Rhinosinusitis in COPD: symptoms, mucosal changes, nasal lavage cells and eicosanoids

Abstract

Abstract:The coexistence of upper airways disease with chronic obstructive pulmonary disease (COPD) is not well documented. The aim of this research was to assess sino-nasal inflammation in COPD by various tools, and look for the impact on quality of life, relation to smoking, disease severity and systemic inflammation. Current and ex-smokers with COPD (n = 42) and healthy never-smokers (n = 21) were included in this study. COPD severity was assessed by GOLD criteria and BODE index. Markers of systemic inflammation were measured. Nasal symptoms and general quality of life were assessed using the questionnaires; sino-nasal questionnaire (SNAQ-11) and St. George's Respiratory Questionnaire (SGRQ). Nasal endoscopy and saccharine test were performed. Nasal lavages were collected for cytological examination and eicosanoids (cysteinyl leukotrienes, leukotriene B4, 8-isoprostane). Symptoms and endoscopic scores were higher in COPD (P  0.0001). Only SGRQ symptoms subscore correlated with SNAQ-11 (r = 0.34, P = 0.035). Mucociliary clearance was impaired only in current smokers (9.91 ± 0.49 versus 13.12 ± 0.68 minutes, P  0.001). 8-isoprostane was higher in COPD smokers compared to the controls (0.17 ± 0.04 versus 0.34 ± 0.09 pg/g protein, P  0.05). Endoscopic score and mucociliary of impairment patients who currently smoked cigarettes correlated with concentrations of 8-isoprostane. None of the parameters correlated with disease severity and markers of systemic inflammation. We provide evidence of upper airways disease in COPD, which appears to be related more to patients who currently smoke than to disease severity.

Nasal lavage natural killer cell function is suppressed in smokers after live attenuated influenza virus

“…The identification of NK cells as a prominent immune cell type in NLF is, to our knowledge, a novel finding and suggests that the study of innate immune responses in the upper airways should take NK cells into account. The use of cell differentials alone to phenotype NLF cells has likely overlooked NK cells [ 4 - 6 ]. As shown in Figure 4 , NK cells have non-descript morphologies and could be mistaken for NLF monocytes, macrophages or even basal epithelial cells.…”

“…In fact, NK cells appear similar to macrophages or monocytes after H&E staining [ 3 ]. As a result, neutrophils, basophils, and eosinophils, but not NK cells, have been identified in NLF using cell differentials with H&E staining [ 4 - 6 ]. As an alternative to H&E staining, flow cytometry can be used to positively identify leukocytes in NLF.…”