The Role Of Th17 Cells In Chronic Rhinosinusitis With Nasal Polyps Combining Allergic Rhinitis

Objective:Th17 cells have played an important role in a variety of autoimmune and inflammatory diseases. This paper aims to study with the expression of IL-17, IL-22, retinoid-related orphan Receptor yt(RORyt) and eosinophils(Eos) in nasal polyps of chronic rhinosinusitis with nasal polyps(CRSwNP) combining allergic rhinitis (AR)or not, to discuss the possible mechanism of IL-17, IL-22, RORyt and Eos and the relevance of them, as well as the influence of allergic factors on CRSwNP.Methods:Case screening, the experimental group, drawn specimens and experimental methods. The selected cases were hospitalized patients from June 2015 to September 2015 period Otolaryngology Head and Neck Surgery at the First Affiliated Hospital of Guangxi Medical University, receiving functional endoscopic sinus surgery routinely. According to whether combining allergic rhinitis, patients were divided into group of CRSwNP combining AR and group of CRSwNP not combining AR. Experimental group collected nasal polyps of CRSwNP in patients, while control group collected inferior turbinate mucosa from deviated septum with inferior turbinate hypertrophy. Using H-E staining to observe tissue morphology and detect eosinophils cells counting; Immunohistochemistry was used to detect the relative content of IL-17, L-22 and RORyt. All data were analysised by SPSS 19.0 statistical software.Results:(1) Eosinophil cells counting in the groups of CRSwNP combining AR or not were significantly higher than the control group (P<0.01); Eosinophil cells counting in the group of CRSwNP combining AR was higher than the group of CRSwNP not combining AR (P<0.05).(2)The expression of IL-17 in the groups of CRSwNP combining AR or not were significantly higher than the control group (P<0.01); The expression of IL-17 in the group of CRSwNP combining AR was higher than the group of CRSwNP not combining AR (P<0.05). (3)The expression of RORyt in the groups of CRSwNP combining AR or not were significantly higher than the control group (P<0.01); The expression of RORyt in the group of CRSwNP combining AR was higher than the group of CRSwNP not combining AR (P<0.05). (4)The expression of IL-22 in the groups of CRSwNP combining AR or not were significantly higher than the control group (P<0.01); The expression of IL-22 in the group of CRSwNP combining AR was higher than the group of CRSwNP not combining AR (P<0.05).(5) In the group of CRSwNP combining AR, eosinophil cells counting, RORyt score and IL-22 score showed a straight linear correlation with IL-17 score (each P value was less than 0.05, r values were 0.589,0.691,0.646); IL-22 score was also found straight linear correlation with eosinophil cells counting (P<0.05, r= 0.573); RORyt score was also found straight linear correlation with IL-22 (P<0.05, r=0.562). In the group of CRSwNP not combining AR, eosinophil cells counting, RORyt score and IL-22 score showed a straight linear correlation with IL-17 score (each P value was less than 0.05, r values were 0.614,0.504,0.462); IL-22 score was also found straight linear correlation with eosinophil cells counting (P<0.05, r=0.471); RORyt score was also found straight linear correlation with IL-22 (P<0.05, r= 0.694).Conclusion:(1) Th17 cells and the cytokine of IL-17, IL-22 showed great significance in the generation and development of CRSwNP; Regulating the differentiation of Th17 cells and inhibiting the expression of IL-17, IL-22 may provide new ideas for the treatment of CRSwNP.(2) In clinical, screening the patients of CRSwNP combining AR, controlling the expression of Th17 cells and strengthening perioperative desensitization therapy at the same time, may improve the efficacy and prognosis of CRSwNP.