Vitamin D₃ as a novel regulator of basic fibroblast growth factor in chronic rhinosinusitis with nasal polyposis

Abstract

Background The immunopathogenesis of chronic rhinosinusitis (CRS) is largely unknown, but it is thought that different inflammatory profiles are responsible for the different CRS subtypes. 25-hydroxyvitamin-D (25-VD3) has been shown to alter inflammatory mediators in other disease processes and 25VD3 deficiency is associated with CRS with nasal polyps (CRSwNP), but it is unknown if 25VD3 levels impacts local inflammation in CRS. This study investigated the correlation between plasma 25-VD3 and sinonasal mucus MCP-1, RANTES and bFGF levels in patients with CRS. Methods Study subjects undergoing endoscopic sinus surgery (ESS) for CRS were prospectively enrolled from January 2012-August 2014. Control subjects included patients undergoing ESS for non-inflammatory pathology. Blood and sinonasal mucus were collected at the time of ESS. Plasma 25-VD3 was measured by ELISA and mucus levels of MCP-1, RANTES, and bFGF by cytometric bead array (CBA). Results A total of 57 patients were enrolled and categorized as CRS without nasal polyps (CRSsNP) (n=31), CRSwNP (n=14) and controls (n=12). No significant correlation was found between MCP-1 and 25-VD3. There was a significant negative correlation between 25-VD3 and RANTES (r= −0.612; p=0.026) and bFGF (r= −0.578; p=0.039) in CRSwNP patients; however, there was no significant correlation in CRSsNP patients. Conclusion This data suggests that 25-VD3 may play a role in regulation of RANTES and bFGF expression in CRSwNP. This may occur through regulation of nasal polyp fibroblasts or other immune cells. Further investigation is warranted to better elucidate the role of RANTES, bFGF and 25-VD3 in CRSwNP.

A study to evaluate the relationship between serum vitamin d level and chronic rhinosinusitis

“…It appears that sinonasal epithelial cells express 1-α-hydroxylase and can produce 1. 22 These studies are in accordance with our findings that the incidence of CRSwNP increases with the age, mean age of onset being 42 years.…”

“…A study done by Sansoni et al (2015), there were 26 (45.6%) males and 31 (54.5%) females. 22 A study done by Sedaghat et al (2015), there were 59.2% females and 40.2% males. 23 In our area most of the females are housewives and they mostly remains indoor which might be the reason for low vitamin D levels as well as increased incidence of CRSwNP.…”

The Relationship between Serum Vitamin D and Chronic Rhinosinusitis: A Systematic Review

“…The full texts of the remaining 25 articles were reviewed, with 18 publications excluded because they did not meet the inclusion criteria. Seven articles were included in the final review 22–28 (four prospective and three retrospective studies), with a total of 513 patients. However, five of the studies were from the same group, 22–26 and, therefore, it is highly likely that the same patients were included in more than one study.…”

“…This final group of studies included one study of patients entirely with CRSwNP, 23 two mixed cohort studies of CRSsNP and CRSwNP, 25,28 and four studies that compared CRS subtypes and controls. 22,24,26,27…”

Chronic rhinosinusitis with polyposis and serum vitamin D levels

“…Several studies suggest that vitamin D3 acts as a steroid hormone that has anti-inflammatory effects 7-9 and plays an important role in regulating dendritic cells (DC) 10 . The mechanism of immune system modification by vitamin D3 is similar to other corticosteroids 710-12 . Various studies have shown that vitamin D3 is able to stop the production of cytokines and inhibit differentiation of immune cells.…”