muramidase and Nasal-Polyps

Nasal polyps frequently appear in patients with cystic fibrosis (CF). The aims of this study were to focus on what problems (symptoms, endoscopic findings, and laboratory correlates) nasal polyps cause the CF patient, and how these correlate to the total health situation of this patient group.. The clinical histories, endoscopic investigations of the nasal cavity, and analyses of nasal lavage fluid of 44 patients with CF complicated with nasal polyposis have been compared with those of 67 CF control subjects. The patients were examined at annual control examinations (with pulmonary tests, working capacity, liver tests, and bacterial and blood tests) from 1995 to 1996 at Stockholm Cystic Fibrosis Center, Huddinge University Hospital. All patients were > 2 years of age. The endoscopic findings were related to the actual pulmonary function, inflammatory blood parameters, colonizing pathogens, antibodies (Staphylococcus aureus and Pseudomonas aeruginosa), and genotype.. The patients with nasal polyps differed with respect to chronic colonization of P aeruginosa in sputum samples and had a higher occurrence of serum antibodies against the same species. The two groups did not differ in pulmonary functions, inflammatory parameters, or genotype. The polyps found were mainly small (within the meatus media) and gave no significant increase in ongoing clinical symptoms such as rhinorrhea, nasal obstruction, or hyposmia. Neither was any significantly marked finding concerning the nose (mucosal swellings, secretion, etc.) made in the polyp patients. The patients with CF scored slightly lower in a smell identification test in comparison with the healthy control group. The nasal lavage fluid was analyzed (in 93 of the 111 patients) for the occurrence of P aeruginosa (by polymerase-chain reaction [PCR]), interleukin [IL]-5, IL-8, and lysozyme. The lysozyme and IL-8 content was equal in the two CF groups but increased in comparison with the healthy control group. P aeruginosa was not detected with PCR in any nasal lavage fluid. No measurable levels of IL-5 in the nasal lavage were found.. There was a higher frequency of chronic colonization of P aeruginosa in the lower respiratory tract in patients with nasal polyps. Otherwise, nonsevere nasal polyposis was not an indicator of lower respiratory tract morbidity in CF patients.

Topics: Adolescent; Adult; Antibodies, Bacterial; Child; Child, Preschool; Cystic Fibrosis; Endoscopy; Female; Humans; Interleukin-5; Interleukin-8; Male; Muramidase; Nasal Lavage Fluid; Nasal Polyps; Pseudomonas aeruginosa; Pseudomonas Infections; Respiratory Tract Infections; Risk Factors; Staphylococcal Infections

In rhinologic disorders such as polyposis or rhinitis, nasal cytology allows differentiation between patients according to the degree of eosinophilia in nasal secretions. The egress of eosinophil and/or neutrophil polymorphonuclears from the underlying mucosa might correlate with the release of soluble mediators of cell activation such as the chemokine IL-8, and such molecules of the innate immunity as the LPS-receptor CD14 or lysozyme. We assayed the levels of these three molecules in nasal secretions in correlation with cytologic findings and especially the degree of eosinophilia.. Fifty-four patients from a prospective study of nasal secretions were enrolled in this work. They constituted two groups of 27 patients each, respectively, with or without more than 20% eosinophils in nasal secretions. Nasal secretions were collected by aspiration, weighed and diluted in a fixed amount of buffer. Classic cytologic analyses were performed on the pelleted cells and IL-8, sCD14, and lysozyme levels were assayed in the cell-free supernatants.. Cytologic analyses included cell-enumeration in Neubauer's chambers, and differentials performed on May-Grünwald Giemsa-stained cytospins. ELISA tests were used to assay the levels of IL-8 and sCD14. Lysozyme concentrations were assayed in immuno-nephelometry.. Significantly lower levels of IL-8 and sCD14 were observed in patients with eosinophilia than in patients with a predominance of neutrophils, whereas no difference was observed in lysozyme concentrations.. These data show that the egress of neutrophils in nasal secretions is associated with high levels of IL-8 and sCD14.

Topics: Adolescent; Adult; Aged; Eosinophilia; Female; Humans; Inflammation Mediators; Interleukin-8; Leukocyte Count; Lipopolysaccharide Receptors; Male; Middle Aged; Muramidase; Nasal Lavage Fluid; Nasal Mucosa; Nasal Polyps; Neutrophils; Reference Values; Rhinitis; Sinusitis

Mucus hypersecretion is a characteristic feature in chronic sinusitis with nasal polyps. The objective of this study is to examine whether the polyp epithelium itself contributes to a certain extent to the increased mucous secretions in chronic sinusitis with nasal polyps, and if it does, to determine which mucin genes are responsible for the increased mucin secretion.. Three pooled samples of normal nasal epithelial cells from each subject were obtained by scrapings from the inferior turbinates of 30 healthy adult volunteers and nasal polyps from 6 patients who underwent intranasal ethmoidectomy and polypectomy. Isolated epithelial cells were used for total RNA isolation for reverse transcriptase polymerase chain reaction and cell lysates for immunoblotting.. The intracellular level of mucin from polyp epithelium was 2.9 times higher than that of normal nasal epithelium (P < .05). Interestingly, MUC2 and MUC8 messenger RNA (mRNA) levels were clearly upregulated in polyp epithelium compared with those of normal turbinate epithelium.. Polyp epithelium can be considered to contribute in part to increased secretion in chronic sinusitis with polyps, and increased mucous secretion might be related to the increased mRNA level of MUC2 or MUC8 or both.

Topics: Adult; Humans; Immunoblotting; Mucin-1; Mucin-2; Mucins; Muramidase; Nasal Mucosa; Nasal Polyps; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Turbinates

To study the local protective role of lysozyme(LZ) and lactoferrin(LF) in the uncinate process mucosa during chronic sinusitis.. Expression of LZ and LF was determined in 17 samples from normal subjects and 70 samples from chronic sinusitis patients with ABC immunohistochemical method. According to the presence or absence of nasal polyps, patients were divided into two groups.. Serous cells of submucosal glands displayed a strongly positive staining reaction to both LZ and LF in the normal uncinate process mucosa and mucosa from patients with chronic sinusitis. A positive though weak staining for LZ could also be found frequently within mucous cells of submucosal mixed glands and occasionally within goblet cells. In the mucosa from patients without nasal polyps, the staining reaction to LZ appeared to be intensified in goblet cells when compared with normal controls (P < 0.05). In patients with nasal polyps, the staining reaction to LZ appeared to be intensified in submucosal glands when compared with normal controls (P < 0.01) and patients without nasal polyps (P < 0.05). For LF, the staining reaction from patients with nasal polyps was stronger than that in normal controls (P < 0.01). The epithial cells stained negatively for LZ and LF.. It suggests that the observed increase in LZ and LF secreting activity of goblet cells and submucosal mixed glands may play a part role in the defense mechanism of uncinate process mucosa during the course of chronic sinusitis.

Topics: Adolescent; Adult; Child; Chronic Disease; Ethmoid Sinus; Female; Humans; Lactoferrin; Male; Middle Aged; Muramidase; Nasal Mucosa; Nasal Polyps; Sinusitis

Topics: Anti-Infective Agents, Local; Dermatologic Agents; Humans; Muramidase; Nasal Cavity; Nasal Polyps; Paranasal Sinuses; Polyps