Role Of Treg Cells In The Pathogenesis Of Nasal Polyps And Its Clinical Significance

Nasal polyps is the common disease of chronic persistent inflammation of nasal mucosa, and its clinical features is that nasal mucosa edema with extreme in the middle nasal meatus form a single or multiple polyps.The incidence rate and recurrence rate is extremely high,many in adult onset,the current use of operation treatment mode.But the operation only for the treatment of symptoms rather than the cause of treatment.At present,the pathogenesis of nasal polyps is not yet clear,generally considered a variety of factors common result of.Objective: Based on the Foxp3,IL-4,TGF-beta 1 in nasal polyp tissues and adjacent tissues and ethmoid mucosa in chronic sinusitis and to investigate the expression of regulatory T cells in the pathogenesis of nasal polyps,reveal the pathogenesis of nasal polyps, for its diagnosis, treatment,prevention and its clinical application to provide a theoretical basis.Materials and methods: The experiment is divided into nasal polyps,chronic sinusitis and nasal polyps adjacent tissues and normal mucosa of inferior turbinate group and control group.All the samples were obtained from 2012 February to 2013 January in Baoding the first hospital in hospital inpatient and outpatient endoscopic operation of chronic sinusitis, nasal polyps patients specimens,20 cases of nasal polyp specimens from patients with nasal polyps were treated with male14 cases,female 6 cases;age16~60years old;20cases with chronic nasal sinusitis specimens from patients with chronic sinusitis,male 14 cases,female 6cases,age14~66years old;15 cases of nasal polyp tissue samples from patients by nasal polyps,male8 cases,female7cases;age16~59years old;10specimens of normal nasal mucosa from nasal septum deviation complicated with inferior turbinate hypertrophy patients,male 8 cases female 2 cases, age16~50years old.All the patients had no serious allergic rhinitis,bronchial asthma,aspirin intolerance and other system.All the tissues were fixed in 4% paraformaldehyde,dehydrated,embedded in paraffin,tissue slices after routine HE staining, special staining of mast cells,and stick to the specimens of Foxp3,IL-4,TGF-beta1 expression by immunohistochemical method. Data are obtained using SPSS17.0 for the corresponding statistical analysis.Results: 1 HE staining: nasal polyps tissue,surrounding tissue of polyps,ethmoid mucosa tissues were showed different degrees of eosinophil infiltration under light microscope,mainly distributed in the mucosa of subcutaneous,glands and small vessels. While the control group were rare.Nasal polyp group levels of eosinophils(17.13+5.06)/HP was significantly higher than that in adjacent tissue,polyps group(5.68+2.19)/HP,sinusitis group(5.53+2.36)/HP,inferor turb inate mucosa group(1.2+1.02)/HP.The four group had statistical significance( P<0.01), Sinusitis and nasal polyp tissue surrounding tissue showed no statistical significance(P>0.05),two groups were statistically significant(P<0.0 1). 2 Mast cell specific staining: Nasal polyps mast cell level(14.31+4.89)/HP was significantly higher than that in adjacent tissue polyps group(5.56+1.50)/HP,sinusitis group(6.01+ 2.25)/HP,inferior turbinate mucosa group(5.15+2.39)/HP.The four groups had statistical significance(P<0.01), the difference among the three groups has no statistical significance except nasal polyps outside(P>0.05)(Table 1). 3 The expression of IL-4 in each tissue specimen The positive rate of IL-4 in nasal polyp tissue was 90%,the positive rate of tissue in near the polyps was 60% positive rate is 65% in the sinus mucosa.They.were significantly higher than that of inferior turbinate, which is20%, the difference was statistically significant(P<0.05).But compared with no statistically significant positive rate of polyp adjacent tissues and paranasal sinus mucosa(P>0.05). 4 The expression of TGF-beta1 in each tissue specimen: TGF-beta1 positive expression in cytoplasm were yellow or brown granules.A large number of expression in many interstitial aggregation ofinflammatory cells in the tissue surrounding mucosa of chronic sinusitis and polyps in ethmoid sinus.In the normal inferior turbinate mucosa tissues a little expression,but rare in nasal polyp tissue.The four groups had statistical significance compared with the positive rate(P<0.05),compared the two two adjacent tissues except polyps adjacent tissues group and ethmoid sinus mucosa tissue were not statistically significant the had statistical significance. 5 The expression of Foxp3 in each tissue specimen: The Foxp3 positive products in the inferior turbinate expressed around submucosal glands and blood vessels.The nucleus or cytoplasmcoloration.But rare in nasal polyps.the remaining two small set expression,the four groups had statistical significance compared with the positive rate(P<0.01),Sinusitis and nasal polyp tissue surrounding tissues showed no statistical significance(P >0.05).Correlation analysis showed that the number of Foxp3 positive cells in nasal polyps and polyps in the surrounding tissue and sinusitis mucosal tissues and eosinophil numbers were negative correlated(r1=-0.768,p<0.01;r2=-0.75 9,p<0.01;r3=-0.721;p<0.01).Conclusion: 1 eosinophilic hyperplasia is an important pathological features of nasal polyps. 2 mast cell mediated allergic to reflect on the occurrence and development of nasal polyps and play an important role,it also reveals the differences between the chronic sinusitis without nasal polyps and chronic rhinosinusitis with the pathogenesis of nasal polyps. 3 the IL-4 effect on B cells,inducing B cell growth and activation,produce Ig E,promote the mast cells eosinophils infiltration of inflammatory cells,vascular dilatation,increased exudation,edema,promote the generation of nasal polyps. 4 The down-regulation of Foxp3 and CD4+CD25+decreased induced inhibitory dysfunctionis a cause of nasal polyps. 5 TGF-beta1 resulted in the down regulation of the regulatory T lymphocytes and other inflammatory cells participate in the development of nasal polyps.