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NLRP3炎性小体及相关因子在嗜酸性慢性鼻窦炎伴鼻息肉（Eosinophilic chronic rhinosinusitis with nasal polyps,eosCRSwNP）与非嗜酸性慢性鼻窦炎伴鼻息肉（Non-eosinophilic chronic rhinosinusitis with nasal polyps,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18例鼻中隔偏曲患者下鼻甲黏膜组织，44例慢性鼻窦炎伴鼻息肉（chronic rhinosinusitis with nasal polyps,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。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要高于对照组（P＜0.05）。non-eosCRSwNP组中NLRP3和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评分等结果有正相关性并有统计学意义（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。

Abstract:

OBJECTIVE: To investigate the expression level of NLRP3 inflammasome and relative proinflammatory factors in eosinophilic and non-eosinophilic chronic sinusitis with nasal polyp, and further to analyze the relationship between NLRP3 and prognosis of non-eosinophilic chronic sinusitis with nasal polyp. 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, which were divided into 22 eosCRSwNP patients and 22 non-EOSCRSWNP patients 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 VAS score, Land-Mackay score, Lund-Kennedy score, and follow-up relapse information of CRSwNP patients were collected. RESULTS:Immunohistochemical results showed that NLRP3 protein was expressed in both Non-EosCRSwNP and eosCRSwNP, and the staining degree was higher than that of the control group (P < 0.05). In particular, the level of Immunohisto chemical NLRP3 expression in recurrent non-EoscRSWNP was positively correlated with preoperative VAS score, Land-Mackay score and Lund-Kennedy score (P < 0.05). CONCLUSION: Studies have shown that 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- Non-EosCRSwNP