The Expression And Meaning Of Three Neuropeptides In The Inistial Stage Of Recurring Nasal Polyp

Objective: To explore the expression and meaning of Substance P(SP), calcitonin gene-related peptide (CGRP) and vasoactive intestinal peptide(VIP) in the initial stage of recurring nasal polyp.Method: Mucosa specimens of thirty nasal endoscopic surgery patients who insist clinic examining were selected randomly as the experiment group and divided into two subgroups depending on accompanying atopic disease (such as allergic rhinitis, asthma et al) or not. So that each subgroup includes fifteen cases. Nine mucosa specimens without any nasal disease were investigated as control group. Radioimmunoassay and immuneohistochemistry was used to compare the expression , distribution and tissue content of SP, CGRP, VIP in the experiment group and control group .Results:1.Significant increase of SP,CGRP and VIP were found in experiment group compared to the controls(p<0.05) by RIA.The tissue contents of SP,CGRP and VIP are 2.27±1.14, 5.62±0.30, 8.68±1.83 pg/mg in the allergic subgroup and 2.47±1.48, 6.55±2.78, 8.18±2.29 pg/mg in the non- allergic subgroup respectively.But the tissue contents of SP,CGRP and VIP are only 1.04±0.38 , 2.95±1.03 , 5.51 ±0.74 pg/mg in the control group. However, the difference between two subgroup has no significance(p>0.05).2.Simultaneously the resuls of immunohistochemistry reveal that the terminals ofSP ,CGRP and VIP in the basilar part of recurring nasal polyp are markedly increased in density of immunostaining compared to that of the controls(P<0.05).The mean integral optic density(IODM) of SP ,CGRP and VIP are2124.89±315.59> 2147.75±310.47, 2082.52±241.98 in the allergic subgroup and 1995.13±218.67, 2085.54±333.87> 1979.88±138.89 in the non- allergic subgroup respectively.However,the IODMs of the control group are onlyl772.21±177.59, 1801.95±157.17. 1806.91±183.48. But the differences between the two experiment group has no significance(p>0.05).Conclusion: The surgical traumata (the machine damnification, the light damnification,etc) can make the neuropeptide fibre and endocrine-like cells in the nasal mucosa release lots of neuropeptides,such as SP ,CGRP and VIP.These neuropeptides not only can induce vasodilation, permeability, strengthened oedema and gland secretion enhancement but also can turn the inflammatory reaction worse through an axonal reflex. In other words they can intensify inflammation. And if this process is complexed by infection , the inflammation would be more stronger.If this condition cann't be intervened in time, the infiltrative inflammatory cells (such as eosinophil ,mast cell etc)will not only start or enlarges the cell and humoral immunity in partial nasal mucosa, also regulate the activities of the neuropeptide nerve fiber and inflammatory cells through the positive feedback. So that such inflammation becomes constant. Along with the course of illness, mucosa edema , saccular dilatation of gland and proliferation of fibroblast could not be reversed. Then the recurring nasal polyps are coming into being. In shrot words, recurring nasal polyps are the consequence of the mess of nerve- endocrine- immunity system of nasal mucosa which can be caused by many factors,including trauma and infection. The neuropeptide fibre system plays important role in this course. In a sense, neuropeptides, such as SP ,CGRP and VIP , not only are involved in the pathophysiological mechnism of the initial stage of recurring nasal polyp,but also act as the initiators.