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ABSTRACT: Background
It has been established that patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have co-existing asthma.Objective
We aimed to test two hypotheses: (i) upper and lower airway inflammation in CRSwNP is uniform in agreement with the united airways concept; and (ii) bronchial inflammation exists in all CRSwNP patients irrespective of clinical asthma status.Methods
We collected biopsies from nasal polyps, inferior turbinates and bronchi of 27 CRSwNP patients and 6 controls. All participants were evaluated for lower airway disease according to international guidelines. Inflammatory cytokines were investigated using a Th1/Th2 assay including 14 chemokines and cytokines; tissue concentrations were normalized according to tissue weight and total protein concentration. Individual cytokines and multivariate inflammatory profiles were compared between biopsy sites and between patients and controls.Results
We found significantly higher concentrations of Th2 cytokines in nasal polyps compared to inferior turbinate and bronchial biopsies. In addition, we showed that the inflammatory profile of nasal polyps and bronchial biopsies correlated significantly (p<0.01). From the Th2 cytokines measured, IL-13 was significantly increased in bronchial biopsies from CRSwNP patients with, but not without asthma.Conclusion
Our findings support the united airways concept; however, we did not find evidence for subclinical bronchial inflammation in CRSwNP patients without asthma. Finally, this study indicates for the first time that nasal polyps potentially play an important role in the airway inflammation rather than being a secondary phenomenon.
SUBMITTER: Hakansson K
PROVIDER: S-EPMC4489400 | biostudies-literature | 2015
REPOSITORIES: biostudies-literature
Håkansson Kåre K Bachert Claus C Konge Lars L Thomsen Simon Francis SF Pedersen Anders Elm AE Poulsen Steen Seier SS Martin-Bertelsen Tomas T Winther Ole O Backer Vibeke V von Buchwald Christian C
PloS one 20150701 7
<h4>Background</h4>It has been established that patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have co-existing asthma.<h4>Objective</h4>We aimed to test two hypotheses: (i) upper and lower airway inflammation in CRSwNP is uniform in agreement with the united airways concept; and (ii) bronchial inflammation exists in all CRSwNP patients irrespective of clinical asthma status.<h4>Methods</h4>We collected biopsies from nasal polyps, inferior turbinates and bronchi of 27 CRSw ...[more]