The expression and significance of nasal mucosal glandular hyperplasia and eosinophil infiltration in chronic rhinosinusitis.

Abstract

Background: The pathophysiological mechanisms underlying nasal mucosal glandular changes in chronic rhinosinusitis (CRS) remains poorly understood.

Objectives: This study aimed to examine nasal mucosal glandular density and eosinophil (Eos) infiltration in CRS patients and their role in disease pathogenesis.

Materials and methods: HE staining was used to assess glandular density and Eos infiltration in nasal mucosal lesion tissues from 86 CRS patients during FESS (16 CRS without nasal polyps (CRSsNP), 55 non-eosinophilic CRS with nasal polyps (nECRSwNP), and 15 eosinophilic CRSwNP (ECRSwNP)). Immunohistochemical analysis was conducted to evaluate eosinophil cationic protein (ECP), lysozyme, and immunoglobulin A (IgA) expression within these tissues. The Kruskal-Wallis test was used to reveal the statistical difference in therapeutic efficacy among the groups.

Results: The CRSsNP group showed nasal mucosal glandular density of '+++/++' with minimal Eos infiltration, and 94% achieved control. The nECRSwNP group exhibited atypical glandular hyperplasia and Eos infiltration, with 22% achieving complete control, 51% partial control, and 27% no control. The ECRSwNP group had significant Eos infiltration '++/+++' and reduced glands, with 93% showing uncontrolled conditions.

Conclusions and significance: The findings suggest that extensive Eos infiltration and ECP secretion contribute to glandular and epithelial damage, reducing lysozyme and IgA production. These changes may promote chronic inflammation and increase the likelihood of nasal polyp recurrence.