NLRP3炎性小体在非嗜酸性慢性鼻窦炎伴鼻息肉中的表达及临床意义

The expression and clinical significance of NLRP3 inflammasome in non-eosinophilic chronic sinusitis with nasal polyps

摘要:

目的 研究核苷酸结合寡聚化结构域样受体蛋白3(NOD-like receptors protein 3,NLRP3)炎性小体及相关因子在嗜酸性慢性鼻窦炎伴鼻息肉(eosCRSwNP)与非嗜酸性慢性鼻窦炎伴鼻息肉(non-eosCRSwNP)中的表达水平差异，进一步分析NLRP3与non-eosCRSwNP临床预后关系。方法 鼻内镜手术收集44例慢性鼻窦炎伴鼻息肉(CRSwNP)患者鼻息肉组织，通过组织HE染色将其分为22例eosCRSwNP患者和22例non-eosCRSwNP患者;同期收集18例鼻中隔偏曲患者下鼻甲黏膜组织，用逆转录聚合酶链式反应(RT-PCR)检测NLRP3炎性小体和IL-1β的mRNA水平;利用免疫组化观察NLRP3的蛋白表达情况。收集患者术前VAS评分、Land-Mackay评分、Lund-Kennedy评分及CRSwNP患者随访复发信息等。结果 免疫组化结果显示non-eosCRSwNP和eosCRSwNP中均有NLRP3蛋白表达且染色程度高于对照组(P＜0.05)。Non-eosCRSwNP组中NLRP3和白介素-1β(IL-1β)的mRNA表达水平明显升高(P＜0.05)。尤其，在复发型non-eosCRSwNP中免疫组化NLRP3表达程度与术前VAS评分、Land-Mackay评分及Lund-Kennedy评分比较呈正相关性(P＜0.05)。结论 研究表明NLRP3炎性小体及促炎因子IL-1β在non-eosCRSwNP中的表达显著，NLRP3表达程度与临床症状体征严重程度之间存在正相关性。因此，NLRP3炎性小体在预判non-eosCRSwNP复发上具有潜在临床价值。

关键词:慢性鼻窦炎伴鼻息肉;核苷酸结合寡聚化结构域样受体蛋白3;白介素-1β;复发

Abstract:

Objective To investigate the differences of expression levels of NLRP3 inflammasome and relative proinflammatory factors in eosinophilic and non-eosinophilic chronic sinusitis with nasal polyp (CRSwNP), and further analyze the relationship between NLRP3 and prognosis of non-eosinophilic chronic sinusitis with nasal polyp (non-eosCRSwNP).Methods Mucosa tissues of inferior turbinate from 18 patients with deviated septum and nasal polyp tissues from 44 patients with CRSwNP were collected during nasal endoscopic surgery. The patients with CRSwNP were divided into eosinophilic CRSwNP (eosCRSwNP) group (n=22) and non-eosCRSWNP (n=22) by tissue HE staining. The mRNA levels of NLRP3 inflammasome and IL-1β were detected by reverse transcription polymerase chain reaction (RT-PCR). The protein expression of NLRP3 was observed by immunohistochemistry. Preoperative visual analog score (VAS), Land-Mackay score, Lund-Kennedy score, and postoperative follow-up information of all the CRSwNP patients were collected.Results Immunohistochemical results showed that NLRP3 protein was expressed in both non-eosCRSwNP and eosCRSwNP, with higher staining degree than that of the control group (P<0.05). RT-PCR revealed elevated mRNA levels of both NLRP3 and IL-1β in non-eosCRSwNP (P<0.05). In particular, the level of immunohistochemical NLRP3 expression in recurrent non-eoscRSWNP was positively correlated with preoperative VAS score, Land-Mackay score and Lund-Kennedy score (P<0.05).Conclusions NLRP3 inflammasome and pro-inflammatory factor IL-1β are significantly expressed in non-eosCRSwNP, and there is a positive correlation between NLRP3 expression and the severity of clinical symptoms and signs. Therefore, NLRP3 inflammasome has potential clinical value in predicting recurrence of non-eosCRSwNP.

Key words:Chronic sinusitis with nasal polyps;NLRP3;IL-1β;Recurrence