Expression Of IL-2 And IL-18 In Eosinphilic And Neutrophilbased Chronic Rhinosinusitis With Nasal Polyps

Objective:Studying the clinical and histopathological features of different pathological types of chronic rhinosinusitis with nasal polyps,and the expression of IL-2 and IL-18 in nasal polyps,to investigate the relevance between IL-2,IL-18 and chronic rhinosinusitis with nasal polyps.Methods:The nasal polyp tissues of patients undergoing endoscopic surgery in our department were collected from June 2016 to October 2017.After HE staining,40 cases of neutrophil-dominated nasal polyps and 48 cases of eosinophilic nasal polyps were screened under a 400-fold microscope and become two experimental groups.At the same time.An appropriate amount of inferior turbinate mucosa was collected from20 patients with simple nasal septum deviation diorthosis during the same period as the control group.Preoperative routine examinations,including anterior rhinoscopy,fasting blood routine,sinus CT,and inhaled allergen testing,were performed.Statistics,comparison,analysis of gender,neutrophil percentage,eosinophil percentage,major symptoms of SNOT-20 between the experimental groups,and immunohistochemistry was used to detect the expressions of IL-2?IL-18 in nasal polyps and normal inferior turbinate mucosa.Results:In this experiment,eosinophils/total inflammatory cells in nasal polyps >10% as a standard for the diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP);neutrophils/total inflammatory cells > 4%,as a diagnostic criterion for neutrophil-based chronic rhinosinusitis with nasal polyps(NCRSwNP).Patients with NCRSwNP and ECRSwNP were compared for the characteristics and clinical manifestations of CRSwNP.In terms of gender,percentage of neutrophils,and percentage of eosinophils,P>0.05,the difference was not statistically significant.It was not considered that there were significant differences in gender,percentage of neutrophils,and percentage of eosinophils.On the five main symptoms of the SNOT-20 scale,the median values of scores of the symptom of Pus snot in NCRSwNP and ECRSwNP were [2(1,2)] and [1(1,2)],P(P=0.008)<0.05,the difference was statistically significant,indicating that patients with NCRSwNP were more severe than those with ECRSwNP in the symptom of Pus snot.There were no significant differences between the two groups in the remaining four symptoms:cough,poor nighttime sleep quality,sneezing,Pain or pressure in the head or face.Regarding the pathological features of CRSwNP,the positive rates of IL-2 and IL-18 in the experimental groups and the control group were compared.The positive rate of IL-2 in NCRSwNP and ECRSwNP patients was significantly lower than that in the control group,but the positive rate of NCRSwNP(65%)was significantly higher than that of ECRSwNP(37.5%),and P<0.0125.The difference was statistically significant.The positive rate of IL-18 in NCRSwNP and ECRSwNP patients was significantly higher than that in the control group,but the positive rate of NCRSwNP(45%)was significantly lower than that of ECRSwNP(75%),and P<0.0125,the difference was statistically significant.Conclusion:Neutrophil-based CRSwNP has obvious clinical symptoms and inflammatory properties.Compared with the control group,IL-2 was lowly expressed in nasal polyps and mainly related to neutrophils,indicating that IL-2 may be one of the causes of the development of neutrophil-type CRSwNP.IL-18 is highly expressed in nasal polyps and is mainly associated with eosinophils,suggesting that IL-18 may beone of the causes of the development of CRSwNP,which is predominantly eosinophil-type.IL-2 and IL-18 play a role in the formation and development of nasal polyps.This will provide new ideas for future clinical and pathophysiological studies of CRSwNP,indicating a new direction for the treatment of neutrophil-based nasal polyps.