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Chronic nasal - sinusitis patients with tumor necrosis factor -α expression of glucocorticoid receptor β Relationship

Author: LiuHuiNing
Tutor: ZhangXun
School: Hebei Medical University
Course: Otorhinolaryngology
Keywords: Sinusitis Nasal polyps Tumor necrosis factor -α Glucocorticoid receptor β Immunohistochemistry
CLC: R765
Type: Master's thesis
Year: 2008
Downloads: 85
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Abstract

Objective: Chronic nasal - sinusitis (chronic rhinosinusitis CRS) is ENT diseases, the treatment of chronic sinusitis and nasal polyps usually with surgery, but perioperative antibiotics, treatment with corticosteroids is essential to improve the cure rate essential, local glucocorticoid (glucocorticoid GC) applications is an important component of its occurrence and the development of polyps in the control play an important role in the treatment and prevention. GC on the premise that the inflammatory response suppressing the glucocorticoid receptor (glucocorticoid receptor GR) combined with the membrane DNA conjugate specific sites - answering points glucocorticoids (glucocorticoid response elements, GRE) binding to reduced inflammation cytokines and media transcription, and ultimately lead to a variety of biological effects. GR points GRα and GRβ2 subtypes, some studies show that GRβ is the potential effect of endogenous GC antagonistic factors associated with hormone resistance, known as the \kind of receptor expression is abnormal, respectively, in the clinical part of the application process GC patients showed insensitivity or ineffective treatment, which become the recent research focus for its mechanism, researchers have done a lot of work at home and abroad, some scholars proposed glucocorticoid resistance (glucocorticoid-resistant) concept used to describe the part of the patient on high dose GC poor response to treatment or no response to the phenomenon. In recent years, TNF-α has been reported to increase the expression of GRβ, which may be induced by inflammatory cytokines glucocorticoid resistance of the internal mechanism. In this paper, our department from January 2007 to July 2007 hospitalized chronic nasal - sinusitis patients, according to Haikou standard (1997) is divided into two groups of type I and type II, explore the chronic nasal - sinusitis in patients with TNF-α and GRβ expression and whether relevant, in order for the future of steroid-resistant chronic rhinosinusitis - clinical treatment of sinusitis and nasal polyps provide new ideas. Methods: Immunohistochemical SP method was observed in control group, chronic sinusitis type I and type I1 TNF-α and GRβ expression difference. Specific steps are as follows: a choice of subjects: Choose January 2007 to July for my inpatient chronic nose - a total of 40 cases of sinusitis patients, divided into Type I and II, in which 12 cases of type I, II in 18 cases , using immunohistochemical SP method and computer image analysis system, observe the follow-up data of 40 patients with chronic nasal - sinusitis patients, all selected candidates within 2 months before surgery did not receive local or systemic corticosteroids, including type II CRS pathologically confirmed polyps, excluding recurrence after endoscopic sinus surgery Suozhi type Ⅲ CRS. According to Haikou standards are divided into two groups: Ⅱ type group (Ⅱ type 1 ~ 3) 18 cases, including 13 males and 5 females, aged 17 to 66 years, with a median age of 49 years; history of 2.5-10 years, average of 10.25 years. I-type group (I Type 1 ~ 3) 12 cases, 7 males and 5 females, aged 19 to 68 years, with a median age of 36 years, history of 3-20 years, mean 10.7 years. Also select no nose - sinusitis and allergic diseases in patients with a history of 10 cases of traumatic nasal surgery in the middle turbinate mucosa as a control group, 7 males and 3 females, aged 20 to 40 years with a median age of 35 years , a history of 3-12 days, an average of 7.8 days. Two specimens of the production: the removed specimen immediately with 10% formalin-fixed, automatic dehydration, paraffin embedding, serial paraffin sections, thick 4μm, respectively HE staining, TNF-α immunohistochemical staining, GRβ immune staining, the effects of different types of chronic nasal - sinusitis, TNF-α, GRβ expression. 3 Statistical analysis using completely randomized ANOVA and SNK test pairwise comparison test analysis and processing of data, as the difference in α = 0.05 significance level, while TNF-α, GRβ was analyzed. Results: The three groups of TNF-α, GRβ expression of different changes in a variety of staining observed results are as follows: 1 TNF-α immunohistochemical staining showing different types of chronic nasal - sinusitis and its expression of different groups of TNF-α (x ± s) were: control group (4.35 ± 2.08), I chronic nasal - sinusitis group (6.85 ± 1.21), II chronic nasal - sinusitis group (8.35 ± 2.15). Compared with control group, chronic nasal - sinusitis patients in each group TNF-α values were increased to type II chronic nasal - sinusitis and nasal polyps most significant statistical results with a type I chronic nasal - sinusitis group and the control group significant difference (P lt; 0.05). I type with the control group there was significant difference (P lt; 0.05) 2 GRβ immunohistochemical staining showing different types of chronic nasal - sinusitis and its expression of different groups of GRβ (x ± s) were: control group (10.56 ± 1.08) , I-type chronic nasal - sinusitis group (17.85 ± 1.31), II chronic nasal - sinusitis and nasal polyps group (30.35 ± 3.12). Compared with control group, chronic nasal - sinusitis patients in each group GRβ values were increased to type II chronic nasal - sinusitis and nasal polyps most significant statistical results with a type I chronic nasal - sinusitis and control groups was significant difference (P lt; 0.05). I type with the control group there was significant difference (P lt; 0.05). 3 TNF-α induce high expression of GRβ, there is significant correlation between type I and type II in chronic nasal - sinusitis, TNF-α, GRβ values were highly expressed, TNF-α elevated levels were positively correlated with GRβ In type I CRS group correlation coefficient of r = 0.7983, in type II CRS group correlation coefficient of r = 0.8125, with statistical significance (P lt; 0.05). Conclusion: I type and type II chronic nasal - sinusitis lesions of TNF-α, GRβ were highly expressed between the two there is a certain positive linear correlation. GRβ high expression of chronic sinusitis may have a role in disease development. TNF-α and GRβ with exacerbations its expression gradually increased. By detecting TNF-α, GRβ help determine prognosis and guide treatment adjustments.

Chronic nasal - sinusitis patients with tumor necrosis factor -α expression of glucocorticoid receptor β Relationship

Abstract

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