Correlating matrix metalloproteinase-9 sinus secretion levels with tissue biopsy levels.

BACKGROUND: Collecting mucosal biopsies is invasive and creates additional inflammation, hampering a better understanding of nasal and sinus disease evolution and response to treatment. We examine whether sinus secretion collection can replace tissue biopsy for protein determination. METHODS: Prior to surgical intervention for chronic rhinosinusitis (CRS), a piece of gelatin foam was used to collect secretions from the ethmoid mucosa. A tissue biopsy was then taken from the same location. Matrix metalloproteinase-9 (MMP-9) protein levels were measured in each sample. RESULTS: MMP-9 protein levels in secretions and tissues were significantly correlated (p = 0.0033, r = 0.52, by Pearson correlation). CONCLUSION: Secretion collection can replace tissue biopsy for MMP-9 determinations, reducing morbidity. Furthermore, secretion collection allows sequential sampling from the same location.

Up-regulation of heparanase in the ethmoid sinus mucosa of patients with chronic sinusitis.

BACKGROUND: Heparanase (HPA) is known to be involved in tissue remodeling of various organs with inflammatory diseases. The aim of this study was to investigate the level of expression and the pattern of distribution of HPA in normal human sinus mucosa, inflammatory sinus mucosa, and nasal polyps to evaluate the possible effect of HPA on the tissue remodeling of chronic inflammatory sinus mucosa and nasal polyps. METHODS: Normal sinus mucosa was obtained from the ethmoid sinus during endoscopic reduction in 25 patients with blowout fractures. Inflammatory sinus mucosa and nasal polyps were obtained from 25 patients undergoing endoscopic sinus surgery for chronic sinusitis with nasal polyps. The levels of expression and the pattern of distribution of HPA were evaluated in normal human sinus mucosa, inflammatory sinus mucosa, and nasal polyps, using reverse transcriptase-polymerase chain reaction, immunohistochemical analysis, and Western blot analysis. RESULTS: HPA mRNA and protein were detected in inflammatory sinus mucosa and nasal polyps but not in normal sinus mucosa. HPA was mainly localized in the vascular endothelium, epithelium, submucosal glands, and inflammatory cells of inflammatory sinus mucosa. In nasal polyps, inflammatory cells and vascular endothelium showed immunopositivity in the entire portion, whereas glands and epithelial cells did not show positivity. CONCLUSION: Our results indicate that HPA is not constitutively expressed in normal sinus mucosa and is upregulated in chronic inflammatory sinus mucosa and nasal polyps, suggesting that HPA may play an important role in the tissue remodeling in chronic sinusitis.