Neutrophil extracellular traps promote ΔNp63+ basal cell hyperplasia in chronic rhinosinusitis

J Allergy Clin Immunol. 2024 Mar;153(3):705-717.e11. doi: 10.1016/j.jaci.2023.11.016. Epub 2023 Nov 22.

Abstract

Background: Neutrophil extracellular traps (NETs) are observed in chronic rhinosinusitis (CRS), although their role remains unclear.

Objectives: This study aimed to investigate the influence of NETs on the CRS epithelium.

Methods: Forty-five sinonasal biopsy specimens were immunofluorescence-stained to identify NETs and p63+ basal stem cells. Investigators treated human nasal epithelial cells with NETs and studied them with immunofluorescence staining, Western blotting, and quantitative real-time PCR. NET inhibitors were administered to a murine neutrophilic nasal polyp model.

Results: NETs existed in tissues in patients with CRS with nasal polyps, especially in noneosinophilic nasal polyp tissues. p63+ basal cell expression had a positive correlation with the release of NETs. NETs induced the expansion of Ki-67+p63+ cells. We found that ΔNp63, an isoform of p63, was mainly expressed in the nasal epithelium and controlled by NETs. Treatment with deoxyribonuclease (DNase) I or Sivelestat (NET inhibitors) prevented the overexpression of ΔNp63+ epithelial stem cells and reduced polyp formation.

Conclusions: These results reveal that NETs are implicated in CRS pathogenesis via basal cell hyperplasia. This study suggests a novel possibility of treating CRS by targeting NETs.

Keywords: Chronic rhinosinusitis; hyperplasia; nasal polyps; neutrophil extracellular traps; ΔNp63.

MeSH terms

  • Animals
  • Chronic Disease
  • Extracellular Traps*
  • Humans
  • Hyperplasia / pathology
  • Mice
  • Nasal Mucosa / pathology
  • Nasal Polyps* / pathology
  • Rhinitis* / pathology
  • Rhinosinusitis*
  • Sinusitis* / pathology