Microparticles in nasal lavage fluids in chronic rhinosinusitis; potential biomarkers for diagnosis of Aspirin Exacerbated Respiratory Disease

Publication date: Available online 24 February 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Toru Takahashi, Atsushi Kato, Sergejs Berdnikovs, Whitney W. Stevens, Lydia A. Suh, James Norton, Roderick G. Carter, Kathleen E. Harris, Anju T. Peters, Kathryn E. Hulse, Leslie C. Grammer, Kevin Welch, Stephanie Shintani-Smith, Bruce K. Tan, David B. Conley, Robert C. Kern, Bruce S. Bochner, Robert P. Schleimer
BackgroundMicroparticles (MPs) are submicron sized shed membrane vesicles released from activated or injured cells and are detectable by flow cytometry. MP levels have been utilized as biomarkers to evaluate cell injury or activation in patients with pathological conditions.ObjectiveTo compare MP types and levels in nasal lavage fluids (NLFs) from controls and patients with chronic rhinosinusitis without nasal polyps (CRSsNP), CRS with NP (CRSwNP) and aspirin exacerbated respiratory disease (AERD).MethodsWe collected NLFs from CRSsNP (n=33), CRSwNP (n=45), AERD (n=31), and control (n=24) subjects. Standardized flow cytometry methods were used to characterize the following MP types; endothelial MPs, epithelial MPs (EpCAM(+)MPs, E-cadherin(+)MPs), platelet MPs (CD31(+)CD41(+)MPs), eosinophil MPs (EMR1(+)MPs), mast cell MPs (FcεRI(+)c-kit(+)MPs) and basophil MPs (CD203c(+)c-kit(-)MPs). Basophil activation was evaluated by the MFI of CD203c (CD203cMFI) on basophil MPs.ResultsActivated mast cell MPs (CD137(+)FcεRI(+)c-kit(+)MPs) were significantly increased in NLFs compared to controls in CRSsNP (2.3-fold, p<0.02), CRSwNP (2.3-fold, p<0.03) and in AERD (7.4-fold, p<0.0001). Platelet MPs (3.5-fold, p<0.01) and basophil MPs (2.5-fold, p<0.05) were increased only in AERD. CD203cMFI on MPs was increased in CRSwNP (p<0.002) and AERD (p<0.0001), but not CRSsNP. EpCAM(+)epithelial MPs in CRSwNP were no different from control (p= 0.91) and lower than those in CRSsNP (p<0.02) and AERD (p<0.002).ConclusionBased on released MPs, mast cells, platelets, and basophils were more highly activated in AERD than in CRS. Epithelial injury was lower in CRSwNP than in CRSsNP and AERD. MP analysis may help identify phenotypes of CRS, and in distinguishing AERD from CRSwNP.

Teaser

Microparticles are released into the nasal cavity from activated immune cells and injured structural cells in CRS and AERD. Assessment of microparticle levels in nasal lavage fluid may help distinguish the various phenotypes, especially AERD.


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