| BackgroundFungal Rhinosinusitis mainly includes inflammatory diseases of the nasal cavity and/or sinuses caused by fungal infections.Many conditionally pathogenic bacteria can cause this disease,among which Aspergillus is the most common.Because it is located in the south,the weather is warm and humid,and the incidence of fungal sinusitis in Guangxi is higher than other regions.Anatomical obstacles,environmental exposure,microbial toxicity,genetic background and the immune status of the infected host are considered potential causes.In healthy people and patients with chronic sinusitis,fungi are present in the nasal mucosa and paranasal sinuses.The colonization and infection of fungi are different.Not every colonized patient will develop a fungal infection.The interaction of fungi with the host’s immune system determines the occurrence or disappearance of infection.The patient’s immune status largely determines the nature of nasal fungal diseases.Joanna Leszczyńska et al.believe that among the comorbidities of fungal sinusitis,hypertension and confirmed type 2 diabetes are the main factors.In addition,there are many factors that may lead to the occurrence of chronic fungal sinusitis,and some data show that 10 % Of the patients were exposed to a harmful working environment(mining),10% of the patients smoked,and 20%of the patients had surgery for chronic sinusitis.At present,our research found that the pathological changes of fungal colonization to the formation of fungal sinusitis take about one to three years.However,the pathophysiological mechanism of the patient’s transformation from harmless fungal colonization to fungal sinusitis is still unclear.Therefore,in-depth exploration of the immune mechanism of fungal sinusitis,help susceptible persons to establish immune prevention,and promote immune reconstruction of infected patients,is of great significance to improve the prognosis.In recent years,the role of C-type lectin in antifungal immunity has become a research hotspot.At present,the most studied is Dectin-1 receptor,which can recognize β-1,3 glucan on the cell wall of fungi and activate many cell responses.,Including phagocytosis,the generation of reactive oxygen species and the production of a large number of cytokines through various signaling pathways,can simultaneously induce Th1 producing IFN-γ and Th17 producing IL-17 immune responses.Th1 and Th17 play a key role in anti-fungal immunity.Studies have shown that Th1 cells and Th17 cells play a major role in the immune response of fungal keratitis,but there is currently no domestic expression and expression of Dectin-1 receptor,IFN-γ,IL-17 in fungal rhinosinusitis Relevance research.Some studies have achieved good results by interfering with the Dectin-1 receptor,but more in-depth discussion is needed.Therefore,our research on the expression of Dectin-1 receptor,IFN-γ,IL-17 in fungal rhinosinusitis can provide new evidence for the adaptive immune system of fungi,which has very important clinical significance.ObjectiveThis article intends to explore the expression level of Dectin-1 receptor in patients with fungal sinusitis,and the correlation between Dectin-1 and IFN-γ,IL-17 in the serum of patients,in order to reveal the antifungal properties of Dectin-1 receptor The role and mechanism of the immune response in sinusitis can provide further experimental basis for clinical diagnosis and treatment of fungal keratitis and finding new therapeutic targets.MethodsA total of 60 patients after inpatient treatment in the Department of Otolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University from January 2019 to July 2019 were collected.-20 patients with sinusitis(inclusion criteria: patients with high suspicion based on medical examination and imaging examination before surgery,and pathological examination after surgery have been confirmed to be fungal rhinosinusitis);common initial treatment of sinusitis(CRS Group)20 cases(inclusion criteria: CRS patients who have not received any nasal surgery);another 20 cases of nasal non-inflammatory diseases were collected as a control group(inclusion criteria: based on their symptoms,signs,CT,nasal endoscopy,etc.Excluding the possibility of nasal sinus inflammatory diseases(including chronic sinusitis),patients were not treated with immunosuppressants and hormones within 1 month).During surgery,FRS and CRS sinus mucosa tissues and normal control nasal mucosa tissues were collected.All collected tissues were divided into two parts,and part of them were placed in paraformaldehyde to make wax block slices for immunohistochemical measurement of Dectin-1in mucosal tissue The expression in the;part of the quantitative quantitative PCR to determine the expression of Dectin-1;preoperative patients with peripheral blood were used to detect the content of Dectin-1,IL-17,IFN-γ in serum.Results1.Immunohistochemical results: Dectin-1 receptor is expressed in mucosal epithelial cells of fungal sinusitis group,chronic sinusitis group and control group,mainly distributed in the cell membrane and cytoplasm of cells,Dectin-1 in fungi The expression in the sinusitis group was strongly positive,but was weakly positive in the control group and chronic sinusitis group.2.Fluorescence quantitative PCR results: the expression of Dectin-1 in the fungal rhinosinusitis group was significantly increased compared with the chronic sinusitis group and the control group(P <0.05),while the expression of Dectin-1 in the chronic sinusitis group was the There was no statistical difference(P> 0.05).3.ELISA results:jThe serum IFN-γ level of fungal rhinosinusitis group and CRS group was significantly higher than that of the control group(P<0.05),while the serum IFN-γ level of CRS group was significantly higher than that of FRS group(P<0.05).kthe serum IL-17 level of fungal rhinosinusitis group was significantly higher than that in the chronic sinusitis group and the control group(P <0.05),and the serum IL-17 level of chronic sinusitis group was also significantly higher than that in the control group(P <0.05).lthe level of Dectin-1 in FRS group was significantly higher than that in CRS group and control group(P < 0.05),but there was no significant difference between CRS group and control group(P > 0.05).mthere was a positive correlation between the increase of IFN-γ,IL-17 and the increase of Dectin-1 in FRS patients,the difference was statistically significant(P < 0.05).Conclusion1.The levels of IFN-γ,IL-17 and Dectin-1 in patients with fungal rhinosinusitis are higher than those in normal people.It can be speculated that all three are involved in the body’s antifungal immunity;2.There is a positive correlation between elevated levels of IL-17 and Dectin-1 in patients with fungal rhinosinusitis;3.The in-depth study of IFN-γ,IL-17 and Dectin-1 aims to provide a theoretical basis for the three to participate in the antifungal immunity of fungal rhinosinusitis,and to find new treatments for clinical diagnosis and treatment of fungal rhinosinusitis The target provides further experimental basis. |
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