Features of airway remodeling in different types of <scp>C</scp>hinese chronic rhinosinusitis are associated with inflammation patterns

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>The remodeling patterns in different types of chronic rhinosinusitis (<jats:styled-content style="fixed-case">CRS</jats:styled-content>) have rarely been compared, particularly the difference between eosinophilic and noneosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content> with nasal polyps (<jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content>). Moreover, whether there is a link between remodeling and inflammation remains controversial.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To directly compare the remodeling features of different <jats:styled-content style="fixed-case">CRS</jats:styled-content> and to explore their relationship with inflammation in <jats:styled-content style="fixed-case">C</jats:styled-content>hinese patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Histologic characteristics of surgical samples were analyzed in 33 controls, 72 eosinophilic and 76 noneosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content>, and 72 <jats:styled-content style="fixed-case">CRS</jats:styled-content> without nasal polyps (<jats:styled-content style="fixed-case">CRS</jats:styled-content>s<jats:styled-content style="fixed-case">NP</jats:styled-content>) patients. Tissue samples from 38 controls, 26 eosinophilic and 26 noneosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content>, and 32 <jats:styled-content style="fixed-case">CRS</jats:styled-content>s<jats:styled-content style="fixed-case">NP</jats:styled-content> patients were measured for <jats:styled-content style="fixed-case">mRNA</jats:styled-content> and/or protein expression of profibrotic growth factors, metalloproteinases (<jats:styled-content style="fixed-case">MMP</jats:styled-content>s), tissue inhibitor of metalloproteinases (<jats:styled-content style="fixed-case">TIMP</jats:styled-content>s), hypoxia‐inducible factor (<jats:styled-content style="fixed-case">HIF</jats:styled-content>)‐1α, interleukin (<jats:styled-content style="fixed-case">IL</jats:styled-content>)‐8, eosinophil cationic protein (<jats:styled-content style="fixed-case">ECP</jats:styled-content>), and myeloperoxidase (<jats:styled-content style="fixed-case">MPO</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The amount of collagen decreased, whereas the edema scores increased, from <jats:styled-content style="fixed-case">CRS</jats:styled-content>s<jats:styled-content style="fixed-case">NP</jats:styled-content> to noneosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content> and to eosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content>. Transforming growth factor (<jats:styled-content style="fixed-case">TGF</jats:styled-content>)‐β2 protein levels were enhanced in <jats:styled-content style="fixed-case">CRS</jats:styled-content>s<jats:styled-content style="fixed-case">NP</jats:styled-content> compared with <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content>. <jats:styled-content style="fixed-case">TIMP</jats:styled-content>‐4 protein levels decreased in eosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content> compared with noneosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content> and <jats:styled-content style="fixed-case">CRS</jats:styled-content>s<jats:styled-content style="fixed-case">NP</jats:styled-content>. The number of neutrophils decreased from <jats:styled-content style="fixed-case">CRS</jats:styled-content>s<jats:styled-content style="fixed-case">NP</jats:styled-content> to noneosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content> and to eosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content>. <jats:styled-content style="fixed-case">ECP</jats:styled-content> levels were only up‐regulated in eosinophilic <jats:styled-content style="fixed-case">CRS</jats:styled-content>w<jats:styled-content style="fixed-case">NP</jats:styled-content>. <jats:styled-content style="fixed-case">ECP</jats:styled-content> levels and neutrophil number correlated positively with the severity of edema and fibrosis, respectively. Neutrophils were t ...