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Group 2 innate lymphoid cells ( ILC 2s) are increased in chronic rhinosinusitis with nasal polyps or eosinophilia
Author(s) -
Ho J.,
Bailey M.,
Zaunders J.,
Mrad N.,
Sacks R.,
Sewell W.,
Harvey R. J.
Publication year - 2015
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12462
Subject(s) - nasal polyps , innate lymphoid cell , medicine , eosinophilia , endotype , sinusitis , immunology , population , immunoglobulin e , asthma , eosinophil , gastroenterology , cd8 , allergy , eosinophilic , pathology , immunity , antibody , immune system , environmental health
Summary Background Chronic rhinosinusitis ( CRS ) is a heterogeneous disease with an uncertain pathogenesis. Group 2 innate lymphoid cells ( ILC 2s) represent a recently discovered cell population which has been implicated in driving Th2 inflammation in CRS ; however, their relationship with clinical disease characteristics has yet to be investigated. Objective The aim of this study was to identify ILC 2s in sinus mucosa in patients with CRS and controls and compare ILC 2s across characteristics of disease. Methods A cross‐sectional study of patients with CRS undergoing endoscopic sinus surgery was conducted. Sinus mucosal biopsies were obtained during surgery and control tissue from patients undergoing pituitary tumour resection through transphenoidal approach. ILC 2s were identified as CD 45 + Lin − CD 127 + CD 4 − CD 8 − CRTH 2( CD 294) + CD 161 + cells in single cell suspensions through flow cytometry. ILC 2 frequencies, measured as a percentage of CD 45 + cells, were compared across CRS phenotype, endotype, inflammatory CRS subtype and other disease characteristics including blood eosinophils, serum IgE, asthma status and nasal symptom score. Results 35 patients (40% female, age 48 ± 17 years) including 13 with eosinophilic CRS ( eCRS ), 13 with non‐ eCRS and 9 controls were recruited. ILC 2 frequencies were associated with the presence of nasal polyps ( P = 0.002) as well as high tissue eosinophilia ( P = 0.004) and eosinophil‐dominant CRS ( P = 0.001) (Mann–Whitney U ). They were also associated with increased blood eosinophilia ( P = 0.005). There were no significant associations found between ILC 2s and serum total IgE and allergic disease. In the CRS with nasal polyps ( CRS w NP ) population, ILC 2s were increased in patients with co‐existing asthma ( P = 0.03). ILC 2s were also correlated with worsening nasal symptom score in CRS ( P = 0.04). Conclusion and clinical relevance As ILC 2s are elevated in patients with CRS w NP , they may drive nasal polyp formation in CRS . ILC 2s are also linked with high tissue and blood eosinophilia and have a potential role in the activation and survival of eosinophils during the Th2 immune response. The association of innate lymphoid cells in CRS provides insights into its pathogenesis.