Impact of chronic rhinosinusitis on severe asthma patients

PLoS One. 2017 Feb 15;12(2):e0171047. doi: 10.1371/journal.pone.0171047. eCollection 2017.

Abstract

Coexistence of chronic rhinosinusitis (CRS) with asthma appears to impair asthma control. Type-2 innate lymphoid cells (ILC2s) respond to the cytokines of thymic stromal lymphopoietin (TSLP), interleukin (IL)-25 and IL-33, thus contributing to airway diseases such as CRS and asthma. We investigate whether the augmented Th2-cytokines in CRS might be related to sinonasal tract ILC2s corresponding to enhanced IL-25, IL-33 and TSLP release in severe asthmatics, and be involved in asthma control. Twenty-eight asthmatics (12 non-severe and 16 severe) with CRS receiving nasal surgery were enrolled. The predicted FEV1 inversely associated with CRS severity of CT or endoscopy scores. Higher expression of Th2-driven cytokines (IL-4, IL-5, IL-9, and IL-13), TSLP, IL-25 and IL-33 in nasal tissues was observed in severe asthma. Severe asthmatics had higher ILC2 cell counts in their nasal tissues. ILC2 counts were positively correlated with Th2-cytokines. Nasal surgery significantly improved asthma control and lung function decline in severe asthma and CRS. The higher expression of IL-33/ILC2 axis-directed type 2 immune responses in nasal tissue of CRS brought the greater decline of lung function in severe asthma. ILC2-induced the upregulated activity of Th2-related cytokines in asthmatics with CRS may contribute to a recalcitrant status of asthma control.

MeSH terms

  • Adult
  • Asthma / complications
  • Asthma / diagnosis*
  • Asthma / pathology
  • Chronic Disease
  • Cytokines / genetics
  • Cytokines / metabolism
  • Endoscopy
  • Female
  • Humans
  • Immunohistochemistry
  • Interleukin-17 / genetics
  • Interleukin-17 / metabolism
  • Interleukin-33 / genetics
  • Interleukin-33 / metabolism
  • Male
  • Microscopy, Confocal
  • Middle Aged
  • Nasal Mucosa / metabolism
  • Nasal Mucosa / pathology
  • Nasal Polyps / metabolism
  • Nasal Polyps / pathology
  • Real-Time Polymerase Chain Reaction
  • Rhinitis / complications
  • Rhinitis / diagnosis*
  • Rhinitis / surgery
  • Severity of Illness Index
  • Sinusitis / complications
  • Sinusitis / diagnosis*
  • Sinusitis / surgery
  • Thymic Stromal Lymphopoietin

Substances

  • Cytokines
  • Interleukin-17
  • Interleukin-33
  • Thymic Stromal Lymphopoietin

Grants and funding

The research grant of this work was supported by Chang Gung Memorial Hospital (CMRPG3D0831).