Features of airway remodeling in different types of Chinese chronic rhinosinusitis are associated with inflammation patterns

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