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Evidence for distinct histologic profile of nasal polyps with and without eosinophilia.

ABSTRACT: To evaluate the histology, RNA, and protein signatures of nasal polyps (NPs) in order to demonstrate specific subtypes of disease and differentiate "idiopathic" NPs based on tissue eosinophilia.Prospective laboratory-based study.NP tissue was obtained from patients referred to the University of Virginia Health System for sinus surgery. Histology analyses included hematoxylin-eosin, Gomori's trichrome, toluidine blue, and chloroacetate staining. RNA and protein were extracted from tissue and cytokine transcript or protein concentrations determined.Idiopathic NPs can be divided into distinct subsets characterized by absence (NE) and presence (E) of prominent eosinophilia. The validity of this distinction is supported by the demonstration that NE polyps are further distinguished by glandular hypertrophy, dense collagen deposition, and mononuclear cellular infiltrate. In contrast, E-NP display edema, rare glandularity, and minimal collagen deposition except within the basement membrane. Total mast cell numbers were reduced in E-NP, whereas connective tissue mast cells were increased in NE-NP. Consistent with the distinctive pattern of increased fibrosis, NE-NP displayed increased transforming growth factor-? and vascular endothelial growth factor transcripts. Similarly, NE-NPs had higher concentrations of transforming growth factor-?, fibroblast growth factor-?, and platelet-derived growth factor protein.Idiopathic NPs can be distinguished by NE and E and are supported by the observations that these display distinct histologic, gene, and protein expression patterns. The findings suggest that as unique diseases, idiopathic NPs will require distinct therapeutic interventions.

SUBMITTER: Payne SC

PROVIDER: S-EPMC3183261 | biostudies-literature | 2011 Oct

REPOSITORIES: biostudies-literature

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Evidence for distinct histologic profile of nasal polyps with and without eosinophilia.

Payne Spencer C SC Early S Brandon SB Huyett Phillip P Han Joseph K JK Borish Larry L Steinke John W JW

The Laryngoscope 20110906 10

<h4>Objective/hypothesis</h4>To evaluate the histology, RNA, and protein signatures of nasal polyps (NPs) in order to demonstrate specific subtypes of disease and differentiate "idiopathic" NPs based on tissue eosinophilia.<h4>Study design</h4>Prospective laboratory-based study.<h4>Methods</h4>NP tissue was obtained from patients referred to the University of Virginia Health System for sinus surgery. Histology analyses included hematoxylin-eosin, Gomori's trichrome, toluidine blue, and chloroace ...[more]

PMID: 21898422

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Project description:Background:Eosinophilic inflammation is a major phenotype associated with poorly controlled disease in nasal polyp patients. The difference between systemic and local eosinophilia in relation to disease control is poorly understood. Objective:To explore whether blood and polyp tissue eosinophil numbers are independent risk factors for poor disease control in patients with nasal polyp. Methods:By using the electronic medical records database and manual evaluation, 183 nasal polyp patients who had undergone endoscopic sinus surgery at least one year prior to the study with complete data of tissue specimens, baseline blood routine test, nasal endoscopy and sinus computed tomography, were identified and recruited to assess disease control based on the criteria of a European position paper on rhinosinusitis and nasal polyps 2012 (EPOS 2012). Multiple logistic regression model was used to determine the association between blood and tissue eosinophil numbers and risk of poor disease control by adjusting for demographics and comorbidities. Results:We broke down the cohort into 4 groups according to blood (0.3 ?× ?109/L) and tissue (10%) eosinophils. The patients without eosinophilic inflammation represented the largest group (41.5%). The group with concordant blood and tissue eosinophilia represented the second largest (31.2%), and the patients with isolated tissue (15.3%) or blood (12.0%) eosinophilia were relatively rare. Multiple logistic regression models found blood eosinophil count and tissue eosinophil percentage were independently associated with increased risk for poor disease control after adjustments for covariates related to poor treatment outcome. Furthermore, subjects with concordant blood and tissue eosinophilia had a higher risk for poor disease control than those with isolated blood or tissue eosinophilia. Conclusion:Concordant blood and tissue eosinophilia relates to a higher likelihood of poor disease control than isolated blood or tissue eosinophilia after adjustment of potential confounders in nasal polyp patients.

Dataset Information

Evidence for distinct histologic profile of nasal polyps with and without eosinophilia.

Publications

Evidence for distinct histologic profile of nasal polyps with and without eosinophilia.

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