Heterogeneous inflammatory patterns in chronic rhinosinusitis without nasal polyps in Chicago, Illinois

Abstract

CRSsNP is a heterogenous disease but type 2 inflammation in CRSsNP was more common than type 1 inflammation among patients in Chicago, Illinois. Distinct therapeutic strategies may be needed depending on the type of inflammation found in CRSsNP.

Fig. 1. Messenger RNAs for markers of type 2 and 3 inflammation were elevated in CRSsNP

Total RNA was extracted from whole tissue of control IT (n=19), control UT (n=21), control ET (n=33), CRSsNP IT (n=53), CRSsNP UT (n=44), CRSsNP ET (n=61), CRSwNP IT (n=28), CRSwNP UT (n=29), CRSwNP ET (n=40) and CRSwNP NP (n=48). Expression of mRNAs for IFN-γ, CLC, IL-5, IL-13 and IL-17A was analyzed using real-time RT-PCR. Gene expression was normalized to a housekeeping gene, β-glucuronidase (GUSB), and expression levels were shown as % expression of GUSB. Results are shown as medians (25% to 75% interquartile ranges) (A, B) or mean ± SEM (C). Dotted line indicates the threshold based on the 95th percentile expression in control ET (CLC: 96.4, IL-5: 36.5, IL-13: 11.2, IFN-γ: 13.2, IL-17A: 12.1) (C). In order to display undetectable data, we plotted 0 as 0.01 in the log scaled figures (C). * p<0.05, ** p<0.01, *** p<0.001, **** p<0.0001, by one-way ANOVA.

Fig. 2. Type 2 and 3 cytokines were elevated in CRSsNP tissue protein extracts

Protein extracts were generated from ET of control (n=34), CRSsNP (n=83) and CRSwNP (n=45) and from NPs (n=60). Expression of ECP, IL-5, IL-13, IFN-γ and IL-17A proteins in tissue homogenates was measured using ELISA and Luminex. The protein concentrations were normalized to the concentration of total protein. Dotted line indicates the threshold based on the 95th percentile expression in control ET (ECP: 131.5 ng/mg, IL-5: 0.02 pg/mg (detectable), IL-13: 5.5 pg/mg, IFN-γ: 8.1 pg/mg, IL-17A: 0.02 pg/mg (detectable)). In order to display undetectable data, we plotted 0 as 0.01 in the log scaled figures. * p<0.05, ** p<0.01, *** p<0.001, **** p<0.0001, by one-way ANOVA.