瘦素在肥胖成人慢性鼻-鼻窦炎伴鼻息肉发病中的作用

Preliminary study on the role of leptin in the pathogenesis of chronic rhinosinusitis with nasal polyps in obese adults

摘要:

10071520.202003008·论著· 目的初步探讨瘦素（Leptin）在肥胖成人慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）发病中的作用及机制。方法按照体重指数（BMI）随机选取肥胖CRSwNP患者40例，体重正常CRSwNP患者30例，选取同期肥胖鼻中隔偏曲患者30例为对照组。通过酶联免疫吸附法（ELISA）测定3组患者血清中Leptin及其受体水平、EOS相关因子IL4、IL13的水平；RTPCR及免疫组织化学方法检测3组患者局部鼻黏膜中Leptin及其受体水平表达；苏木精-伊红染色法观察3组患者组织中EOS细胞浸润程度。另Pearson相关性分析Leptin水平与EOS相关指标及浸润程度的关系。结果与对照组比较，两组CRSwNP患者的血清与局部Leptin及其受体水平表达均升高，血清中EOS相关因子IL4、IL13的水平表达均显著升高，差异具有统计学意义（P<0.05）；两组CRSwNP患者中肥胖患者的各项检测指标均显著高于体重正常患者（P<0.05），且Leptin及其受体水平与EOS相关指标、EOS浸润程度均呈正相关（P<0.05）。结论Leptin在CRSwNP患者中水平显著升高，且肥胖患者组更高，并与EOS浸润及其促进因子显著相关，提示Leptin可能通过促进EOS增殖浸润参与肥胖成人CRSwNP发病。

关键词:慢性鼻窦炎|鼻息肉|瘦素|肥胖|嗜酸性粒细胞

Abstract:

ObjectiveTo investigate the role and mechanism of leptin in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) in obese adults.MethodsAccording to body mass index (BMI), 40 obese CRSwNP patients and 30 CRSwNP patients with normal weight were randomly selected, and 30 cases of obesity with deviation of nasal septum in the same period were chosen as the control group. Levels of leptin and its receptors, eosinophil (EOS)related factors interleukin (IL)4 and IL13 in serum were measured by enzymelinked immunosorbent assay (ELISA). Levels of leptin and its receptors in nasal mucosa of the three groups were detected by immunochistochemistry and reverse transcriptionpolymerase chain reaction (RTPCR). Degree of EOS infiltration was observed by hematoxylineosin staining. Pearson correlation was used to analyze the relationships between leptin level and EOSrelated indicators and infiltration degree.ResultsCompared with the control group, the levels of leptin and its receptors in serum and local tissue as well as the serum levels of IL4 and IL13 in the CRSwNP groups were significantly elevated (all P<0.05). Moreover, the levels of abovementioned indexes in the obese CRSwNP group were significantly higher than those in the CRSwNP group with normal weight (all P<0.05). Furthermore, the levels of leptin and its receptors were positively correlated with EOSrelated indicators and EOS infiltration in obese CRSwNP group (all P<0.05).ConclusionLevels of leptin are significantly increased in CRSwNP patients and higher in obese patients, which is positively correlated with EOS infiltration and its promoters, suggesting that leptin may participate in the pathogenesis of CRSwNP in obese adults by promoting EOS proliferation and infiltration.

Key words:Chronic rhinosinusitis|Nasal polyps| Leptin| Obesity| Eosinophils