Which are the best murine models to study Eosinophilic Chronic Rhinosinusitis? A contemporary review

A long-term mixed eosinophilic and neutrophilic chronic rhinosinusitis C57BL/6 mouse model with neuroinflammation, olfactory dysfunction and anxiety-like behaviors

BACKGROUND

Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by persistent inflammation and high recurrence rates. The mixed granulocytic endotype, marked by increased eosinophils and neutrophils, is particularly refractory and prone to relapse.

OBJECTIVE

This study aimed to evaluate the papain-induced mouse model for investigating the more refractory mixed granulocytic CRS endotype, characterized by elevated eosinophils and neutrophils.

METHODS

Male C57BL/6 mice were intranasally administered papain for 11 days to induce CRS. Cytokine profiles, nasal tissue histology, olfactory bulb analysis, assessments of olfactory function, cognition, anxiety-like and depression-like behaviors were performed at 30, 60, and 90 days post-treatment.

RESULTS

A long-term mixed eosinophilic and neutrophilic CRS model was successfully established, showing elevated IgE, IL-4, IL-5, IL-13, IL-33, TSLP, and TNF-α in nasal lavage fluid, alongside infiltration of eosinophils and neutrophils in both olfactory and respiratory regions. Chronic pathology included increased mast cells, goblet cells, basal cells, mucus hyperproduction, and epithelial damage, persisting up to 90 days, with partial improvement observed at the 60-day mark. Brain analysis revealed ongoing neuroinflammation, olfactory dysfunction, and anxiety-like behaviors in CRS mice, without signs of cognitive impairment or depression-like behaviors.

CONCLUSIONS

This study phenotypically delineated a long-term mixed eosinophilic and neutrophilic CRS mouse model, demonstrating sustained neuroinflammation, olfactory dysfunction, and anxiety-like behaviors following short-term papain exposure. These findings highlighted the role of mixed inflammation in CRS and provided a time-efficient platform for further exploration of its pathogenesis and mind-brain-body interactions.

Deficiency of INPP4A promotes M2 macrophage polarization in eosinophilic chronic rhinosinusitis with nasal polyps

OBJECTIVE

The treatment of eosinophilic chronic rhinosinusitis with nasal polyps (E-CRSwNP) remains a challenge due to its complex pathogenesis. Inositol polyphosphate-4-phosphatase type IA (INPP4A), a lipid phosphatase, has been implicated in allergic asthma. However, the expression and function of INPP4A in E-CRSwNP remain unclear. This study aims to investigate the role of INPP4A in macrophages in E-CRSwNP.

METHODS

We assessed the expression of INPP4A in human and mouse nasal mucosal tissues via immunofluorescence staining. THP-1 cells were cultured and exposed to various cytokines to investigate the regulation of INPP4A expression and its functional role. Additionally, we established a murine nasal polyp (NP) model and administrated an INPP4A-overexpressing lentivirus evaluate its impact on NP.

RESULTS

The percentage of INPP4A + CD68 + macrophages among total macrophages decreased in the E-CRSwNP group compared to the control and the non-eosinophilic CRSwNP (NE-CRSwNP) groups, exhibiting an inverse correlation with an increased percentage of CD206 + CD68 + M2 macrophages among total macrophages. Overexpression of INPP4A led to a reduced percentage of THP-1 cells polarizing towards the M2 phenotype, accompanied by decreased levels of associated chemotactic factors including CCL18, CCL22, CCL24, and CCL26. We also validated the involvement of the PI3K-AKT pathway in the function of INPP4A in vitro. Furthermore, INPP4A overexpression in the murine NP model resulted in the attenuation of eosinophilic inflammation in the nasal mucosa.

CONCLUSIONS

INPP4A deficiency promotes macrophage polarization towards the M2 phenotype, leading to the secretion of chemokines that recruit eosinophils and Th2 cells, thereby amplifying eosinophilic inflammation in E-CRSwNP. INPP4A may exert a suppressive role in eosinophilic inflammation and could potentially serve as a novel therapeutic strategy.