.178,0.582,0.905,respectively;all P ＞ 0.05).Postoperative value of MCA1,MCA2,NV5 among three groups had statistical difference (F value was 4.010,5.126,4.901,respectively;all P ＜ 0.05).Postoperative ratio of MCA1,MD1,NV5 and Rlr among three groups had no statistical difference (F value was 1.023,0.944,0.524,0.996,respectively;all P ＞ 0.05).Postoperative ratio of MCA2 and MD2 among three groups had statistical difference (F value was 4.859,4.357,respectively;all P ＜ 0.05).Conclusion Severity of nasal obstruction is related to structural variation of nasal cavity and the purpose of surgery is to restore structural symmetry of bilateral nasal cavity.

OBJECTIVE: To evaluate the short-term efficacy and investigate the factors of specific immunotherapy (SIT) efficacy of allergic rhinitis. METHOD: Fifty-seven patients with allergic rhinitis to dermatophagoides pteronysinus were included to receive SIT. Pair t-test was used to compare the symptom scores, visual analogue scores (VAS) and medication scores in patients before SIT and into maintain treatment statement to evaluate the clinical efficacy. T-test and Spearman correlation analysis were used to analyze the correlation between gender, age,reaction condition of skin prick test (SPT) and serum sIgE and the efficacy of SIT. RESULT: SIT was able to significantly reduce the symptom scores, VAS and medication scores. But the correlation between gender, age, SPT, and sIgE and theefficacy of SIT were not significant. CONCLUSION SIT is effective in the short-term treatment of AR. Further research is needed to investigate the factors that impact the efficacy of SIT.
Animals ; Humans ; Immunoglobulin E ; blood ; Immunotherapy ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Skin Tests