bromochloroacetic-acid and Sinusitis

Chronic rhinosinusitis (CRS) defines a group of disorders characterized by persistent inflammation of the sinonasal tract. Epithelial changes and structural remodelling are present, but whether epithelial differentiation is altered remains uncertain.. To evaluate the differentiation state of the sinonasal epithelium in CRS, sinonasal biopsies from patients with CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP), or with allergic rhinitis (AR), as compared to controls, were processed by immunohistochemistry and RT-qPCR for terminal differentiation (E-cadherin, high molecular weight cytokeratins (Hmw CK) and CK5, vimentin) and lineage differentiation (ß-tubulin IV+ ciliated cells, MUC5AC+ goblet cells, p63 + basal cells). Findings were correlated with subepithelial fibrosis and clinical CT score.. Expression of E-cadherin was decreased at protein and mRNA levels in CRSwNP and CRSsNP, as compared to controls. Staining for Hmw CKs was also reduced in CRSwNP and CRSsNP, and CK5 mRNA was decreased in CRSwNP. These features were not due to changes in lineage specification, but associated with increases in vimentin-expressing epithelial cells. In addition, vimentin expression correlated with the basement membrane thickening and with CT score, as well as with tissue eosinophils.. Features of epithelial dedifferentiation towards a mesenchymal phenotype are observed in CRSwNP and CRSsNP and correlate with airway fibrosis and inflammation.

Topics: Adolescent; Adult; Aged; Airway Remodeling; Cadherins; Case-Control Studies; Cell Count; Cell Dedifferentiation; Chronic Disease; Epithelial-Mesenchymal Transition; Female; Fibrosis; Gene Expression; Goblet Cells; Humans; Keratins; Male; Middle Aged; Nasal Polyps; Phenotype; Respiratory Mucosa; Rhinitis; Risk Factors; Sinusitis; Tomography, X-Ray Computed; Vimentin; Young Adult

Concordance between sinusitis and otitis media with effusion (OME) has been reported in 5-60% of patients. Since nasal diseases induce edema and lymphoid tissue hyperplasia in the nasopharyngeal mucosa, especially the adenoids, chronic infection of the adenoids has been reported to induce otitis media. In addition, deterioration in the mucosal barrier of the adenoids makes the latter vulnerable to bacterial infections, resulting in OME or sinusitis. We therefore evaluated adenoid local immunity and Eustachian tube function by sinusitis and the concordance between sinusitis and OME.. We examined PNS series and tympanometry of 520 patients who had undergone adenotonsillectomies. In addition, local adenoidal immunity was evaluated in 10 children with OME and sinusitis, 11 with only sinusitis, 10 with only OME and 12 with no history of OME or sinusitis. Adenoid size, squamous metaplasia, IgA, BCL-6, and mucosal barrier were also determined.. Of 520 patients, 80 (15.4%) had both OME and sinusitis. The incidence of Eustachian tube dysfunction differed significantly between patients with and without sinusitis (p=0.03). The incidence of squamous metaplasia differed significantly between patients with sinusitis plus OME and patients with sinusitis alone (p=0.01), and between patients with OME alone and those without both conditions (p=0.005). Patients with both sinusitis and OME differed significantly in IgA secretion (p=0.01) and Bcl-6 expression (p=0.02) from those with sinusitis alone, as did patients with OME alone and those without both conditions (p=0.02 and p=0.03, respectively).. Sinusitis plus OME were present in 15.4% of patients. Eustachian tube dysfunction was present in 37.9% of sinusitis patients and in 28.4% of those without sinusitis. IgA, BCL-6 and squamous metaplasia were important in local adenoidal immunity.

Topics: Acoustic Impedance Tests; Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; DNA-Binding Proteins; Epithelium; Eustachian Tube; Female; Humans; Immunoglobulin A; Infant; Keratins; Male; Metaplasia; Otitis Media with Effusion; Proto-Oncogene Proteins c-bcl-6; Sinusitis

The pathogenesis of respiratory epithelial adenomatoid hamartoma (REAH) and inverted papilloma (IP) is poorly understood, especially compared with sinonasal adenocarcinoma (SNAC). One feature of malignant glandular lesions is loss of the basal/myoepithelial layer. The immunophenotype of the basal/myoepithelial layer has not been fully examined in benign glandular lesions of the sinonasal tract.. To examine benign and malignant glandular lesions in the sinonasal tract for the immunophenotype of basal/myoepithelial cells, proliferation index, and cytokeratin and intestinal differentiation profiles.. Sinonasal adenocarcinoma (intestinal-type adenocarcinoma [ITAC] and nonintestinal type adenocarcinoma [non-ITAC]), REAH, IP, and chronic sinusitis (CS) were stained for cytokeratin (CK) 7, CK20, 34betaE12, CDX-2, p63, Ki-67, smooth muscle actin (SMA), S100 protein, and calponin.. Basal/myoepithelial cells in CS and REAH were positive for p63 and 34betaE12 but negative for SMA, S100 protein, and calponin. Proliferative activity was localized to the compartment containing p63-positive cells. Inverted papilloma demonstrated broad areas staining for p63 and 34betaE12, with intermediate proliferative activity in these areas. Sinonasal adenocarcinoma had the highest Ki-67 labeling index, and p63-positive SNACs had higher proliferation indices than p63-negative SNACs. REAH, IP, CS, and most SNACs expressed CK7. Only SNAC expressed CK20. Sixty percent of morphologic ITACs expressed CDX-2.. Basal/myoepithelial cells in CS and REAH should be considered basal and not myoepithelial cells. In benign lesions, proliferative activity is limited to the compartments with p63 staining. In SNAC and IP, p63 expression correlates with proliferation index. REAH, IP, and CS share similar immunoprofiles (CK7+, CK20-, and CDX-2-), contrasting with SNAC (CK7+, CK20+/-, CDX-2-/+).

Topics: Actins; Adenocarcinoma; Biomarkers, Tumor; Calcium-Binding Proteins; Calponins; CDX2 Transcription Factor; Cell Proliferation; Chronic Disease; Diagnosis, Differential; Epithelial Cells; Female; Hamartoma; Homeodomain Proteins; Humans; Immunohistochemistry; Immunophenotyping; Keratins; Ki-67 Antigen; Male; Membrane Proteins; Microfilament Proteins; Middle Aged; Papilloma; Paranasal Sinus Neoplasms; S100 Proteins; Sinusitis; Trans-Activators

The olfactory mucosa was examined by immunohistochemistry in patients with olfactory disturbance: anosmia due to choanal atresia and chronic sinusitis, early-stage common cold, late-stage common cold, and head trauma. The results indicate that the olfactory mucosa of patients with olfactory disturbance shows specific kinds of immunoreactive patterns and that immunohistochemistry is useful for examining the degree of degeneration of pathologic human olfactory mucosa and for clarification of prognosis.

Topics: Choanal Atresia; Chronic Disease; Common Cold; Craniocerebral Trauma; Humans; Immunoenzyme Techniques; Keratins; Olfaction Disorders; Olfactory Mucosa; Phosphopyruvate Hydratase; S100 Proteins; Sinusitis