Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Δευτέρα 17 Οκτωβρίου 2022

The role of Interleukin 36γ in the Epithelial‐Mesenchymal Transition process of Chronic Rhinosinusitis: a pilot study

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Abstract

Purpose

Epithelial-mesenchymal transition (EMT) is an important characteristic in the remodeling of chronic rhinosinusitis with nasal polyps (CRSwNP). IL-36γ and fibroblast activation protein (FAP) may exacerbate remodeling in CRS. Here, we aimed to determine whether IL-36γ and FAP expression are associated with EMT and may be a predictor for CRSwNP prognosis.

Methods

52 non-Eos CRSwNP patients and 12 control patients were obtained and were followed up for more than 1 year after surgery. IL-36γ, FAP and EMT markers expression were evaluated by real-time polymerase chain reaction and western-blot. Masson trichrome staining was adopted to assess tissue fibrotic changes. Furthermore, the soluble form of IL-36γ and FAP in nasal secretions were detect by ELISA.

Results

While basal expression of E-cadherin decreased, the expression of IL-36γ, vimentin and FAP increased in nasal polyps. In well prognosis patients, the expression of IL-36γ, vimentin and FAP were significantly decreased than in poor prognosis patients, while the protein expression of E-cadherin was increased. The protein expression of IL-36γ was notably increased in recurrent nasal polyps than in preoperation specimens. A positive relationship between IL-36γ and FAP expression, a negative relationship between IL-36γ and E-cad expression was noted. The soluble form of IL-36γ and FAP increased during the development of non-Eos CRSwNP, with the highest level in poor prognosis patients after surgery.

Conclusion

Non-Eos CRSwNP have partially undergone EMT under baseline conditions. IL-36γ and FAP expression were related with EMT, the soluble form of IL-36γ and FAP in nasal-secretions may predict the prognosis of patients.

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Laryngopharyngeal Symptoms and Esophageal Disorder: The Role of Heterotopic Gastric Mucosa in Upper Esophagus

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Abstract

Background

Heterotopic gastric mucosa in the upper esophagus (HGMUE) was considered as geneogenous manifestation. However, its clinical characteristics may beyond to our knowledge if we focus on its extra-esophageal presentation. So the aim of this study was to investigate the relationship between HGMUE and laryngopharyngeal symptoms.

Method

Eight hundred and eleven patients who had gastric endoscopy examination were enrolled in this study and the cervical esophagus was examined for the patch during withdrawal of the endoscope. Questionnaire for gastroesophageal reflux disease (GERD-Q) and Reflux Symptom Index (RSI) were completed by all the patients. Pathology feature and therapeutic effect of HGMUE patients were evaluated.

Result

About 34.53% of the patients undergoing the gastroduodenoscopy had laryngopharyngeal (LP) symptoms. The relevance rate of HGMUE in LP(+)group(10.69%) was higher than that in LP(-) group(2%). The LP symptoms were related to the histological type and expression of H+-K+-ATPase in the histological sample of HGMUE patients. The positive rate of H+-K+-ATPase was 100% in LP(+) group, and that in LP(-) group was 28.6%. PPI therapy was effective for improving the LP symptoms in HGMUE patients. The RSI score in LP(+) patients decreased from 8.12±1.46 at baseline to 4±0.74 at the end of 8 weeks after treatment of PPI.

Conclusion

HGMUE was an important cause of LP symptoms in patients, especially in those who had no evidence of GERD. The mechanism of HGMUE induced LP symptoms was due to its location and the function of acid secretion according to the endoscopic finding and histologic characteristics.

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