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Vukadinović T, Đurđević BV, Perić A. Expression of Major Basic Protein and Endothelial Adhesion Molecules in Chronically Inflamed Mucosa of the Ethmoid Labyrinth. Immun Inflamm Dis 2024; 12:e70066. [PMID: 39698923 PMCID: PMC11656366 DOI: 10.1002/iid3.70066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Revised: 10/21/2024] [Accepted: 10/28/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND/OBJECTIVES Tissue remodeling, including dense eosinophil infiltration, is essential for forming inflammatory nasal polyps (NPs) and the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). Toxic eosinophil major basic protein (MBP) damages the sinus mucosa epithelium and lamina propria, which initiates reparative processes leading to tissue remodeling. MBP specifically binds to BMK-13 antibodies allowing immunohistochemical (IHC) tissue staining for eosinophils. This study evaluated the association between NP stromal BMK-13 and endothelial adhesion molecule staining, and clinical parameters of NP patients compared to IHC expression and clinical parameters in subjects with healthy nasal mucosa. METHODS We included 30 patients with bilateral NPs who were selected for endoscopic ethmoidectomy. The control group was of 30 subjects with non-inflamed nasal mucosa but with middle turbinate aeration, chosen for surgery. All participants were clinically scored before surgery, according to quality of life (QoL) outcome and symptoms. The degree of disease extension on computed tomography scans of the paranasal sinuses was also evaluated. Tissue samples after surgery were IHC stained for BMK-13 and endothelial proliferation markers CD31 and CD34. RESULTS Expression of BMK-13, CD31, and CD34 in tissues of NPs was higher than in healthy nasal mucosa. Positive correlations were observed between BMK-13 expression, impaired QoL, and radiologically assessed extension of inflammation in NP patients. CONCLUSION Apart from the fact that the NP tissue has, as expected, more intense eosinophilic infiltration, the proliferation of blood vessels is more pronounced in the NP tissue than in the tissue of healthy nasal mucosa. Expression of MBP in the tissue of ethmoidal NPs could serve as a potential marker of the degree of expansion of CRSwNP and indicate the severity of the disease. CLINICAL TRIAL REGISTRATION None, because it was a cross-sectional study.
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Affiliation(s)
- Tijana Vukadinović
- University of Montenegro Faculty of MedicinePodgoricaMontenegro
- Clinic of Otorhinolaryngology, Clinical Center of MontenegroPodgoricaMontenegro
| | | | - Aleksandar Perić
- Department of Otorhinolaryngology, Faculty of Medicine of the Military Medical AcademyUniversity of DefenceBelgradeSerbia
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de Góes HAN, Sarafan M, do Amaral JB, dos Anjos Almeida J, Voegels RL, de la Cruz LT, Thamboo A, Gomes LF, Pezato R. Differential Angiogenic Induction Impacts Nasal Polyp Tissue Growth. Indian J Otolaryngol Head Neck Surg 2023; 75:893-900. [PMID: 37206760 PMCID: PMC10188751 DOI: 10.1007/s12070-023-03469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
In chronic rhinosinusitis with nasal polyps, inflammatory edema drives tissue remodeling favoring anomalous growth of the nasal mucosa, but a proangiogenic contribution of nasal polyp in support of tissue growth is still controversial. The chorioallantoic membrane of chicken embryo model was employed to address the potentiality of nasal tissue fragments to modulate angiogenesis. Fifty-seven fertilized eggs were implanted with polyp or healthy nasal mucosa tissue or were kept as non-implanted controls. The embryos' size, length, and development stage, and chorioallantoic membrane vasculature morphology were evaluated after 48 h. Quantitative computer vision techniques applied to digital chorioallantoic membrane images automatically calculated the branching index as the ratio between the areas of the convex polygon surrounding the vascular tree and the vessels' area. Ethics approval and consent to participate: the study was approved by the Human Research Ethics Committee of the Federal University of São Paulo (CAAE number: 80763117.1.0000.5505) and by the Animal Research Ethics Committee of University of São Paulo (nº CEUA 602-2019). Mucosal, but not polyp tissue implants, hampered embryo development and induced underdeveloped chorioallantoic membranes with anastomosed, interrupted, and regressive vessels. Vessels' areas and branching indexes were higher among the chorioallantoic membranes with polyp implants and controls than among those with healthy mucosa implants. Nasal polyp presents differential angiogenic induction that impacts tissue growth.
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Affiliation(s)
- Hallyson Andre Nascimento de Góes
- ENT Research Lab, Department of Otorhinolaryngology – Head and Neck Surgery, Federal University of São Paulo – UNIFESP, São Paulo, SP Brazil
| | - Masih Sarafan
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada
| | - Jônatas Bussador do Amaral
- ENT Research Lab, Department of Otorhinolaryngology – Head and Neck Surgery, Federal University of São Paulo – UNIFESP, São Paulo, SP Brazil
| | - Joyce dos Anjos Almeida
- General Physics Department, Institute of Physics, Faculty of Pharmaceutical Sciences, University of São Paulo – USP, São Paulo, SP Brazil
| | - Richard Louis Voegels
- Department of Ophthalmology and Otorhinolaryngology, University of São Paulo – USP, São Paulo, SP Brazil
| | - Leandro Ticlia de la Cruz
- Marine Biology Department – Oceanographic Institute, University of São Paulo – USP, São Paulo, SP Brazil
| | - Andrew Thamboo
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada
| | - Lígia Ferreira Gomes
- General Physics Department, Institute of Physics, Faculty of Pharmaceutical Sciences, University of São Paulo – USP, São Paulo, SP Brazil
| | - Rogério Pezato
- ENT Research Lab, Department of Otorhinolaryngology – Head and Neck Surgery, Federal University of São Paulo – UNIFESP, São Paulo, SP Brazil
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada
- Department of Ophthalmology and Otorhinolaryngology, University of São Paulo – USP, São Paulo, SP Brazil
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3
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do Amaral JB, David AG, Mello L, Bachi ALL, Voegels RL, Thamboo A, Pezato R. Impact of Chronic Rhinosinusitis with Nasal Polyposis on IL-12 and IL-8. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2023; 35:21-27. [PMID: 36721412 PMCID: PMC9872264 DOI: 10.22038/ijorl.2022.53663.2829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 08/08/2022] [Indexed: 02/02/2023]
Abstract
Introduction The pathophysiology of Chronic Rhinosinusitis is coordinated by distinct inflammatory reactions in different individuals. Inflammatory environments with a predominance of Th2 lymphocytes tend also to be rich in eosinophils. These environments are common during the formation of nasal polyps associated with aspirin intolerance, which is also marked by an increase in inflammatory mediators, especially IL-4, IL-5, and IL-13. Despite the significance of these inflammatory mediators, the relevance of IL-12 subunits' presence within eosinophilic nasal polyps, however, has been less studied. The current study aims to evaluate the presence of IL-12 subunits, IL-12p40 and IL-12p70, in eosinophilic nasal polyps and their correlations with IL-8 presence. Materials and Methods We compared the concentrations of IL-8, IL12p40, and IL12p70 among samples of eosinophilic nasal polypoid tissue, eosinophilic nasal polypoid tissue associated with aspirin intolerance, and healthy nasal mucosa, using an indirect immunoassay (ELISA) kit. Results When compared to healthy nasal mucosa, there was a lower concentration of IL-8 in Chronic Rhinosinusitis with Nasal Polyp (CRSwNP) tissue. Aspirin Intolerant polypoid tissue also presented a lower concentration of IL-12 subunits compared to healthy nasal mucosa. There was no significant correlation between IL-8 and IL-12 in the eosinophilic polypoid conditions. Conclusion In CRSwNP, there is a reduction in IL-8 and IL-12 subunits compared to control, with a lack of correlation between IL-12 and IL-8. The lack of correlation can be justified by a type two inflammatory storm environment.
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Affiliation(s)
- Janatas Bussador do Amaral
- ENT Research Lab. Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil.,Corresponding Author: ENT Research Lab. Department of Otorhinolaryngology –Head and Neck Surgery, Federal University of Sao Paulo. Rua Pedro de Toledo 781, 1o andar, sala 3 - Vila Clementino - Sao Paulo - SP - Brazil CEP 04039-032. E-mail:
| | - Andrea Goldwasser David
- ENT Research Lab. Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Luciane Mello
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
| | - Andre Luis Lacerda Bachi
- ENT Research Lab. Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil.,Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), Sao Paulo, Brazil.
| | - Richard Louis Voegels
- Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
| | - Andrew Thamboo
- Division of Rhinology, University of British Columbia, Vancouver, Canada.
| | - Rogério Pezato
- ENT Research Lab. Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil.,Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
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4
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Coronel N, Pezato R, do Amaral JB, Ticlia L, Pinto Bezerra TF, Gomes LF, Dreyfuss J, Chamon W, Gregório LC. Structural changes in the extracellular matrix after cross-linking of nasal polyp tissue. ACTA ACUST UNITED AC 2021; 40:426-434. [PMID: 33558771 PMCID: PMC7889257 DOI: 10.14639/0392-100x-n0566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 08/04/2020] [Indexed: 12/04/2022]
Abstract
Chronic rhinosinusitis with nasal polyposis is a disease characterised by a mechanical dysfunction that facilitates anomalous growth of the nasal mucosa, due to its unique remodelling process. The development of procedures capable of interfering with this process is thus of the utmost importance. This study deals with the evaluation of the effects of cross-linking upon the nasal polyp tissue extracellular matrix. Six patients undergoing surgery for polypectomy were selected. The riboflavin/UVA collagen cross-linking technique was applied to the surface of epithelialised and de-epithelialised resected polyps of the intervention group. The control group polyps were not submitted to cross-linking procedures. Ultrathin polyp tissue sections (8 μm) were processed for immunofluorescence with mouse anti-type I collagen antibody and AlexaFluor 488 conjugated secondary antibody plus DAPI counterstaining, and analysed by confocal microscopy. The effect of riboflavin/UVA collagen cross-linking was visible on confocal fluorescence microscopy. Quantitative morphology was associated with fluorescence imaging analysis, and pixel density and brightness were evaluated. The surface of treated polyps exhibited a higher density of collagen fibres compared to control polyps, as could be observed both visually and through objective measurements of the fluorescent regions. The effect was enhanced on the surface of the de-epithelialised polyps. The higher density of collagen fibres exhibited by the de-epithelialised treated polyps demonstrates the feasibility of this technique in interfering with the remodelling process and the mechanical dysfunction found in chronic rhinosinusitis with nasal polyposis.
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Affiliation(s)
- Nathalia Coronel
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Rogério Pezato
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Jônatas Bussador do Amaral
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Leandro Ticlia
- Laboratory of Microrheology and Molecular Physiology, Institute of Physics, University of São Paulo-USP, São Paulo, SP, Brazil
| | | | - Lígia Ferreira Gomes
- Laboratory of Microrheology and Molecular Physiology, Institute of Physics, University of São Paulo-USP, São Paulo, SP, Brazil
| | - Juliana Dreyfuss
- Department of Biochemistry, Federal University of São Paulo-Unifesp, São Paulo, SP, Brazil
| | - Wallace Chamon
- Department of Ophthalmology and Visual Sciences, Federal University of São Paulo-Unifesp, São Paulo, SP, Brazil.,Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Luiz Carlos Gregório
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
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Chen S, Kent B, Cui Y. Interventions to prevent aspiration in older adults with dysphagia living in nursing homes: a scoping review. BMC Geriatr 2021; 21:429. [PMID: 34273953 PMCID: PMC8285814 DOI: 10.1186/s12877-021-02366-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 06/29/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dysphagia is highly prevalent condition in older adults living in nursing homes. There is also evidence indicating that aspiration is one of the major health risks for these older adults, which is more likely to result in respiratory infections, aspiration pneumonia and sudden bolus death. Evidence syntheses have demonstrated the effectiveness of interventions for prevention of aspiration among hospitalized older people. The aim of this scoping review is to describe the current spread of interventions to prevent or reduce aspiration in older adults with dysphagia with a specific focus on those who reside in nursing homes. METHODS The Joanna Briggs Institute methods and PRISMA-ScR guidelines were used to inform this review. MEDLINE, CINAHL, EMBASE, Cochrane Library, Joanna Briggs Institute EBP Database and Web of Science were searched for related articles from 2010 to 2020 as well as Chinese databases (CNKI, WANFANG DATA and VIP) and databases for unpublished material. A three-step search strategy was utilized, including the use of citation software to manage search results and de-duplication, abstract review and full-text review by two reviewers. Details of included studies were then extracted using a prepared data extraction tool. The resulting map was displayed in tabular form along with a narrative summary. RESULTS Although 637 articles were located, 19 papers were included in the final analysis. Interventions to prevent aspiration in older adults with dysphagia living in nursing homes included: more bedside evaluation, modification of dietary, creating an appropriate environment for swallowing, providing appropriate feeding assistance, appropriate posture or maneuver for swallowing, appropriate rehabilitation program, medication treatment, and stimulation treatment. CONCLUSION Nursing homes, particularly those in developing countries, require more support for staff training and necessary equipment. Professional interventions provided by speech and language therapists are still limited in the setting of nursing homes. Modification of dietary was the most frequently used intervention to prevent or reduce aspiration. Multi-disciplinary interventions had the best results for aspiration management, but for many nursing homes, access to such teams is limited. Nursing home residents respond well to person-centered interventions that have a comprehensive consideration of their degree of aspiration risk, health condition, individual feelings and cognitive state.
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Affiliation(s)
- Shen Chen
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Bridie Kent
- The University of Plymouth Centre for Innovations in Health and Social Care: A Joanna Briggs Institute Centre of Excellence, Plymouth, UK
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, China.
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Lino WVS, Bachi ALL, Neto JAM, Caetani G, Amaral JBD, Pezato R. CD133, a Progenitor Cell Marker, is Reduced in Nasal Polyposis and Showed Significant Correlations with TGF-β1 and IL-8. Int Arch Otorhinolaryngol 2021; 26:e091-e096. [PMID: 35096164 PMCID: PMC8789493 DOI: 10.1055/s-0041-1726043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction
Combination of chronic inflammation and an altered tissue remodeling process are involved in the development of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Studies demonstrated that mesenchymal stem cells expressing the progenitor gene
CD133
were involved in a significant reduction of the chronic inflammatory process in the polypoid tissue.
Objective
To evaluate the levels of CD133 (Prominin-1) in nasal polypoid tissue and its correlation with interleukin-8 (IL-8) and transforming growth factor β1 (TGF-β1).
Methods
A total of 74 subjects were divided in the following groups: control group (
n
= 35); chronic rhinosinusitis with nasal polyps nonpresenting comorbid asthma and aspirin intolerance (CRSwNPnonAI) group (
n
= 27); and chronic rhinosinusitis with nasal polyps presenting comorbid asthma and aspirin intolerance (CRSwNPAI) group (
n
= 12). Histologic analysis and also evaluation of the concentration of CD133, IL-8, and TGF-β1 by enzyme-linked immunosorbent assay (ELISA) kits were performed in nasal tissue obtained from nasal polypectomy or from middle turbinate tissue.
Results
Higher eosinophilic infiltration was found in both CRSwNP groups by histologic analysis. Lower levels of TGF-β1 and IL-8 were observed in both CRSwNP groups when compared with the control group, whereas the CD133 levels were significantly reduced only in the CRSwNPnonAI group compared with the control group.
Conclusion
It was demonstrated that the nasal mucosa presenting polyposis showed a significant reduction of CD133 levels, and also that this reduction was significantly correlated with the reduction of TGF-β1 levels, but not with IL-8 levels. Therefore, these findings may be involved in the altered inflammatory and remodeling processes observed in the nasal polyposis.
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Affiliation(s)
- Wagner Vargas Souza Lino
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - André Luis Lacerda Bachi
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Instituto Brasileiro Ensino/Pesquisa em Imunologia Pulmonar, São Paulo, SP, Brazil
- Postgraduation Program in Health Science, Universidade Santo Amaro), Sao Paulo, SP, Brazil
| | - José Arruda Mendes Neto
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Gabriel Caetani
- Hospital Universitário Gafree e Guinle, Universidade Federal do Estado do Rio de Janeiro,, Rio de Janeiro, RJ, Brazil
| | - Jônatas Bussador do Amaral
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rogério Pezato
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Hospital Universitário Gafree e Guinle, Universidade Federal do Estado do Rio de Janeiro,, Rio de Janeiro, RJ, Brazil
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Pezato R, Gregório LL, Pérez-Novo C, Bezerra TFP, Kosugi EM. Montelukast Has no Impact on the Systemic Production of TGFβ-1 in Patients with Nasal Polyposis Associated with Aspirin Intolerance. Int Arch Otorhinolaryngol 2021; 25:e88-e91. [PMID: 33542757 PMCID: PMC7851368 DOI: 10.1055/s-0040-1702972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/26/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction Nasal polyposis is a disease characterized by a mechanical dysfunction of the nasal mucosa, closely related to the unique makeup of its extracellular matrix, which develops as the result of an anomalous tissue remodeling process. Transforming growth factor beta 1 (TGF-β1) is reduced not only in the nasal polypoid tissue, but also in the plasma of aspirin-intolerant patients. These patients exhibit an imbalance in the production of eicosanoids characterized by an increase in leukotrienes. Thus, it is important that the relationship between the production of leukotrienes and TGF-β1 be assessed. Objective To evaluate the effects of the cysteinyl leukotriene (CysLT) receptor antagonist montelukast on the systemic production of TGF-β1 in patients with nasal polyposis, with or without concomitant aspirin intolerance. Methods The sample comprised 48 individuals with diagnosis of nasal polyposis and 15 healthy controls for comparison of the baseline TGF-β1 levels in the peripheral blood and after treatment with CysLT receptor antagonist montelukast in the nasal-polyposis group. Results There was no difference in the change in TGF-β1 levels after the treatment with montelukast in the subgroup of patients with polyposis and asthma ( p = 0.82) and in the subgroup with polyposis, asthma, and aspirin intolerance ( p = 0.51). Conclusion we found no impact of the therapy with a leukotriene receptor blocker on the production of TGF-β1, making the antileukotriene therapy a highly questionable choice for the treatment of nasal polyposis, particularly from the standpoint of seeking to modify the remodeling process in this disease.
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Affiliation(s)
- Rogério Pezato
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luciano Lobato Gregório
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Claudina Pérez-Novo
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Eduardo Macoto Kosugi
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
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do Amaral JB, Bloise AC, França CN, Perez-Novo C, Machado-Santelli GM, Alencar AM, Pezato R. Alterations in cellular force parameters and cell projections in Nasal polyps-derived fibroblasts. Auris Nasus Larynx 2019; 47:98-104. [PMID: 31272842 DOI: 10.1016/j.anl.2019.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/07/2019] [Accepted: 06/20/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is a disease that features a mechanical dysfunction involving chronic inflammation and altered tissue remodeling. In this study, we aim to evaluate the fibroblast morphology and its cellular traction force in primary fibroblasts cell cultures obtained from both healthy individuals (n=7) and patients with CRSwNP (n=8). METHODS Using a Traction-force Microscopy we analyzed parameters of Force/Tension in fibroblasts cultures in both experimental groups. RESULTS The analysis of the Projected Area of Cell revealed that fibroblasts derived from nasal mucosa of healthy individuals have an area on average 39.24% larger than the fibroblasts obtained from the nasal polyp tissue. We also observed that the parameters directly related to the force of the cell, Max Cumulative Force and Net Contractile Moment, presented a high Force/Tension per unit of area in the fibroblasts derived from the healthy nasal mucosa (on average 41% and 52.54% higher than the fibroblasts of the nasal polyp respectively). CONCLUSION Our results demonstrate a cellular mechanism that may be associated with the mechanical dysfunction found in the Nasal Polyp tissue. The weak traction force of nasal polyp-derived fibroblast may, in lower dimensions, impact on the remodeling of nasal mucosa in CRSwNP.
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Affiliation(s)
- Jônatas Bussador do Amaral
- ENT Research Lab., Department of Otorhinolaryngology - Head and Neck Surgery, Federal University of Sao Paulo, Rua Coronel Lisboa, 958, Vila Clementino, São Paulo, SP, 04020-041, Brazil.
| | - Antonio Carlos Bloise
- Institute of Physics, University of Sao Paulo, Rua do Matão, Travessa R Número 187, Cidade Universitária, São Paulo, SP 05508-090, Brazil
| | - Carolina Nunes França
- Universidade Santo Amaro, Pós Graduação em Ciências da Saúde, Rua Enéas de Siqueira Neto, 340 Jardim das Imbuias, São Paulo, SP 04829-300, Brazil
| | - Claudina Perez-Novo
- Laboratory of Proteinchemistry, Proteomics and Epigenetic Signalling Department of Biomedical Sciences, Campus Drie Eiken, building T, first floor Universiteitsplein 1 2610 Wilrijk University of Antwerp, Belgium
| | - Gláucia Maria Machado-Santelli
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of Sao Paulo, Avenida Prof Lineu Prestes, 1524, dade Universitária, Sao Paulo, SP 05508-900, Brazil
| | - Adriano Mesquita Alencar
- Institute of Physics, University of Sao Paulo, Rua do Matão, Travessa R Número 187, Cidade Universitária, São Paulo, SP 05508-090, Brazil
| | - Rogério Pezato
- ENT Research Lab., Department of Otorhinolaryngology - Head and Neck Surgery, Federal University of Sao Paulo, Rua Coronel Lisboa, 958, Vila Clementino, São Paulo, SP, 04020-041, Brazil
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9
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Pezato R, Voegels RL, Pignatari S, Gregório LC, Pinto Bezerra TF, Gregorio L, Balsalobre L, Tepedino MS, Coronel N, Pinna FDR, Mendes Neto J, Oliveira P, Macoto E, Stefanini R, Figueiredo C, Haddad F, Pilan R, Bezerra Soter A, Melo NA, Candido DA, Amaral JD, Santos RDP, Van Zele T, Fujita R, Dreyfuss JL, Chamon W, Alencar AM, Perez-Novo C, Stamm AC. Nasal Polyposis: More than a Chronic Inflammatory Disorder-A Disease of Mechanical Dysfunction-The São Paulo Position. Int Arch Otorhinolaryngol 2019; 23:241-249. [PMID: 30956711 PMCID: PMC6449132 DOI: 10.1055/s-0038-1676659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/21/2018] [Indexed: 01/02/2023] Open
Abstract
Introduction The importance of our study lies in the fact that we have demonstrated the occurrence of mechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP.
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Affiliation(s)
- Rogerio Pezato
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Shirley Pignatari
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Luiz Carlos Gregório
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Luciano Gregorio
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Leonardo Balsalobre
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Nathália Coronel
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - José Mendes Neto
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Pedro Oliveira
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Eduardo Macoto
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Renato Stefanini
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Claudia Figueiredo
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Fernanda Haddad
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Renata Pilan
- Department of Otolaryngology, USP, São Paulo, SP, Brazil
| | | | | | | | - Jonatas do Amaral
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Thibaut Van Zele
- Ear, Nose and Throat Department,, University of Ghent, Ghent, Belgium
| | - Reginaldo Fujita
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Wallace Chamon
- Department of Ophthalmology and Visual Sciences, Unifesp, São Paulo, SP, Brazil
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Adriano Mesquita Alencar
- Laboratory of Microrheology and Molecular Physiology, Institute of Physics, USP, São Paulo, SP, Brazil
| | - Claudina Perez-Novo
- Proteinscience, Proteomics and Epigenetic Signaling, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Aldo Cassol Stamm
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
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10
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Balsalobre L, Pezato R, Mangussi-Gomes J, Gregorio L, Haddad FLM, Gregorio LC, Fujita R. What is the Impact of Positive Airway Pressure in Nasal Polyposis? An Experimental Study. Int Arch Otorhinolaryngol 2019; 23:147-151. [PMID: 30956697 PMCID: PMC6449137 DOI: 10.1055/s-0038-1676095] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/06/2018] [Indexed: 11/21/2022] Open
Abstract
Introduction
It has been hypothesized that increasing the interstitial hydrostatic pressure within the sinonasal mucosa of patients with nasal polyposis (NP) might decrease the size of nasal polyps.
Objective
To evaluate the effects of positive airway pressure, delivered by a continuous positive airway pressure (CPAP) device, in patients with NP and in control subjects.
Methods
Twelve patients with NP and 27 healthy subjects were exposed to CPAP (20 cm H2O) for 2 hours. Visual analog scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE) scale, acoustic rhinometry (AR), peak nasal inspiratory flow (PNIF) and nasal endoscopy (NE—Meltzer polyp grading system) were performed before and after the intervention, for all patients.
Results
The control group showed a significant worsening in nasal obstruction symptoms, as measured by VAS and NOSE (
p
< 0.01), and a significant decrease in nasal patency, as measured by the PNIF and AR (
p
< 0.01). For the NP group, VAS, NOSE, and AR did not differ significantly (
p
= 0.72,
p
= 0.73, and
p
= 0.17, respectively), but PNIF values worsened (
p
= 0.04) after exposure to CPAP. There was a statistically significant reduction in the nasal polyps' size (
p
= 0.04).
Conclusions
Positive pressure worsened the nasal obstruction symptoms and decreased objective parameters of nasal patency in control subjects. In patients with NP, exposure to CPAP reduced the nasal polyps' size, and the nasal patency, as measured by PNIF. However, it had no significant effects in AR and in nasal obstruction symptoms.
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Affiliation(s)
- Leonardo Balsalobre
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Rogerio Pezato
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Joao Mangussi-Gomes
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Luciano Gregorio
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Fernanda Louise Martinho Haddad
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Luiz Carlos Gregorio
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Reginaldo Fujita
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
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