Decrease in number of mast cells in resected nasal polyps as an indicator for postoperative recurrence of chronic...

Area of Science:

• Immunology
• Otorhinolaryngology
• Pathology

Background:

• Chronic rhinosinusitis with nasal polyps (CRSwNP) is phenotyped as eosinophilic (ECRS) or non-eosinophilic (NECRS) in Japan.
• Current classifications may miss patients with low eosinophil counts, potentially impacting recurrence risk assessment.
• Identifying reliable markers for CRSwNP recurrence is clinically significant.

Purpose of the Study:

• To identify cellular or molecular markers that can predict nasal polyp recurrence in CRSwNP patients.
• To investigate the role of mast cells and eosinophils in CRSwNP phenotypes and recurrence.
• To explore potential new diagnostic approaches beyond current classifications.

Main Methods:

• Nasal polyps from 32 CRSwNP patients undergoing endoscopic sinus surgery were analyzed.
• Patients were classified into ECRS, NECRS, and unknown groups using the JESREC score and eosinophil counts.
• Immunohistochemistry was used to quantify mast cells, tryptase-positive cells, and transforming growth factor β1-positive cells.

Main Results:

• Eosinophil infiltration was highest in the ECRS group.
• Mast cells and tryptase-positive cells were significantly lower in ECRS and unknown groups compared to NECRS.
• Mast cell and tryptase-positive cell counts negatively correlated with the JESREC score, while transforming growth factor β1 showed positive correlations.

Conclusions:

• Mast cell enumeration in resected nasal polyps may serve as a predictive marker for postoperative recurrence in CRSwNP.
• This finding suggests a potential alternative or complementary approach to current phenotypic classifications for predicting CRSwNP outcomes.
• Further research into mast cell involvement could refine treatment strategies for CRSwNP.