Chronic rhinosinusitis without nasal polyps is associated with increased expression of trefoil factor family peptides

Abstract

TFF1 and TFF3 are overexpressed in CRSsNP. The role of TFF peptides in mucosal protection and repair suggests a possible important physiologic role in maintaining the sinonasal epithelial barrier and modulating innate immunity in the sinonasal tract.

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…Two recent studies reported that patients with CRSwNP have normal level of antimicrobial proteins TFF1, TFF3, SP-A, and SP-D when compared to that of healthy controls. 485,936 Taken together, these studies provide significant evidence of altered antimicrobial protein and peptide activity in CRSwNP. Some protein families are increased whereas others are decreased and some studies show contradictory results.…”

“…Li and Turner 485 showed that TFF1 and TFF3 mRNAs and protein levels were significant higher in ethmoid tissue of CRSsNP compared to control patients. They concluded that the putative role of TFF peptides may be important regulators of the sinonasal epithelial barrier in patients with CRSsNP.…”

Differential Expression of TFF1 and TFF3 in Patients Suffering from Chronic Rhinosinusitis with Nasal Polyposis

“…In the airway, they have been identified within the mucosa of the upper and lower respiratory tract, mostly in goblet cells, ciliated cells, and in some submucosal cells [9]. Their expression was confirmed in the respiratory mucosa of healthy human subjects, as well as in patients suffering from inflammation-driven diseases, such as cystic fibrosis, chronic sinusitis, and bronchitis, however, in the latter case, with diverse expression pattern as compared with uninflamed mucosa [9,10]. In a study by Li and Turner, expression of TFF1 and TFF3 was significantly higher in mucosa from CRSsNP patients, while there was no difference between controls and CRSwNP patients [10].…”

“…Their expression was confirmed in the respiratory mucosa of healthy human subjects, as well as in patients suffering from inflammation-driven diseases, such as cystic fibrosis, chronic sinusitis, and bronchitis, however, in the latter case, with diverse expression pattern as compared with uninflamed mucosa [9,10]. In a study by Li and Turner, expression of TFF1 and TFF3 was significantly higher in mucosa from CRSsNP patients, while there was no difference between controls and CRSwNP patients [10]. A recent study reported increased TFF1 gene and protein expression in patients suffering from either CRSsNP or nasal polyposis without CRS, and its level negatively correlated with Clara cell 10-kDa protein (CC10), another mucosa-associated peptide with known anti-inflammatory and immunomodulatory functions [11].…”

“…Taking all that into consideration and the fact that TFF expression is also abundant in the upper respiratory tract, it can be hypothesized that they could act in a similar fashion in the upper respiratory tract by promoting maintenance of the sinonasal epithelial barrier integrity, protecting against inflammation and nasal polyps formation [5,20]. Contrary to their beneficial physiological effects, there is emerging evidence that TFF peptides can also act as drivers of human cancer by acting as oncogenes and tumor suppressors, and thus they could potentially have an adverse role in dysregulation of sinonasal epithelia leading to the growth of benign tumors such as nasal polyps found in CRSwNP patients [8,9,10,21].…”