18.教室における内反足外来の現況と難治例について(第595回千葉医学会例会,整形外科例会)

Monthly distribution of rotavirus infections in children during pre-vaccine (2004–2006), early-vaccine (2008–2010), and post-vaccine (2011–2015) periods. (JPG 272 kb

MBP-Positive and CD11c-Positive Cells Are Associated with Different Phenotypes of Korean Patients with Non-Asthmatic Chronic Rhinosinusitis

<div><p>Background</p><p>Asthmatic nasal polyps primarily exhibit eosinophilic infiltration. However, the identities of the immune cells that infiltrate non-asthmatic nasal polyps remain unclear. Thus, we thought to investigate the distribution of innate immune cells and its clinical relevance in non-asthmatic chronic rhinosinusitis (CRS) in Korea.</p><p>Methods</p><p>Tissues from uncinate process (UP) were obtained from controls (n = 18) and CRS without nasal polyps (CRSsNP, n = 45). Nasal polyps (NP) and UP were obtained from CRS with nasal polyps (CRSwNP, n = 56). The innate immune cells was evaluated by immunohistochemistry such as, eosinophil major basic protein (MBP), tryptase, CD68, CD163, CD11c, 2D7, human neutrophil elastase (HNE) and its distribution was analyzed according to clinical parameters.</p><p>Results</p><p>In comparisons between UP from each group, CRSwNP had a higher number of MPB⁺, CD68⁺, and CD11c⁺ cells relative to CRSsNP. Comparisons between UP and NP from CRSwNP indicated that NP have a higher infiltrate of MBP⁺, CD163⁺, CD11c⁺, 2D7⁺ and HNE⁺ cells, whereas fewer CD68⁺ cells were found in NP. In addition, MBP⁺ and CD11c⁺ cells were increased from UP of CRSsNP, to UP of CRSwNP, and to NP of CRSwNP. Moreover, in UP from CRSwNP, the number of MBP⁺ and CD11c⁺ cells positively correlated with CT scores. In the analysis of CRSwNP phenotype, allergic eosinophilic polyps had a higher number of MBP⁺, tryptase⁺, CD11c⁺, 2D7⁺ cells than others, whereas allergic non-eosinophilic polyps showed mainly infiltration of HNE⁺ and 2D7⁺ cells.</p><p>Conclusions</p><p>The infiltration of MBP⁺ and CD11c⁺ innate immune cells show a significant association with phenotype and disease extent of CRS and allergic status also may influences cellular phenotype in non-asthmatic CRSwNP in Korea.</p></div

Patient characteristics and type of method.

<p>Lund-Kennedy score was evaluated at postoperative 6 months.</p><p>Patient characteristics and type of method.</p

Comparison of MBP⁺ cell, tryptase⁺ cell, CD68⁺ cell, CD163⁺ cell, CD11c⁺ cell, 2D7⁺ cell, and HNE⁺ cell were performed in nasal polyp tissues among four groups: non-eosinophilic non-allergic (NE-NA-NP), non-eosinophilic allergic (NE-A-NP), eosinophilic allergic (E-NA-NP), eosinophilic allergic NP (E-A-NP) (*<i>P</i><.05, **<i>P</i><.01, ***<i>P</i><.001).

<p>Comparison of MBP⁺ cell, tryptase⁺ cell, CD68⁺ cell, CD163⁺ cell, CD11c⁺ cell, 2D7⁺ cell, and HNE⁺ cell were performed in nasal polyp tissues among four groups: non-eosinophilic non-allergic (NE-NA-NP), non-eosinophilic allergic (NE-A-NP), eosinophilic allergic (E-NA-NP), eosinophilic allergic NP (E-A-NP) (*<i>P</i><.05, **<i>P</i><.01, ***<i>P</i><.001).</p

The number of MBP⁺<i>(A)</i>, tryptase⁺<i>(B)</i>, CD68⁺<i>(C)</i>, CD163⁺<i>(D)</i>, CD11c⁺<i>(E)</i>, 2D7⁺<i>(F)</i>, and HNE⁺<i>(G)</i> cells in nasal mucosal tissues was compared according to different types of chronic rhinosinusitis.

<p>Correlation between innate immune cells was analyzed; in terms of MBP⁺ cell <i>(H)</i> and CD11c⁺ cell <i>(I)</i>. UP, uncinate process tissue; NP, nasal polyp tissue; CRSsNP, chronic rhinosinusitis without nasal polyps; CRSwNP, chronic rhinosinusitis with nasal polyps (*<i>P</i><.05).</p

The number of MBP⁺<i>(A)</i>, tryptase⁺<i>(B)</i>, CD68⁺<i>(C)</i>, CD163⁺<i>(D)</i>, CD11c⁺<i>(E)</i>, 2D7⁺<i>(F)</i>, and HNE⁺<i>(G)</i> cells in nasal mucosal tissues was compared according to clinicohistologic parameter: NE-NP, non-eosinophilic CRSwNP; E-NP, eosinophilic CRSwNP; NA-NP, non-allergic CRSwNP; A-NP, allergic CRSwNP (*<i>P</i><.05, **<i>P</i><.01, ***<i>P</i><.001).

<p>†symbol means statistical significance when it compared with uncinate process tissue from CRSwNP.</p

The immunohistochemical detection of innate immune cells was performed by using MBP, tryptase, CD68, CD163, CD11c, 2D7, and HNE (magnification x400).

<p>UP, uncinate process tissue; NP, nasal polyp tissue; CRSsNP, chronic rhinosinusitis without nasal polyps; CRSwNP, chronic rhinosinusitis with nasal polyps; MBP, anti-human eosinophil major basic protein; HNE, anti-human neutrophil elastase.</p

Relationship between immunohistochemistry analysis and clinical parameters.

<p>LK score means Lund-Kennedy score.</p><p>*<i>P</i><.05.</p><p>Relationship between immunohistochemistry analysis and clinical parameters.</p