Expression of Periostin in Vocal Fold Polyps

Expression of Vascular and Tissue Repair Factors in Laryngeal Granulomas

Voice abuse, chronic cough, laryngeal surgery, and tracheal intubation may lead to injury and subsequent repair/remodeling in the vocal fold mucosa. Periostin is known to be involved in airway remodeling and is also associated with various otolaryngological diseases. D-β-aspartic acid is the major isomer of D-aspartic acid found in tissues of elderly individuals. In ischemic heart disease, increased CD31 expression has been observed around cardiomyocytes during remodeling, and endothelial proliferation has been reported at these sites. In this study, we investigated the expression and role of CD31, CD34, D-β-aspartic acid, and periostin in the formation of laryngeal granulation tissue. This retrospective study involved five patients who underwent surgical treatment for laryngeal granulation tissue. The expressions of CD31, CD34, D-β-aspartic acid, and periostin in surgical samples were investigated by immunohistochemistry. Histologically, the specimens showed inflammatory cell infiltration, fibrin exudation, fibrosis, and neovascularization, but no tumor cells. No stratified squamous epithelial covering was observed. The expression of periostin and D-β-aspartic acid was also observed in the specimens. CD31-positive cells (endothelial cells) and CD34-positive cells (progenitors of endothelial cells) were observed in the specimens. Our results indicate that the overexpression of CD31, CD34, D-β-aspartic acid, and periostin may play a role in the pathogenesis of laryngeal granulation tissue, and we speculate that D-β-aspartic acid and periostin could serve as novel biomarkers and therapeutic targets for laryngeal granulation tissue.

Immunohistochemical localization of CD31, CD34, and periostin in vocal fold polyps

BACKGROUND

Long-term voice-abuse or sudden vocal fold microvascular disruption can lead to injury and subsequent repair/remodeling of the vocal fold mucosa. Periostin is known to be involved in airway remodeling and in various otolaryngological diseases. In ischemic heart disease, increased CD31 expression has been observed around cardiomyocytes during remodeling, and endothelial proliferation has been reported to occur at these sites.

OBJECTIVES

We investigated the expression and the roles of CD31, CD34, and periostin in the formation of vocal fold polyps.

MATERIALS AND METHODS

Fifty-seven samples of vocal fold polyps were investigate histopathologically and immunohistochemically.

RESULT

Expression of CD31 and CD34 was detected in 41 (71.9%) and 53 (93.0%) samples, respectively, obtained from patients with vocal fold polyp. Expression of periostin was detected in 41 (71.9%) samples obtained from patients with vocal polyps. The vocal polyp samples could be classified into three histological subtypes. Three patterns of CD31 and CD34 expression were observed in the vocal polyp. Four patterns of periostin expression were observed in vocal polyps. An association was observed between the CD31 expression pattern and the histological subtype of vocal fold polyps.

CONCLUSION AND SIGNIFICANCE

In vocal fold polyps, evaluation of vascular endothelial markers may be useful for staging.

Periostin is an aggravating factor and predictive biomarker of eosinophilic chronic rhinosinusitis

BACKGROUND

Patients with eosinophilic chronic rhinosinusitis (ECRS) respond poorly to many treatment modalities. Overproduction of periostin in the nasal mucosa is reported to contribute to polyp formation. This study examined periostin levels in patients with ECRS in comparison with levels in patients with non-ECRS.

METHODS

Fifty-nine patients with chronic rhinosinusitis were grouped into those with ECRS and those with non-ECRS. We compared the relationships between peripheral blood eosinophil level, serum periostin level, histopathological findings, clinical and laboratory findings, nose findings, diagnostic score of the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis Study, and postoperative recurrence of nasal polyps in each group.

RESULTS

In the ECRS group, a positive correlation was found between peripheral blood eosinophil level and serum periostin level (r_s = 0.49, P < 0.01: Spearman's rank correlation coefficient). ROC curve analysis was used to evaluate the serum periostin level that could predict postoperative recurrence of nasal polyps in the ECRS group: the area under the curve (AUC) was 0.95, sensitivity was 92%, and specificity was 100%; the serum periostin cutoff value for postoperative recurrence of nasal polyps was 130 ng/ml. In ROC curve analysis to evaluate peripheral blood eosinophil level, the AUC was 0.73, sensitivity was 69.2%, and specificity was 85.0%; the cutoff value was 8.8%.

CONCLUSIONS

periostin was implicated in the pathophysiology of ECRS. Periostin shown to be a more useful biomarker than eosinophils in ECRS. Periostin was shown to likely be an important biomarker for pathological severity of ECRS and postoperative recurrence of nasal polyps.