Exploring The Correlation Between Neutrophil,IL-17A And Chronic Rhinosinusitis

Objective: As a common disease in otolaryngology department,the pathogenesis and inflammatory pattern of chronic rhinosinusitis are closely related to patients’ race and geographical environment.Current studies have shown that patients with chronic sinusitis in Europe and America are mainly characterized by type 2 inflammation accompanied by eosinophils infiltration,while patients with chronic sinusitis in Asia are mainly characterized by Th1/Th17 mixed inflammation accompanied with neutrophils infiltration.The purpose of this study is to explore the correlation between neutrophils and IL-17 A in the pathogenesis of chronic rhinosinusitis,in order to provide new experimental data for the pathogenesis of chronic rhinosinusitis.Methods: We collected nasal polyps,uncinate tissues and inferior turbinate tissues during functional endoscopic sinus surgery.The patients in the 3 sample types were scored by the Snot-22 scale and Lund-Mackay scale before surgery.Hematoxylin-eosin staining were performed on the tissues of each patient.We used Real-time fluorescence quantitative PCR to detect the m RNA expression levels of related transcription factors(IL-17 A,CXCL1,CXCL2,CXCL8,MMP-9,MMP-2,TIMP-1).The secretion levels of related factors(IL-17 A,CXCL1,CXCL2,CXCL8,MMP-9,MMP-2,TIMP-1)were detected by enzyme-linked immunosorbent assay.Nasal polyps were stained with fluorescence-labeled antibodies against IL-17 AR and neutrophil elastase.Dispersed nasal polyp cells(DNPCs)were cultured with the different concentration IL-17 A to detect the effect of IL-17 A on DNPCs.Results:(1)In CRSw NP and CRSs NP,the neutrophil infiltration was positively correlated with the score of Snot-22 scale and Lund-Mackay scale.(2)Compared with the control,the expression of IL-17 A was significantly increased in the CRSw NP,and the level of IL-17 A was positively correlated with the score of Snot-22 scale and LundMackay scale and the degree of neutrophils infiltration.(3)In nasal polyps,Immunofluorescence showed a certain expression of IL-17 AR on neutrophils.(4)The expressions of CXCL1,CXCL2 and CXCL2 in nasal polyps of CRSWNP patients were higher than control,and these related factors were correlated with the expression of IL-17 A in nasal polyps.(5)Compared with the control,the expression of MMP-9 in nasal polyps was up-regulated and positively correlated with the expression of IL-17 A.(6)Under the stimulation of IL-17 A protein,the secretion of CXCL1,CXCL2,CXCL8 and MMP-9 of DNPCs increased.Conclusion: Neutrophil infiltration and IL-17 A can influence the disease severity of patients with chronic rhinosinusitis.IL-17 AR was expressed in neutrophils in chronic sinusitis nasal polyps.In nasal polyps,IL-17 A may induce neutrophil infiltration by affecting the expressions of chemokines CXCL1,CXCL2 and CXCL8,and may also influence the expression of MMP-9 to promote tissue remodeling in inflammation.