| Objective To explore the expression and clinical significance of BTB and CNC homology 2(Bach2)in different types of chronic rhinosinusitis(CRS),and to analyze its role in the molecular mechanism of different types of CRS,so as to provide a theoretical basis for the classification,diagnosis and treatment of CRS.Methods 1.In this study,43 chronic rhinosinusitis with nasal polyps(CRSwNP)patients diagnosed in the Department of Otorhinolaryngology in our hospital according to the guidelines for the treatment of chronic rhinosinusitis in Kunming in 2012 were selected [of which 19 eosinophils chronic rhinosinusitis with nasal polyps(ECRS)patients;24 non-eosinophilic chronic rhinosinusitis with nasal polyps(non-ECRS)patients],and 20 control subjects without any sinus disease were diagnosis of cerebrospinal fluid rhinorrhea,trauma and ethmoid sinus osteomawere enrolled.2.Lund-Kennedy score(nasal endoscopy score),Lund-Mackay score(sinus CT score)and VAS score were used to assess the severity of disease in patients and subjects before operation.3.The nasal polyps from CRSwNP patients and ethmoid sinus mucosa from control subjects were collected during operation,one part were fixed by formaldehyde,then embedded in paraffin to make sections,and the other part were stored at-80 °C.4.HE staining was performed on nasal polyp paraffin sections,and CRSwNP patients were further divided into ECRS patients and non-ECRS patients base on the number of eosinophils per highpower field as set.5.The expression of Bach2 in tissue samples of three groups were determined by quantitative reverse transcription-polymerase chain reaction(qRt-PCR),immunohistochemical staining and Western blotting,and the results of immunohistochemical staining and Western blotting were analyzed by using Image j software.6.Analyze the correlation between qRt-PCR and disease severity(LundKennedy score,Lund-Mackay score and VAS score)and the number of eosinophils per high power field(HPF).Results 1.According to the immunohistochemical staining results of each group,Bach2 was mainly located in the cell layer of nasal epithelium,and the expression level was distinct in different groups.Software analysis of immunohistochemical staining images show that Bach2 was obviously low expressed level in ECRS group compared with nonECRS group(P < 0.01),but was high expressed level in ECRS group compared with control group(P < 0.01).2.The protein expression level of Bach2 was significantly higher in the non-ECRS group than in the ECRS group,and higher in the ECRS group than in the control group(P < 0.01,P < 0.01).The non-ECRS group was also significantly higher than the control group(P < 0.01).3.The relative expression levels of Bach2 mRNA in the ECRS group,non-ECRS group and control group were 1.12±0.520,1.76±1.339 and 0.80±0.289,respectively.There were statistically significant difference between the ECRS group and the non-ECRS group and the control group(P < 0.05).The non-ECRS group was also significantly higher than the control group(P < 0.01).4.The average number of eosinophils per HPF in the ECRS group,non-ECRS group,and control group were: 41±19.322/10 HPF,2.6±1.555/10 HPF,and 1.6±1.276/10 HPF.5.In the ECRS group,there were correlation between the relative expression level of Bach2 mRNA and the sinus CT score,nasal endoscopy score,and the number of eosinophils/HPF in the tissue(P < 0.01,P < 0.05,P < 0.01),and there was no correlation with the VAS score(P > 0.05).In the non-ECRS group,there was a correlation between the relative expression level of Bach2 mRNA and endoscopy score(P < 0.05),but were no significant correlation with the VAS score,the sinus CT score,and the average number of eosinophils per HPF in the tissue(P > 0.05).Conclusion Bach2 plays an important role in the inflammation of CRSwNP.The expression level of Bach2 is lower expressed in ECRS patients compared with non-ECRS,correlated with eosinophilic inflammation in ECRS,and is related to the disease severity. |
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