Different levels of mucus inflammatory mediators in nasal polyposis with and without aeroallergen sensitivity

Aleksandar Dimić; Aleksandar Perić; Uglješa Grgurević; Jelena Sotirović; Milica Labus; Nenad Baletić; Milanko Milojević; Ivan Stanojević; Danilo Vojvodić

doi:10.1002/lio2.794

Different levels of mucus inflammatory mediators in nasal polyposis with and without aeroallergen sensitivity

Laryngoscope Investig Otolaryngol. 2022 Apr 13;7(3):671-678. doi: 10.1002/lio2.794. eCollection 2022 Jun.

Authors

Aleksandar Dimić¹, Aleksandar Perić², Uglješa Grgurević¹, Jelena Sotirović², Milica Labus¹, Nenad Baletić², Milanko Milojević², Ivan Stanojević³, Danilo Vojvodić³

Affiliations

¹ Department of Otorhinolaryngology Military Medical Academy Belgrade Serbia.
² Department of Otorhinolaryngology, Faculty of Medicine of the Military Medical Academy University of Defence Belgrade Serbia.
³ Institute for Medical Research, Division of Clinical and Experimental Immunology Faculty of Medicine of the Military Medical Academy Belgrade Serbia.

Abstract

Objectives: Biomarker levels in nasal secretions can reflect the inflammatory status of nasal mucosa and evolution of sinus disease. The aim of this study was to evaluate the relationship between local inflammatory mediator production and clinical characteristics of patients with nasal polyposis (NP).

Methods: Thirty-one nonaeroallergen sensitized patients with NP (NANP), 29 aeroallergen sensitized patients with NP (ANP), and 30 subjects without inflammation of nasal mucosa as controls (C) entered this prospective, cross-sectional study. Clinical parameters (symptoms, endoscopic, and radiological findings) were assessed. The concentrations of heat shock protein 70 (HSP70), eosinophil cationic protein (ECP), tryptase, substance P and Clara cell protein 16 (CC16) were measured in the nasal secretion samples of all participants by ELISA method.

Results: Our results showed higher concentrations of HSP70, ECP, and tryptase in ANP than in NANP and C (p < .001 for all markers). On the other hand, levels of CC16 were significantly higher in C than in NANP and ANP groups (p < .001; p < .001, respectively). We found positive correlations between HSP70, ECP, tryptase, and substance P levels and nasal symptom score in patients with NP. Also, HSP70, ECP, tryptase, and substance P showed different levels of positive correlation among themselves, with HSP70 showing highest positive correlation with ECP. Finally, relatively strong negative correlations were found between the levels of CC16 and nasal symptoms, as well as between the CC16 levels and levels of other four mediators in nasal fluid.

Conclusion: HSP70, ECP, tryptase, and substance P might play a role in the pathogenesis of NP. The results suggest that chronic inflammation in NP involves a self-sustaining local release of HSP70, ECP, and tryptase, independent of aeroallergen stimulation of the mucosal layer, although the production of these mediators is higher in aeroallergen sensitized NP patients.

Keywords: Tryptases; eosinophil cationic protein; heat‐shock proteins; inflammation; nasal polyps; substance P.