The Disscussion Of Interleukin-17 And Interleukin-6 In The Pathogenesis Of Chronic Rhinosinusitis With Nasal Polyps

Objective: Chronic rhinosinusitis (CRS) with nasal polyps is an upper airway inflammatory disease in which the structural modifications of epithelium (secretory hyperplasia and squamous metaplasia) and lamina propria mucosa (basement membrane thickening, ECM accumulation, and collagen deposition) are associated with inflammatory cell infiltration. The pathologic processes leading to these structural modifications are complex and poorly understood. Interleukin-17 played a key role of the lower airways remodeling and chronic inflammation. IL-17 cytokine family, though still young since discovery, has recently emerged as critical players in immunity and inflammatory diseases. The prototype cytokine, IL-17, plays essential roles in promoting inflammation. IL-6 is now known to be important in IL-17 production. A major effect of IL-17 was found to be the stimulation of stromal cells to secrete IL-6, IL-8, GM-CSF, prostaglandin E2, and nitric oxide. IL-17 was also found to increase the synthesis of IL-6 and IL-11 by bronchial fibroblasts. In support of a potential role for IL-17 in airway remodeling, we previously reported that IL-17 is up-regulated in asthma and that eosinophils were a major source of it. In the present study, we investigated the role in CRS of interleukin-6 (IL-6), a cytokine implicated in the pathogenesis of various inflammatory diseases. Although, IL-6 has been proposed as a marker of inflammation in CRS, the role of IL-6 in CRS is not well defined. And IL-17 is a relatively new cytokine, its role in the pathogenesis of CRSwNP requires further study .To study the expression of interleukin-17 and IL-6 in CRSwNP and explore pathogenesis of CRSwNP.Methods: Choosing cases, grouping and obtaining specimens. Dividing to two groups: CRSwNP and septal deviation. Nasal polyps, inferior turbinate mucosa were all from October 2009～Auguste 2010 in our hospital patients in need of endoscopic sinus surgery. 23 Polyp tissues of CRSwNP were obtained from the patients (males 13,females 10:age range20-65 years,mean age 48.5 years)who were subjected to nasal Polypeetomy in our department. Inferior turbinate mueosa as control group were from 19 patients (males 10,females 9:age range 25--63years,mean age 45 years)with septal deviation. All cases have not the history of asthma, allergy and not receiving steroids before four weeks. The samples were fixed with 10% formalin,embedded in paraffin wax. The slides were detected with HE staining for routine histopathologic examination. Immunohistoehemieal staining was performed for observing the expression of Interleukin-17 and IL-6. To study the expression of Interleukin-17, IL-6and Eos in CRSwNP and control group, explore the different pathogenesis between CRSwNP and control group. All data were analyzed by SPSS13.0. Statistics management Wilcoxon runk sum test, Chi-square test and correlation were used to analyze the data. Asα=0.05, if p value is <0.05, there is difference statistically.Results:1 Nasal Polyps tissue is morphologieally charaeterized by oedema,goblet cell hyperplasia of the epithelium, is extreme edema and gland proliferation. There are a lot of inflammatory cells in nasal polyps tissues by HE. The infiltration of eosinophils in Nasal Polyps tissue is higher than in inferior turbinate of control group.(P<0.01)2 In CRSwNP group, IL-17 expressed, widespread in cytoplasm of eosinophilic, plasma cells and neutrophilic, small in acinar cells. The expression of IL-17 in nasal polyps of CRSwNP is significantly higher than in inferior turbinate of control group. (P<0.01)3 In CRSwNP group, IL-6 expressed, widespread in inflammatory cells and Fibroblasts of mucosa epithelial and the vascular endothelial, small in the extracellular matrix. The expression level of IL-6 in CRSwNP and control group has significant differences. (P<0.01)4 there is a positive correlation between IL-17 and IL-6 in the nasal polyps of CRSwNP r=0.77 (P<0.01) Conclusions:1 It is an important pathological characteristic of CRSwNP that many eosinophils recruit in the nasal mucosa.2 In the CRSwNP patients, the high expression of Th17 cell may be a very important reason.3 IL-6 may synergistic Th17 cells to involve in the occurrence and development of the CRSwNP.4 In CRSwNP, there have close correlations between IL-17and IL-6, which perhaps may provide a new mentality for the CRSwNP's treatment.