Biofilms and inflammation in patients with chronic rhinosinusitis

Abstract

Introduction: The aim of the present study is to evaluate the presence of biofilms in patients with chronic rhinosinusitis (CRS), with or without nasal polyps, and their relationship to eosinophils and plasma cells. We compared the results with those obtained in nonCRS patients.

Methods: A total of 50 patients were included in the study, 30 CRSwNP patients, 10 CRSsNP cases and 10 control patients who were operated for deviated septum. Biofilm detection was performed by means of H&E staining and SEM. Eosinophil and plasma cell values were recorded and compared between groups.

Results: Biofilms were identified in 30 patients (60%), 76.6% (23 out of 30) of the CRSwNP patients, 70% (7 out of 10) of the CRSsNP patients and none of the septoplasty patients. Eosinophil and plasma cell values were more elevated in CRS patients, being strongly correlated to biofilm presence and nasal polyposis.

Conclusion: Biofilm presence was demonstrated in many of the CRS patients, with no evidence in the control cases. Our study findings indicate that inflammatory cell counts are higher in patients with CRS compared to controls, but also more elevated in patients with polyposis. In biofilm-positive patients, eosinophil and plasma cell counts were greater than those in patients without biofilms, demonstrating the proinflammatory action of the biofilm in the sino-nasal pathology.

Keywords: biofilms; chronic rhinosinusitis; eosinophil; microscopy; plasma cells.

Figure 1

Distribution of the sample based on biofilm vs. Group.

Figure 2

Eosinophil value distribution in the biofilm positive and biofilm negative patients.

Figure 3

Plasma cell value distribution in the biofilm positive and biofilm negative patients.

Figure 4

Eosinophil value distribution in the study groups.

Figure 5

Plasma cell value distribution in the study groups.

Figure 6

Eosinophil value distribution expressed as mean.

Figure 7

Plasma cell value distribution expressed as mean.

Figure 8 (A, B, C, D)

Microscopy images of biofilm using SEM technique.

Figure 9 (A, B, C)

Microscopic images of tissue samples in hematoxylin eosin staining: the biofilm presence is clearly evidenced and marked by the black arrow; eosinophils are indicated by the blue arrow.