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Polypoidal rhinosinusitis in cystic fibrosis: a clinical and histopathological study
J M Rowe-Jones1, M Shembekar, N Trendell-Smith
1Department of Otorhinolaryngology, Charing Cross Hospital, London, UK.
Insights
Nasal polyps in cystic fibrosis (CF) patients show more neutrophils, unlike typical eosinophilic polyps. This study found neutrophils and plasma cells in CF polyps, suggesting a different inflammatory profile in CF-related nasal polyposis.
Area of Science:
- Immunology
- Otolaryngology
- Pathology
Background:
- Eosinophils are implicated in nasal polyposis pathogenesis.
- Nasal polyps in cystic fibrosis (CF) are often described as neutrophilic.
- Understanding cellular differences is key to CF-related nasal polyp treatment.
Purpose of the Study:
- Compare cellular composition of nasal polyps in CF vs. non-CF patients.
- Investigate correlations between cell counts, CT scores, and polyp recurrence in CF patients.
- Clarify the role of eosinophils and neutrophils in CF-related nasal polyposis.
Main Methods:
- Histopathological analysis of nasal polyp tissue from 44 CF patients and 50 non-CF patients.
- Quantitative cell counting for eosinophils, neutrophils, and other inflammatory cells.
- Clinical data collection including CT scans and polyp recurrence times for CF patients.
Main Results:
- No significant difference in the prevalence of eosinophils between CF and non-CF groups (P > 0.25).
- CF polyps showed significantly higher neutrophil counts (P < 0.01) and plasma cells (P = 0.038).
- Neutrophil count correlated with CT score (P = 0.025); macrophage count correlated with recurrence time (P = 0.01).
Conclusions:
- Nasal polyps in CF patients exhibit a distinct inflammatory profile, characterized by increased neutrophils and plasma cells.
- The distinction between eosinophilic and neutrophilic polyps may be an oversimplification, especially in CF.
- Cellular composition, particularly neutrophils and macrophages, may influence disease severity and recurrence in CF-related nasal polyposis.
Abstract:
The eosinophil may play a key role in the pathogenesis of nasal polyposis. Polyps in cystic fibrosis, however, have been described as neutrophilic. We compared the cell counts in polyps from 44 patients with cystic fibrosis to polyps from 50 patients without cystic fibrosis. The clinical profile, CT-scan and time to polyp recurrence were also compared with the cell counts in the patients with cystic fibrosis. No significant difference was detected in the number of patients with eosinophils (P > 0.25). Significantly more patients in the group with cystic fibrosis had polyp neutrophils (P < 0.01). Polyps from patients without cystic fibrosis contained more eosinophils (P < 0.001) whilst polyps from patients with cystic fibrosis contained more neutrophils (P = 0.001) and plasma cells (P = 0.038). Significant correlation was found between the neutrophil count and the CT score (P = 0.025) and between the recurrence time of polyps and the macrophage count (P = 0.01). Eosinophils are present in varying degrees in polyps from patients with and without cystic fibrosis and to classify polyps as eosinophilic or neutrophilic may be a false distinction.