Background: Charcot-Leyden crystals (CLCs) are recognized to be classic hallmarks of eosinophilic inflammation.Both protein and mRNA levels of CLC in nasal secretions and nasal brushing samples have been associated with nasal polyp recurrence. However, whether the crystalline CLC structures in nasal tissue could serve as an effective biomarker to predict polyp recurrence remains unclear.Methods: A total of 110 patients with chronic rhinosinusitis with nasal polyps (CRSwNP) completing the postoperative follow-up over a period of 24 months were recruited. Hematoxylin and eosin staining was employed for CLCs identification. The predictive factors for polyp recurrence were determined by binary logistic regression analysis.Results: Thirty three (30.00%) patients developed recurrence during a 24-month postoperative follow-up, in which 84.85% (28/33) patients had crystalline CLC structures. Logistic regression analysis showed that crystalline CLC structure in nasal tissues is predictive of polyp recurrence. Youden index demonstrated crystalline CLC structure higher than 1 per high power field can predict postoperative polyp recurrence with 84.80% sensitivity and 98.70% specificity. Conclusions:The crystalline CLC structures in nasal tissues may serve as an easy-counting and promising biomarker to predict CRSwNP recurrence.To the editor, Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous and challenging inflammatory airway disease involving noneosinophilic and eosinophilic endotypes. In fact, 98.5% eosinophilic CRSwNP (Eos CRSwNP) patients were recurrent after undergone endoscopic sinus surgery (ESS). 1 Therefore, the identification of predictors of recurrence for Eos CRSwNP is crucial for better disease control. The local tissue eosinophilia has been proven to be the most important predictor. 2 However, there are no standard methods for evaluating tissue eosinophilia due to uneven distribution and diversity in geographic conditions. 2,3 Thus, there are limitations to the predict recurrence of CRSwNP based only on tissue eosinophilia.Charcot-Leyden crystals (CLCs), composed by Galectin-10 (Gal-10), were first proposed in the late 1800s by Charcot and Leyden.The typical CLCs are structures identified as needle-shaped bipyramidal Gal-10 crystals detected by morphological methods. Gal-10 protein have three distinct forms including crystalline CLC/Gal-10 crystal structures (CLCs), extracellular vesicles, and extracellular soluble Gal-10. 4 Recent studies have indicated that CLC mRNA and protein levels in nasal brushing/secretions/tissues detected by ELISA and PCR were used as predictive indicators for recurrent CRSwNP and glucocorticoid sensitivity. [5][6][7] Since only crystalline CLCs, but not soluble CLC/Gal-10 protein, drive type 2 immunity, allergy and neutrophilic inflammation, 8,9 the predictive value of functional CLCs for nasal polyp (NP) relapse should be evaluated. However, little is known regarding whether crystalline CLC structures can be utilized to predict NP recurrence.This was a retrospecti...
Background More and more studies had suggested that dyslipidemia was closely related to allergic diseases. High density lipoprotein (HDL) often plays anti-inflammatory and anti-oxidative roles by suppressing immune cell chemotaxis and activation. We aimed to explore the role of HDL in the regulation of group II innate lymphoid cells (ILC2) in allergic rhinitis (AR). Methods The blood lipid levels and their correlation with symptom scores of 20 AR subjects and 20 controls were analyzed. Purified ILC2 were stimulated by HDL and cytokines production were examined by enzyme-linked immunosorbent assay (ELISA) and flow cytometry. The mRNA levels of GATA binding protein 3(GATA3) and retinoid-related orphan receptor α (RORα) expressed by ILC2 were detected using reverse transcription polymerase chain reaction (RT-PCR). Results HDL level was significantly lower in AR than controls and correlated with the symptom scores. The serum HDL levels were negatively related to the increased number of ILC2, IL-5+ ILC2, and IL-13+ ILC2 in AR patients. HDL decreased the number of ILC2 and type II cytokines levels significantly by inhibiting expression of GATA3 and RORα. Conclusions Our data provide preliminary evidence that HDL may play a negative role in ILC2 inflammation in AR, suggesting that HDL may serve as promising treatment target in AR.
Background:The histopathology of pediatric chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) is rarely reported due to low prevalence or the unavailability of tissue samples. Hence, we aimed to characterize and compare the histologic features and protein expression of Th1/Th2/Th17-related cytokines in pediatric CRSsNP and CRSwNP. Methods:The histologic characteristics of 15 children with CRSsNP, 52 children with CRSwNP, and 12 control participants were analyzed using hematoxylin and eosin staining. The expression of Th1/Th2/Th17-related cytokines were examined using immunohistochemistry and the enzymelinked immunosorbent assay.Results: Pediatric subjects with CRSwNP had more intact epithelium and less submucosal mucous glands compared to those with CRSsNP. Tissue eosinophils were more prevalent in the younger CRSwNP group compared to the older CRSwNP or the CRSsNP groups. The protein concentrations of Th2 cytokines were significantly higher in the CRSwNP group than the CRSsNP group or the control group. Moreover, the protein concentrations of Th17 cytokines were significantly higher in the younger CRSwNP group than the older CRSwNP group or the CRSsNP and control groups. The protein concentrations of Th1 and Th17 cytokines were also significantly higher in the CRSsNP group than the control group. Compared with non-eosinophilic CRSwNP, eosinophilic CRSwNP presented with elevated protein concentrations of Th1 and Th17 cytokines. Conclusion:For the first time, we showed that pediatric CRSwNP presents as eosinophilic with Th2/Th17 inflammation, whereas CRSsNP presents as Th1/Th17 inflammation. Our study may provide a theoretical basis for the precise treatment of pediatric CRS in the future.
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