| Objective: To investigate the relationship between MUC5 AC expression in olfactory epithelium and olfaction in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods: Thirty-two patients with CRSwNP in the experimental group and fourteen patients with pituitary microadenoma in the control group were selected.The patients with CRSwNP were divided into two groups according to the eosinophilic count in olfactory lamina propria.One is eosinophilic CRSwNP(ECRSwNP)group with fifteen patients,the other is non-eosinophilic CRSwNP(non-ECRSwNP)group with seventeen patients.Preoperative,bilateral olfactory function test(T&T olfactometer),anterior olfactory cleft score(AOCS)and post olfactory cleft score(POCS),middle meatus and olfactory clef endoscopy score,22-item Sinonasal Outcome Test(SNOT-22),olfactory VAS scores,total IgE,and eosinophil percentage in peripheral blood were evaluated for all patients.During the operation,the middle meatus and olfactory clef were scored by endoscopy,and specimens were obtained from upper turbinate during operation.The morphological changes of the olfactory mucosa were observed by hematoxylin-eosin(HE)staining.The expression of MUC5 AC in the olfactory epithelium of each group was detected by immunohistochemical method,the number of Olfactory receptor neurons were also counted.Results: Olfactory discrimination in ECRSwNP group was significantly higher than that in non-ECRSwNP group and control group(all p < 0.05).Olfactory discrimination in non-ECRSwNP group was higher than that in control group,but there was no statistically significant difference between them(p > 0.05).Olfactory discrimination has moderate positive correlation with olfactory VAS score,AOCS,POCS,middle meatus and olfactory clef endoscopy score,eosinophil count in olfactory mucosa(all p < 0.05).And has moderate negative correlation with ORN count in olfactory epithelium(all p < 0.05),and has mild positive correlation with SNOT-22 score and total IgE in peripheral blood(p < 0.05),and has no correlation with eosinophil percentages in peripheral blood(p > 0.05).Specific IgE was negative in all groups.Compared with the control group and the non-ECRSwNP group,the olfactory epithelium histopathological in ECRSwNP group shows respiratory epithelial metaplasia,disorder of the nuclear layer,thicker basal layer,the decrease of the number of ORN.The expression of MUC5 AC in the olfactory epithelium in ECRSwNP group was significantly higher than the control group and non-ECRSwNP group(p < 0.001,p= 0.001).The ORN counts of ECRSwNP group has statistically significant difference with control group and non-ECRSwNP group respectively.(both p < 0.05).In ECRSwNP group,olfactory discrimination was closely related to the expression of MUC5 AC in olfactory epithelium.And in the non-ECRSwNP group,olfactory discrimination was closely related to the obstructive factors of anterior olfactory clef.Conclusion: Olfactory discrimination in ECRSwNP group was significantly higher than that in non-ECRSwNP group and control group.In CRSwNP patients,olfactory dysfunction was closely related to the high expression of MUC5 AC in olfactory epithelium in ECRSwNP group.However,olfactory dysfunction was closely related to the obstructive factors of anterior olfactory clef in non-ECRSwNP group. |
PDF Full Text Request