Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal Sinusitis

Background Allergic fungal sinusitis (AFS) is considered a different disease from other polypoid chronic rhinosinusitis diseases (CRS) with eosinophilic mucus (EM) termed eosinophilic mucus chronic rhinosinusitis (EMCRS). To substantiate this, studies on cellular responses to fungi and sinus mucosal...

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Main Authors: Harshita Pant M.B.B.S., Ph.D., Dimitra Beroukas B.Sc., Frank E. Kette M.B.B.S., Ph.D., William B. Smith M.B.B.S., Ph.D., Peter J. Wormald M.B.B.S., M.D., Peter J. Macardle Ph.D.
Format: Article
Language:English
Published: SAGE Publishing 2010-01-01
Series:Allergy & Rhinology
Online Access:https://doi.org/10.2500/ajra.2009.23.3356
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author Harshita Pant M.B.B.S., Ph.D.
Dimitra Beroukas B.Sc.
Frank E. Kette M.B.B.S., Ph.D.
William B. Smith M.B.B.S., Ph.D.
Peter J. Wormald M.B.B.S., M.D.
Peter J. Macardle Ph.D.
author_facet Harshita Pant M.B.B.S., Ph.D.
Dimitra Beroukas B.Sc.
Frank E. Kette M.B.B.S., Ph.D.
William B. Smith M.B.B.S., Ph.D.
Peter J. Wormald M.B.B.S., M.D.
Peter J. Macardle Ph.D.
author_sort Harshita Pant M.B.B.S., Ph.D.
collection DOAJ
description Background Allergic fungal sinusitis (AFS) is considered a different disease from other polypoid chronic rhinosinusitis diseases (CRS) with eosinophilic mucus (EM) termed eosinophilic mucus chronic rhinosinusitis (EMCRS). To substantiate this, studies on cellular responses to fungi and sinus mucosal inflammatory cell populations in AFS and other EMCRS diseases are. required. This study was designed to examine polyp inflammatory cell populations and peripheral blood fungal-specific T-cell responses in AFS, other EMCRS subgroups (defined later), and polypoid CRS without EM. Methods A prospective study was performed. Clinical characteristics, including CRS symptoms, sinus computed tomography (CT) scans, allergy status, intraoperative endoscopy, presence of EM, and fungal culture results were used to define patient groups. Polyps and peripheral blood were examined for populations of eosinophils, lymphocytes (CD4 + , CD8 + T cells, natural killer cells, and B cells), and neutrophils using immunohistochemistry, cytospin preparations and flow cytometry. Fungal-specific peripheral blood lymphocyte proliferation was examined in AFS patients, other EMCRS patients, CRS patients, and controls. Results There was no significant difference in the percentage of cell populations and fungal-specific lymphocyte proliferation between AFS and other EMCRS diseases. However, AFS and other EMCRS polyps had a higher percentage of eosinophils and CD8 + T cells whereas CRS polyps had higher CD4 4 T cells. Fungal-specific lymphocyte proliferation was significantly greater in AFS and other EMCRS patients regardless of fungal allergy, whereas in CRS and controls, higher proliferation was observed in fungal-allergic individuals. Conclusion These findings question the basis for differentiating AFS from, other EMCRS diseases based on fungal allergy and fungi in EM. Fungal-specific cellular response was present in AFS and other EMCRS diseases, different from, that associated with fungal allergy, suggesting a nonallergic fungal immune response. Increased CD8 + T cells in EMCRS polyps signify a different type of inflammation to CRS that may be driven by CD8 + T cells.
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spelling doaj.art-04e6bf95c10840a68a5bff0d95677b812022-12-21T23:25:37ZengSAGE PublishingAllergy & Rhinology2152-65672010-01-01110.2500/ajra.2009.23.3356Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal SinusitisHarshita Pant M.B.B.S., Ph.D.Dimitra Beroukas B.Sc.Frank E. Kette M.B.B.S., Ph.D.William B. Smith M.B.B.S., Ph.D.Peter J. Wormald M.B.B.S., M.D.Peter J. Macardle Ph.D.Background Allergic fungal sinusitis (AFS) is considered a different disease from other polypoid chronic rhinosinusitis diseases (CRS) with eosinophilic mucus (EM) termed eosinophilic mucus chronic rhinosinusitis (EMCRS). To substantiate this, studies on cellular responses to fungi and sinus mucosal inflammatory cell populations in AFS and other EMCRS diseases are. required. This study was designed to examine polyp inflammatory cell populations and peripheral blood fungal-specific T-cell responses in AFS, other EMCRS subgroups (defined later), and polypoid CRS without EM. Methods A prospective study was performed. Clinical characteristics, including CRS symptoms, sinus computed tomography (CT) scans, allergy status, intraoperative endoscopy, presence of EM, and fungal culture results were used to define patient groups. Polyps and peripheral blood were examined for populations of eosinophils, lymphocytes (CD4 + , CD8 + T cells, natural killer cells, and B cells), and neutrophils using immunohistochemistry, cytospin preparations and flow cytometry. Fungal-specific peripheral blood lymphocyte proliferation was examined in AFS patients, other EMCRS patients, CRS patients, and controls. Results There was no significant difference in the percentage of cell populations and fungal-specific lymphocyte proliferation between AFS and other EMCRS diseases. However, AFS and other EMCRS polyps had a higher percentage of eosinophils and CD8 + T cells whereas CRS polyps had higher CD4 4 T cells. Fungal-specific lymphocyte proliferation was significantly greater in AFS and other EMCRS patients regardless of fungal allergy, whereas in CRS and controls, higher proliferation was observed in fungal-allergic individuals. Conclusion These findings question the basis for differentiating AFS from, other EMCRS diseases based on fungal allergy and fungi in EM. Fungal-specific cellular response was present in AFS and other EMCRS diseases, different from, that associated with fungal allergy, suggesting a nonallergic fungal immune response. Increased CD8 + T cells in EMCRS polyps signify a different type of inflammation to CRS that may be driven by CD8 + T cells.https://doi.org/10.2500/ajra.2009.23.3356
spellingShingle Harshita Pant M.B.B.S., Ph.D.
Dimitra Beroukas B.Sc.
Frank E. Kette M.B.B.S., Ph.D.
William B. Smith M.B.B.S., Ph.D.
Peter J. Wormald M.B.B.S., M.D.
Peter J. Macardle Ph.D.
Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal Sinusitis
Allergy & Rhinology
title Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal Sinusitis
title_full Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal Sinusitis
title_fullStr Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal Sinusitis
title_full_unstemmed Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal Sinusitis
title_short Nasal Polyp Cell Populations and Fungal-Specific Peripheral Blood Lymphocyte Proliferation in Allergic Fungal Sinusitis
title_sort nasal polyp cell populations and fungal specific peripheral blood lymphocyte proliferation in allergic fungal sinusitis
url https://doi.org/10.2500/ajra.2009.23.3356
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