Features Of Airway Remodeling In Different Types Of Chinese Chronic Rhinosinusitis Are Associated With The Inflammation Patterns

Background and Objective:The remodeling patterns in different types of chronic rhinosinusitis (CRS) have rarely been compared, particularly the difference between eosinophilic and noneosinophilic CRS with nasal polyps (CRSwNP). Moreover, whether there is a link between remodeling and inflammation is still an open and crucial question.Methods:Histologic characteristics of surgical samples were analyzed in33controls,72eosinophilic and76noneosinophilic CRSwNP, and72CRS without nasal polyps (CRSsNP) patients. Tissue samples from29controls,17eosinophilic and17noneosinophilic CRSwNP, and23CRSsNP patients were measured for mRNA expression of transforming growth factor (TGF)-β1, TGF-β2, TGF-β3, metalloproteinase (MMP)-2, MMP-7, tissue inhibitor of metalloproteinase (TIMP)-l, TIMP-4, heparin-binding epithelial growth factor (HB-EGF), hypoxia inducible factor (HIF)-1α, interleukin (IL)-8, and eosinophil cationic protein (ECP). Immunohistochemical staining was employed to examine the protein expression of a-smooth muscle actin (a-SMA), fibronectin, TGF-β2, HIF-la, myeloperoxidase (MPO), and TIMP-4. Result:The amount of collagen in different CRS was CRSsNP> noneosinophilic CRSwNP> eosinophilic CRSwNP; whereas the edema scores were eosinophilic CRSwNP> noneosinophilic CRSwNP> CRSsNP. TGF-β2and HB-EGF levels were enhanced in CRSsNP compared with CRSwNP. TIMP-4levels were decreased in eosinophilic CRSwNP compared with noneosinophilic CRSwNP and CRSsNP. ECP mRNA levels were only upregulated in eosinophilic CRSwNP. The number of neutrophils were CRSsNP> noneosinophilic CRSwNP> eosinophilic CRSwNP. ECP levels and neutrophil number correlated positively with edema and fibrosis, respectively. Neutrophils are the major sources of TGF-(32in CRSsNP and noneosinophilic CRSwNP. HIF-1α expression was upregulated in CRSsNP and noneosinophilic CRSwNP and correlated positively with IL-8, MPO, and TGF-β2expression.Conclusion:Distinct remodeling patterns were revealed for different types of CRS, particularly for eosinophilic and noneosinophilic CRSwNP. Tissue remodeling associates with inflammation in CRS.