Innate immunity mechanism of the respiratory epithelium: the role of extracellular traps in chronic rhinosinusitis pathophysiology

Abstract

Recent studies have shown that neutrophils, masts cells and eosinophils are able to release "extracellular traps" composed by chromatin filaments of nuclear DNA into the extracellular space, aggregated to enzymes and antimicrobial peptides. The extracellular traps have an important role in the innate immune response, with a powerful bactericidal effect. Several studies have demonstrated that in the sinonasal mucosa from patients with chronic rhinosinusitis there is a rich inflammatory cells infiltration of neutrophils and eosinophils, which potentially could explain the presence of ET in the sinonasal mucosa. However, there is no study demonstrating the presence of extracellular traps in the superior respiratory tract mucosa, particularly in persistent inflammatory conditions like chronic rhinosinusitis. Objectives: To investigate the presence of extracellular traps in the sinonasal mucosa and their relationship to the innate mechanisms in the chronic rhinosinusitis pathophysiology. Patients and Methods: Samples of polyps and/or sinonasal mucosa will be collected from patients with Chronic Rhinosinusitis with Polyps (n=15), patients with Chronic Rhinosinusitis without Polyps (n=15) and control patients (n=10), and samples of peripheral blood to extraction of polymorphonuclear cells. ETs will be visualized by scanning electron microscopy, immunofluorescence and immunohistochemestry. They will be also stimulated using phorbol myristate acetate (PMA), in order to compare its formation in sinonasal mucosa in relation to peripheral blood. (AU)