Expression And Clinical Significance Of IL-19 In Different Types Of Chronic Rhinosinusitis With Nasal Polyps

Objective To Investigate the expression and clinical significance of IL?19 in different types of chronic rhinosinusitis with nasal polyps(CRSw NP)and analyze the role of IL?19in the pathophysiological mechanism of different types of CRSw NP,so as to provide help for the clinical diagnosis and treatment of CRSw NP.Materials and methods 1.From January 2019 to June 2019,62 patients were selected from the Department of Otolaryngology,head and neck surgery,affiliated Provincial Hospital of Anhui Medical University.Among them,there were 42 CRSw NP patients in the experimental group,all patients in the experimental group were diagnosed according to the Chinese chronic sinusitis diagnosis and treatment guidelines in 2018,and the experimental group was divided into ECRS group and non?ECRS group according to the postoperative tissue H&E staining,with eosinophils10%as the boundary,including 20 cases in ECRS group and 22 cases in non ECRS group.In the control group,20 patients with simple deviation of nasal septum or simple cyst and trauma of paranasal sinuses were selected.2.All subjects completed routine examination in hospital,complete medical history,complete CT,endoscopic examination and other data;patients independently completed preoperative VAS subjective scale under the guidance of doctors,and could cooperate with doctors to carry out endoscopic examination and CT examination,so as to complete Lund Kennedy score of endoscopic examination and Lund Mackay score of sinus CT.3.During the operation,the specimens of nasal polyps in the experimental group were collected,while the mucosa of uncinate process in the control group was collected.The specimens were divided into two parts,one was fixed by formalin solution,paraffin embedded and sectioned,the other was preserved at?80?.4.Immunohistochemical staining and quantitative reverse transcription polymerase chain reaction(q RT?PCR)were used to detect the expression of IL?19 in the samples.The immunohistochemistry results were analyzed by Image J software.5.Analyze the differences of IL?19 in each group from m RNA and protein levels,and explore the correlation between IL?19 level and clinical manifestations of the disease.Results Without the influence of age and gender,there was no significant difference in VAS scores among the three groups(F=0.616,P>0.05);there was significant difference in endoscopic scores among the control group,non?ECRS group and ECRS group(F=17.26,P<0.05);there was significant difference in CT scores among the control group,non?ECRS group and ECRS group(F=19.24,P<0.05).PCR results showed that the level of IL?19 m RNA in ECRS group was significantly higher than that in non?ECRS group and control group.The relative m RNA expression level of IL?19 was1.17±0.42 in the control group,1.70±0.70 in the non?ECRS group and 3.73±1.32 in the ECRS group.The level of IL?19 m RNA in the control group,non?ECRS group and ECRS group was significantly different(F=47.313,P<0.05).Immunohistochemical staining showed that IL?19 was mainly expressed in the nuclei of epithelial and submucosal gland cells of polyps in ECRS patients.The optical density of IL?19 was 5.18±2.74 in the control group,6.35±2.85 in the non ECRS group and 9.58±3.68 in the ECRS group.The expression level of IL?19 in ECRS group,non?ECRS group and control group was statistically significant.In ECRS group,the m RNA level of IL?19(3.73±1.32)was positively correlated with the percentage of eosinophils in polyps(40.85±17.73),the m RNA level of IL?19(3.73±1.32)was positively correlated with the CT Score of patients(13.45±4.98),the m RNA level of IL?19(3.73±1.32)was positively correlated with the endoscopic score of patients(7.55±2.14),the m RNA level of IL?19(3.73±1.32)was positively correlated with the subjective VAS score of patients There was no significant correlation between the scores(4.00±1.45)(r_s=0.353,P>0.05).Conclusion The expression of IL?19 is different in CRSw NP and control group.IL?19 can promote the development of CRS.In ECRS group,IL?19 was related to the infiltration of eosinophils and the clinical severity of the disease.