Objective:To analyze the correlation between nasal mucosal microbiota diversity and the pathogenesis and prognosis of chronic sinusitis. Methods:A total of 80 patients with chronic sinusitis（CRS） admitted to Second Affiliated Hospital of Suzhou University were selected as the research group, and 80 patients with chronic dacryocystitis and nasal septum deviation without sinus inflammation admitted to our hospital during the same period were selected as the control group, nasal secretory specimens were collected under nasal endoscopic guidance by nasal swab, and matrix-assisted laser desorption ionization classification time mass spectrometry, anaerobic bacterial culture and common bacterial culture were performed to compare the differences in nasal mucosal flora between groups. Patients with chronic sinusitis were followed up for 6 months, and nasal secretions were collected again to detect microflora, and the patients were divided into relapse group（21 cases） and non-recurrence group（59 cases） according to whether the patients had relapse. Compare the diversity of nasal microbiota between groups. Results:There were no significant differences in mean relative abundance（MRA） between the two groups of preoperative phylum Microbacterium verrucobacterium, Cyanobacterium phylum, Phylum Laubia mlaus, Porphyromonas species, Enterococcus species, Fusobacterium species, Enterobacter species, Enterobacter species, Erythrobacterium species, Ralstonia species, Bacteroides and Streptococcus species（P>0.05）. The MRA of Acidobacterium, Proteobacteria, Actinomycetes MRA, Moraxia, Cyanobacterium, Corynebacterium and Staphylococcus were significantly lower than those of the control group（P<0.05）, and the MRA of Escher-Shigella species, Fusobacterium, Bacteroides, Firmicutes, Neisseria, Pseudomonas, Haemophilus and Lactobacillus was significantly higher than that of the control group（P<0.05）, and there was no significant difference in MRA at the level of nasal flora and genus before and after surgery in the relapsed group（P>0.05）. The MRA of Bacteroides after surgery was significantly lower in the non-recurrent group than that before surgery（P<0.05）, the MRA of Corynebacterium and Actinomycetes was higher significantly than that of preoperative（P<0.05）, and there was no significant difference in MRA of other species and phylum（P>0.05）. Conclusion:The onset of CRS is related to nasal mucosal dysbacteria, and whether the dysbacteriosis improves after surgery is correlated with the prognosis of patients.
Humans ; Chronic Disease ; Sinusitis/microbiology* ; Prognosis ; Nasal Mucosa/microbiology* ; Microbiota ; Male ; Female ; Middle Aged ; Adult ; Bacteria/isolation & purification*

BACKGROUNDBiofilms have given new insights to the understanding of pathogenesis of chronic rhinosinusitis (CRS). However, the link between biofilms formation and local inflammatory response remains poorly defined in CRS with nasal polys. The aim of this study was to determine the potential association of the presence of biofilms in the nasal mucosal tissues with clinical features in Chinese patients, which had CRS with nasal polyps (CRSwNP).

METHODSA total of 19 patients with CRSwNP and 12 patients with non-CRS were subjected to endoscopic surgery and their nasal mucosal tissue specimens were examined histologically and by scanning electron microscopy (SEM). Their demographic and clinical features were recorded.

RESULTSThirteen (68.4%) out of the 19 specimens from patients with CRSwNP, but none from control patients, were positive for biofilms that displayed typical characteristics of bacterial and fugal structures. The presence of biofilms in the nasal mucosal tissues was associated with significantly greater values of purulent nasal discharge and preoperative Lund-Kennedy scores, higher levels of serum total IgE and percentages of subjects with endoscopic surgery (ESS) history in patients with CRSwNP, and more severe inflammation in the nasal mucosal tissues of patients with CRSwNP.

CONCLUSIONOur study demonstrated the presence of biofilms in the nasal mucosal tissues of many patients, contributing to the understanding of the pathogenic process of CRSwNP in Chinese patients.

Adolescent ; Adult ; Biofilms ; Chronic Disease ; Female ; Humans ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Nasal Mucosa ; pathology ; Nasal Polyps ; etiology ; microbiology ; pathology ; Rhinitis ; etiology ; microbiology ; pathology ; Sinusitis ; etiology ; microbiology ; pathology

OBJECTIVE: This paper aims to demonstrate the maxillary mucosa restoration after operation to the nasal fungal sinusitis. METHOD: Observation by microscopic, transmission electron microscopic and scanning electron microscopic was done to the same parts in the maxillary mucosa 3-4 months before and after the endoscopic sinus surgery in the 24 cases of the nasal fungal sinusitis during 2003-2005. RESULT: Before the operation, all the cases demonstrated epithelia shedding, proliferation, squamous metaplasia, glandular and fibrous tissue proliferation and lymphocytes infiltration. The microtubule was abnormal and mitochondria diminished, 3-4 months after operation, the cavity was clear and smooth and the epithelia complete. The cilia average increased and the cilia lined in the same direction. The structure of microtubules was clear. The mitochondria was elongated and dense. CONCLUSION There was no significant difference in the damage on ultramicrostructure of the maxillary mucosa between the chronic nasal sinusitis and chronic nasal fungal sinusitis. It is crucial in the successful recovery that the operation gives a thorough clean to the fungal clot and sinus aeration, and that good cleaning and sinus aeration are maintained after the operation. The ultramicrostructure restoration and the function recovery of mucosa will be achieved after careful cleaning for 3-4 months after operation.
Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Fungi ; Humans ; Male ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Middle Aged ; Mycoses ; pathology ; surgery ; Nasal Mucosa ; pathology ; surgery ; ultrastructure ; Sinusitis ; microbiology ; pathology ; surgery ; Young Adult

OBJECTIVETo study the pathologic changes in nasal and oropharyngeal mucosa caused by treponema pallidum (TP) infection.

METHODSTwenty-five cases of nasal and oropharyngeal syphilis were retrieved from the archival files of Department of Pathology of Beijing Tong Ren Hospital collected during the period from June 1996 to September 2005. The hematoxylin and eosin-stained slides were reviewed. Histochemical study using modified Warthin-Starry stain and immunohistochemical study using polyclonal antibody for TP were carried out. The diagnosis of early syphilis was confirmed by rapid plasma regain (RPR) and TP hemagglutination (TPHA) tests.

RESULTSAmong the 25 cases studied, 20 showed neutrophil infiltration, microabscess formation and plasma cell infiltration in the lamina propria. Endothelial swelling of small blood vessels and syphilitic vasculitis was also seen. Tonsillar ulcers associated with abundant plasma cells, lymphocytes and histiocytes were noted in 14 cases. One of which demonstrated florid reactive lymphoid proliferation, with transforming lymphoid cells of various stages identified. Pseudoneoplastic squamous cell proliferation was seen in one case. Spirochetes were detected by modified Warthin-Starry stain in mucosal microabscesses and squamous epithelium in 20 cases, around small blood vessels in 5 cases, and on the surface of tonsillar ulcers in 14 cases. Abundant TP were also found in smears of exudates in 6 cases. TP antigen was detected in 4 cases by immunohistochemical staining. All the 25 cases studied were RPR (1:8 to 128) and TPHA-positive.

CONCLUSIONSEarly syphilis involving nasal cavity and oropharynx has distinctive pathologic features. Detailed histologic examination, together with modified Warthin-Starry stain for demonstration of spirochetes, is important to obtain a correct diagnosis.

Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; microbiology ; pathology ; Nasal Mucosa ; microbiology ; pathology ; Nose Diseases ; microbiology ; pathology ; Palatine Tonsil ; microbiology ; pathology ; Pharyngeal Diseases ; microbiology ; pathology ; Syphilis ; microbiology ; pathology ; Syphilis Serodiagnosis ; Treponema pallidum ; isolation & purification ; Young Adult

Rhinoscleroma is a chronic, granulomatous infectious lesion most frequently affecting the respiratory tract mucosa. This disease is endemic to Africa, Central and South America, South Central and Eastern Europe, the Middle East, and China. We report an extremely rare disease of nasal rhinoscleroma in Korea. The patient was a 63-yr-old man, who suffered from chronic nasal obstruction and septal deviation. Characteristic histology from a nasal biopsy was proven and special stains for bacteria were employed: periodic acid-Schiff, Warthin-Starry silver, Giemsa, and Gram stains. Isolation of Klebsiella rhinoscleromatis from a culture of nasal discharge was failed, but ultrastructural examination of numerous phagocyzed bacilli in the Mikulicz cells confirmed the diagnosis. The histiocytic nature of the Mikulicz cells was confirmed, using CD 68 and alpha-1 antitrypsin, and by the ultrastructural features of Mikulicz cells. Here, we emphasize the recognition of this rare entity in nonendemic regions, frequently leading to delayed diagnosis.
Endemic Diseases ; Fibrosis ; Human ; Klebsiella pneumoniae/*isolation & purification ; Korea ; Male ; Microscopy, Electron ; Middle Aged ; Nasal Mucosa/*microbiology/pathology/ultrastructure ; Rhinoscleroma/*pathology

Escherichia coli heat-labile enterotoxin (LT), which causes a characteristic diarrhea in humans and animals, is a strong mucosal immunogen and has powerful mucosal adjuvant activity towards coadministered unrelated antigens. Here we report the different mucosal adjuvanticity of nontoxic LT derivatives, LTS63Y and LTdelta110/112, generated by immunizing through two different mucosal routes. Intragastric (IG) immunization with Helicobacter pylori urease alone resulted in poor systemic IgG and IgA responses and no detectable local secretory IgA, but IG co-immunization with urease and LTdelta110/112 induced high titers of urease-specific local secretory IgA and systemic IgG and IgA, comparable to those induced by wild-type LT. LTS63Y showed far lower adjuvant activity towards urease than LTdelta110/112 in IG immunization, but was more active than LTdelta110/112 in inducing immune responses to urease by intranasal (IN) immunization. LTdelta110/112 predominantly enhanced the induction of urease-specific IgG1 levels following IG immunization, whereas LTS63Y induced high levels of IgG1, IgG2a and IgG2b following IN immunization. In addition, quantitative H. pylori culture of stomach tissue following challenge with H. pylori demonstrated a 90-95% reduction (p < 0.0002) in bacterial burden in mice immunized intranasally with urease using either mutant LT as an adjuvant. These results indicate that the mechanism(s) underlying the adjuvant activities of mutant LTs towards coadmnistered H. pylori urease may differ between the IN and IG mucosal immunization routes.
Adjuvants, Immunologic/administration & dosage* ; Administration, Intranasal ; Animal ; Bacterial Toxins/immunology* ; Bacterial Toxins/genetics ; Bacterial Toxins/administration & dosage ; Enterotoxins/immunology* ; Enterotoxins/genetics ; Enterotoxins/administration & dosage ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli* ; Feces ; Female ; Gastric Mucosa/microbiology ; Gastric Mucosa/immunology* ; Helicobacter pylori ; Human ; IgA, Secretory/immunology* ; IgG/immunology ; Mice ; Mice, Inbred BALB C ; Mutagenesis, Site-Directed ; NAD+ ADP-Ribosyltransferase/immunology ; NAD+ ADP-Ribosyltransferase/genetics ; Nasal Mucosa/immunology* ; Point Mutation ; Urease/immunology* ; Urease/administration & dosage ; Vaccination*