Analysis of transforming growth factor β signaling in chronic rhinosinusitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It has been reported that there is a significant difference in the local tissue concentration of transforming growth factor (TGF)-β1 between chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis without nasal polyps (CRSwNP) patients. TGF-β has been reported to play an important role in regulating epithelial cell repair in lower airway remodeling and may be a critical factor involved in the remodeling process of chronic rhinosinusitis (CRS).</p><p><b>METHODS</b>Ethmoidal mucosal samples collected from CRS and healthy control patients were analyzed for TGF-β1, TGF-β receptor I, TGF-β receptor II, Smad3, phospho-Smad3, Smad7, and Smad anchor for receptor activation by Western blotting analysis. The proliferation of sinonasal epithelial cells at baseline and after TGF-β1 and/or EGF stimulation was evaluated by the MTT assay.</p><p><b>RESULTS</b>In CRSsNP, TGF-β1, TGF-β receptor I, TGF-β receptor II, and Smad3 protein levels were significantly higher than controls. In CRSwNP, TGF-β1, Smad3, and pSmad3 protein levels were significantly lower than controls. Smad7 protein was significantly higher in CRS than controls. In vitro experiments demonstrated that the baseline proliferation levels of sinonasal epithelial cells were lower in CRS than controls.</p><p><b>CONCLUSIONS</b>CRSwNP is characterized by a lower level of TGF-signaling compared with the control. In CRSsNP, although the upstream signaling of TGF-β was enhanced, the high Smad7 protein expression may restrain the downstream signaling components (e.g., pSmad3) and the TGF-β antiproliferative effect on sinonasal epithelium. The difference in the local tissue concentration of TGF-β1 between CRSsNP and CRSwNP patients did not result in significant differences in epithelial proliferation.</p>

Nasal cavity computer fluid dynamics analysis on 60 healthy Chinese adults / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVES</b>To investigate the aerodynamics characteristics of nasal cavity in inspiration phase from 60 healthy Chinese people and provide the reference values for future computational fluid dynamics (CFD) research.</p><p><b>METHODS</b>CFD was used for numerical simulation. The indices of main airflow passage, total nasal airway resistance, maximal velocity, maximal wall shear stress, nasal mucosa area, nasal volume and surface area-to-volume ratio were extracted from CFD analysis results. SPSS 16.0 software was used to analyze the data.</p><p><b>RESULTS</b>The main airflow passage in nasal cavity was common meatus, the mean total nasal airway resistance was (0.211 ± 0.085) kPa·s·L(-1), the mean maximal velocity was (12.01 ± 2.79) m/s, the mean maximal wall shear stress was (2.50 ± 0.89) Pa, the mean nasal mucosa area was (161.2 ± 34.7) mm(2), the mean nasal volume was (31.7 ± 8.1) ml and the mean surface area-to-volume ratio was (0.58 ± 0.09) mm(-1). No significant difference was detected in aerodynamics indices between male and female people.</p><p><b>CONCLUSIONS</b>The main airflow passage is located in common meatus. The nasal valve area is the key constrictive plane in nasal cavity. There are no gender differences of main airflow characteristics in nasal cavity. The normal ranges of aerodynamics indices could be used for reference values for future CFD research.</p>

Pharyngeal aerodynamic characteristics of obstructive sleep apnea/hypopnea syndrome patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The role of nasal obstruction in the pathogenesis of obstructive sleep apnea/hypopnea syndrome (OSAHS) has been debated for decades. In this prospective study, we compared the pharyngeal aerodynamic characteristics of OSAHS patients and normal people, and investigated the contribution of total nasal airway resistance to the pathophysiology of OSAHS.</p><p><b>METHODS</b>Computational fluid dynamics (CFD) was used to extract the average pressure and average airflow velocity in three transverse cross-sectional planes of the pharynx for statistical analysis, and the correlation between nasal resistance and the average pressure in the pharyngeal cavity was investigated.</p><p><b>RESULTS</b>The negative pressure within the pharyngeal cavity was significantly higher in OSAHS patients than in normal subjects, and total nasal airway resistance correlated well with the average pressure in three consecutive transverse cross-sections of the pharyngeal cavity.</p><p><b>CONCLUSIONS</b>Greater negative pressure within the pharyngeal cavity contributed to the increased collapsibility of the pharynx in OSAHS patients, and the strong correlation between nasal resistance and pharyngeal pressure suggests that the nose plays a role in the pathogenesis of OSAHS.</p>

Effect of intranasal IL-12 gene therapy on the mice eosinophils and IL-5 in the murine model of allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of intranasal liposome-mediated IL-12 gene therapy on the eosinophils and IL-5 in the murine model of allergic rhinitis.</p><p><b>METHODS</b>Thirty-six BALB/C mice were randomly divided into allergic rhinitis (AR) group, gene therapy group and control group. Allergic rhinitis group were sensitized and stimulated by ovalbumin (OVA), and gene therapy group were administered with liposome-mediated pGEG. mIL-12 transnasally before stimulated. The eosinophils in bone marrow were counted by Wright's staining, and the eosinophils in nasal mucosa were counted by HE staining. The eosinophils of peripheral blood were detected by flow cytometry. The expression of IL-5 in bone marrow and nasal mucosa was examined by immunohistochemistry. The IL-5 in serum was detected by ELISA.</p><p><b>RESULTS</b>Among the three groups, the difference of all data was statistically significant (P<0.01). Multiple Comparison showed that the ratio of eosinophils to white cells and the mount of IL-5 positive cells in nasal mucosa and bone marrow of gene therapy group was significantly lower than that of AR group (P<0.05). The ratio of eosinophils to granulocyte (0.124 +/- 0.031) and the expression level of IL-5 [(29.51 +/- 6.68) pg/ml] in peripheral blood [ 0.184 +/- 0.079 and (56.58 +/- 16.80) pg/ml] were significantly lower in gene therapy group than in AR group (P<0.05).</p><p><b>CONCLUSIONS</b>Transnasal administration of liposome- mediated pGEG. mIL-12 could depress the expression of IL-5 in bone marrow, peripheral blood, and nasal mucosa, to influence the proliferation and differentiation of eosinophils and decrease the delivery and transference of eosinophils to peripheral blood and nasal mucosa. It may be a new treatment for respiratory tract allergic inflammation.</p>

Histolopathologic features of CT scan typing of chronic rhinosinusitis and relation with prognosis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the histopathologic changes of the ethmoid bone in CT scan typing of chronic rhinosinusitis (CRS), and investigate relations with outcomes of endoscopic surgery.</p><p><b>METHODS</b>One hundred and twelve random CRS patients undergoing endoscopic sinus surgery at Tongren hospital were prospectively evaluated. According to the preoperative CT scan, these patients were divided into three groups of CT scan typing. The bony changes and bone remodeling of ethmoid bone were graded and relations with outcomes of endoscopic surgery were investigated.</p><p><b>RESULTS</b>The CT scan typing results of ethmoid sinus of CRS were as followed: 22.3% (type III), 39.3% (type II), and 38.4% (type I). Comparison of bone remodeling and postoperative endoscopic scores between the three groups revealed a significant difference (P = 0.01, P = 0.02). A trend toward more advanced bone remodeling grade in association with a higher postoperative endoscopic scores was identified, with a statistically significant correlation.</p><p><b>CONCLUSION</b>The Chinese CT scan typing of CRS has its pathological basis and can a useful method to predict the surgical outcomes of CRS. The new bone formation or bony tissue remodeling of sinus often represents pathogenesis of CRS and implicates the prognosis of sinus surgery.</p>