Evidence for distinct cytokine expression in allergic versus nonallergic chronic sinusitis

Background: The purpose of this study was to characterize the relationship between tissue cytokine expression and the cellular infiltrate present in chronic hyperplastic sinusitis with nasal polyposis (CHS/NP) and to compare the immunopathology and cytokine profile of patients with allergy versus pa...

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Published in:	Journal of allergy and clinical immunology Vol. 96; no. 4; pp. 537 - 544
Main Authors:	Hamilos, Daniel L., Leung, Donald Y.M., Wood, Raymond, Cunningham a, Lynn, Bean, Donna K., Yasruel b, Z., Schotman b, E., Hamid, Qutayba
Format:	Journal Article
Language:	English
Published:	New York, NY Mosby, Inc 01-10-1995 Elsevier
Subjects:	Adolescent Adult Allergic diseases Aspirin - immunology Biological and medical sciences Cell Movement cytokine mRNA cytokines Cytokines - genetics Cytokines - metabolism Drug Hypersensitivity - complications eosinophilia Eosinophilia - pathology Eosinophils - pathology Humans Hypersensitivity - complications Immunopathology in situ hybridization Medical sciences Middle Aged nasal polyps Nasal Polyps - complications nonallergic Respiratory and ent allergic diseases RNA, Messenger - metabolism Sinusitis Sinusitis - complications Sinusitis - etiology Sinusitis - metabolism T-Lymphocytes - physiology IFN CHS/NP IL GM-CSF nonallergic nasal polyps eosinophilia cytokines mRNA cytokine mRNA Sinusitis in situ hybridization Human Immunopathology Allergy Nose disease Leukocyte Cytokine Granulocyte Gene expression Eosinophil Chronic Interleukin 4 Messenger RNA Interleukin 2 Nose ENT disease Paranasal sinus disease Benign neoplasm Comparative study Gamma interferon Polyp
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Summary:	Background: The purpose of this study was to characterize the relationship between tissue cytokine expression and the cellular infiltrate present in chronic hyperplastic sinusitis with nasal polyposis (CHS/NP) and to compare the immunopathology and cytokine profile of patients with allergy versus patients without allergy. Methods: Nasal polyp tissue samples from 12 patients with CHS/NP and nasal turbinate biopsy specimens from 10 normal control patients were examined for the expression of interleukin (IL)-4, IL-2, and interferon (IFN)-γ cytokine messenger RNA (mRNA) species by in situ hybridization. These data were analyzed in conjunction with data previously reported for the cytokine mRNA species granulocyte-macrophage colony-stimulating factor (GM-CSF), IL-3, and IL-5 and the immunocytochemical profile of the inflammatory cell infiltrate. Patients with allergy were distinguished from those without allergy on the basis of allergy skin tests. Results: Tissue eosinophilia was a prominent feature of both allergic and nonallergic CHS/NP and correlated in both subgroups with the density of GM-CSF and IL-3 mRNA + cells. In comparison with normal controls, patients with allergic CHS/NP had significantly higher tissue densities of GM-CSF, IL-3, IL-4, and IL-5 ( p ≤ 0.025). In contrast, patients with nonallergic CHS/NP had significantly higher tissue densities of GM-CSF, IL-3, and IFN-γ ( p ≤ 0.001). The allergic and nonallergic subgroups showed distinct cytokine profiles with the most distinguishing cytokines of the allergic subgroup being IL-4 ( p = 0.001) and IL-5 ( p = 0.017) and of the nonallergic subgroup being IFN-γ ( p = 0.004). Furthermore, patients with allergic CHS/NP showed an increased density of CD3 + T lymphocytes compared with either controls or patients with nonallergic CHS/NP ( p = 0.03). The density of CD3 + T lymphocytes was the only significant difference between patients with allergic and nonallergic CHS/NP. A clinical history of aspirin sensitivity was strongly correlated with nonallergic CHS/NP, as well as the nonallergic CHS/NP profile of cytokines, including IFN-γ. Conclusion: We conclude that distinct mechanisms of eosinophilia exist in patients with allergic versus nonallergic CHS/NP. The allergic mechanism involves production of T H2-type cytokines, including GM-CSF, IL-3, IL-4, and IL-5, by infiltrating T lymphocytes. The nonallergic mechanism remains unknown but does involve production of GM-CSF, IL-3, and IFN-γ. However, nonallergic eosinophilia is independent of IL-4 and IL-5, cytokines that contribute to tissue eosinophilia in allergic inflammation. Aspirin sensitivity is strongly correlated with nonallergic CHS/NP and production of the nonallergic CHS/NP profile of cytokines, including IFN-γ. ( J Allergy Clin Immunol 1995;96:537-44.)
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0091-6749 1097-6825
DOI:	10.1016/S0091-6749(95)70298-9