| Nasal polyp(NP) is very clinical common. Chronic nasal sinusitis with nasal polyps is more common in patients with higher incidence rate and higher recurrence rate.The pathophysiology of nasal polyps is complicated with multi-factors. Recently, with the development of immunology, cytobiology and molecular biology, especially the studies on cytokines has shown that the cytokines such as IL-17, IL-21, VEGF and adhesion molecule etc. have an important role in the development of NP. These cytikines are believed to form network or microenvironment in polyps and impact the development of NP.Objective:By studying the expressions of IL-17 and VEGF in nasal polyps, chronic sinusitis and ethmoid sinus mucosa, and normal turbinate mucosa, investigating the roles which IL-17 and VEGF played in the development of the nasal polyp, and the correlation between them, this paper is aim to fully understand the pathogenesis of nasal polyps, thus providing theoretical basis for the diagnosis, treatment, prevention and clinical application of hand.Materials and methods:The study contains two experimental groups, the nasal polyp group, and the ethmoid mucosa group from chronic sinusitis, and the normal mucosa was control group. All specimens were collected from the inpatient and out-patient clinic of intranasal endoscopic surgery of chronic nasal sinusitis(polyP), chronic nasal sinusitis with polyp and nasal septum deviation complicated with inferior turbinate hypertrophy patients of Baoding First Hospital from February 2013 to June 2014. 30 cases of nasal polyps specimens were collected from chronic nasal sinusitis(with polyps) suffers with 18 male cases, 12 female cases, aged from 18 to 65 years old. 30 cases of ethmoid mucosa specimens were collected from chronic nasal sinusitis(polyp) patients, 15 male cases, 15 female cases, aged 18 to 60 years old, 10 cases of normal inferior turbinate mucosa from nasal septum deviation complicated with inferior turbinate hypertrophy patients, 8 male cases, 2 female cases, ranging in age from 18 to 55 years old. All patients were free of bronchial asthma, allergic rhinitis, aspirin intolerance and other serious diseases. All the specimens were fixed with 4% formaldehyde, conventional dehydration, paraffin embedded, tissue sections were stained with routine HE, and the expression of VEGF and IL-17 in the specimens were detected by immunohistochemistry.All the data were analyzed by using SPSS17.0.Results:1 H&E stainingIn addition to light microscopic observations, different degree of infiltrations were visible in eosinophils in nasal polyps and ethmoid sinus mucosa, which mainly distributed around the subcutaneous, glands and small blood vessels in the mucosa. But infiltration is rare in eosinophil in the inferior turbinate mucosa. Comparison between two of them has statistical significance(P<0.01).2 The expression of IL-17 in nasal polyps, ethmoid mucosa of sinusitis and inferior turbinate mucosa tissuesIL-17 positive products in nasal polyps tissue showed strong positive expression, and in sinusitis and ethmoid sinus mucosa it showed positive expression. The expression was mainly in the neutrophil cell, plasma cell mass, and a few expressed in the epithelial cells in the spinous cell layer of serous acinus and vascular endothelial cell cytoplasm. In normal turbinate mucosa it showed less positive expression. Comparison between two of them has statistical significance.(P<0.01).3 The expression of VEGF in nasal polyps, ethmoid mucosa of sinusitis and inferior turbinate mucosa tissuesVEGF positive products in nasal polyps tissue showed strong positive expression, and in the ethmoid sinus mucosa it showed positive expression, which mainly expressed in vascular endothelial, vascular endothelial mural cells, glands, epithelial cells and stromal invasion of inflammatory cells, positive signal was mainly located in cytoplasm, few bits in the nucleus. It showed less positive expression in normal turbinate mucosa. Comparison between two of them has statistical significance.(P<0.01).4 Analysis on correlation between the expression of IL-17 and VEGF in nasal polyps and ethmoid sinus mucosa tissues of sinusitisCorrelation analysis showed that: there was a positive correlation between IL-17 positive cells and EOS positive cells in the nasal polyps and ethmoid sinus mucosa of sinusitis.(r1=0.543, P1<0.01; r2=0.438, P2<0.01).5 Analysis between the expression of IL-17 and VEGF in nasal polyps and ethmoid sinus mucosa tissues of sinusitisCorrelation analysis showed that a significant positive correlation was founded between IL-17 positive cells and VEGF positive cells in the nasal polyps, ethmoid sinus mucosa sinusitis.(r1=0.732,P1<0.01;r2=0.617, P2<0.01).Conclusion:1 The proliferation of eosinophils play an important role in the occurrence and development of nasal polyps.2 By induce cells, IL-17 produces a large number of Pro inflammatory factors, so that a large number of polymorphonuclear cells in the nasal mucosa raised and activation increased the nasal mucosa reaction, promote angiogenesis, aggravate the inflammatory response, aggravate edema, promote the formation of nasal polyps.3 VEGF can induce the formation of a large number of structural and functional abnormalities of the new born blood vessels, making the tissue edema, local tension increased to squeeze the epithelium, so that epithelial rupture, and gradually form a polyp.4 The correlation between the eosinophils and IL-17 enlarges inflammation, promotes the local tissue injury and mucosa remodeling, and eventually lead to the development of nasal polyps.5 IL-17 and VEGF mutually promoted each other and played a role together in the development of nasal polyps. |
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