Skip to main content

Advertisement

SpringerLink
Log in

Eosinophils and mast cells: a comparison of nasal mucosa histology and cytology to markers in nasal discharge in patients with chronic sino-nasal diseases

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Allergic rhinitis (AR), nasal polyps (NP) as well as chronic rhinosinusitis (CRS) are all known to be associated with eosinophilic infiltration and elevated numbers of mast cells (MC) within the mucosa. Both cell types and their markers eosinophilic cationic protein (ECP) and tryptase are utilized in the diagnosis and management of chronic sino-nasal diseases. Mucosal cytology samples were gathered by cytobrush, histological samples were obtained from the inferior turbinate. In both sample sets, the number of eosinophils and MC was determined. Their corresponding markers ECP and tryptase were quantified from nasal discharge. Patients were grouped with reference to their main diagnosis: AR (n = 34), NP (n = 25), CRS (n = 27) and controls (n = 34). Eosinophil counts from cytobrush and ECP levels were significantly elevated in NP compared to all other groups—31- and 13-fold over control, respectively. However, histologic review did not reveal any difference in eosinophil count among groups. Tryptase was significantly elevated threefold in AR versus CRS and controls. No correlation to cytological and histological MC counts could be found. ECP levels in nasal discharge as well as eosinophil counts can provide useful information with regard to the diagnosis. Likewise, tryptase concentrations can do. The presented data show that the measurement of markers in nasal discharge is superior in differentiating among diagnosis groups. Given that the collection of nasal secretions is more comfortable for patients than the more invasive techniques, we recommend first line ECP and tryptase testing performed on nasal secretions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Braun H, Stammberger H, Buzina W, Freudenschuss K, Lackner A, Beham A (2003) Incidence and detection of fungi and eosinophilic granulocytes in chronic rhinosinusitis. Laryngorhinootologie 82:330–340

    Article  PubMed  CAS  Google Scholar 

  2. Hedman J, Kaprio J, Poussa T, Nieminen MM (1999) Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 28:717–722

    Article  PubMed  CAS  Google Scholar 

  3. Settipane GA, Chafee FH (1977) Nasal polyps in asthma and rhinitis. A review of 6,037 patients. J Allergy Clin Immunol 59:17–21

    Article  PubMed  CAS  Google Scholar 

  4. Stoop AE, van der Heijden HA, Biewenga J, van der Baan S (1993) Eosinophils in nasal polyps and nasal mucosa: an immunohistochemical study. J Allergy Clin Immunol 91:616–622

    Article  PubMed  CAS  Google Scholar 

  5. Mygind N (1990) Nasal polyposis. J Allergy Clin Immunol 86:827–829

    Article  PubMed  CAS  Google Scholar 

  6. Drake-Lee AB, Barker TH, Thurley KW (1984) Nasal polyps. Scanning electron microscopy and artifact. J Laryngol Otol 98:285–292

    Article  PubMed  CAS  Google Scholar 

  7. Borish L (2003) Allergic rhinitis: systemic inflammation and implications for management. J Allergy Clin Immunol 112:1021–1031

    Article  PubMed  CAS  Google Scholar 

  8. Bentley AM, Jacobson MR, Cumberworth V, Barkans JR, Moqbel R, Schwartz LB, Irani AM, Kay AB, Durham SR (1992) Immunohistology of the nasal mucosa in seasonal allergic rhinitis: increases in activated eosinophils and epithelial mast cells. J Allergy Clin Immunol 89:877–883

    Article  PubMed  CAS  Google Scholar 

  9. Gaga M, Lambrou P, Papageorgiou N, Koulouris NG, Kosmas E, Fragakis S, Sofios C, Rasidakis A, Jordanoglou J (2000) Eosinophils are a feature of upper and lower airway pathology in non-atopic asthma, irrespective of the presence of rhinitis. Clin Exp Allergy 30:663–669

    Article  PubMed  CAS  Google Scholar 

  10. Kampe M, Stolt I, Lampinen M, Janson C, Stalenheim G, Carlson M (2011) Patients with allergic rhinitis and allergic asthma share the same pattern of eosinophil and neutrophil degranulation after allergen challenge. Clin Mol Allergy 9:3

    Article  PubMed  Google Scholar 

  11. Kaliner M (1998) Medical management of sinusitis. Am J Med Sci 316:21–28

    Article  PubMed  CAS  Google Scholar 

  12. Fokkens W, Lund V, Mullol J (2007) European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl 20:1–136

    PubMed  Google Scholar 

  13. Bachert C, Hormann K, Mosges R, Rasp G, Riechelmann H, Muller R, Luckhaupt H, Stuck BA, Rudack C (2003) An update on the diagnosis and treatment of sinusitis and nasal polyposis. Allergy 58:176–191

    Article  PubMed  CAS  Google Scholar 

  14. Behnecke A, Mayr S, Schick B, Iro H, Raithel M (2008) Evaluation of ECP release from intact tissue biopsies from patients with nasal polyps. Inflamm Res 57(Suppl 1):S65–S66

    Article  PubMed  CAS  Google Scholar 

  15. Beppu T, Ohta N, Gon S, Sakata K, Inamura K, Fukase S, Kimura Y, Koike Y (1994) Eosinophil and eosinophil cationic protein in allergic rhinitis. Acta Otolaryngol Suppl 511:221–223

    Article  PubMed  CAS  Google Scholar 

  16. Church MK, Levi-Schaffer F (1997) The human mast cell. J Allergy Clin Immunol 99:155–160

    Article  PubMed  CAS  Google Scholar 

  17. Stone KD, Prussin C, Metcalfe DD (2010) IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol 125:S73–S80

    Article  PubMed  Google Scholar 

  18. Rasp G, Hochstrasser K (1993) Tryptase in nasal fluid is a useful marker of allergic rhinitis. Allergy 48:72–74

    Article  PubMed  CAS  Google Scholar 

  19. Canakcioglu S, Tahamiler R, Saritzali G, Alimoglu Y, Isildak H, Guvenc MG, Acar GO, Inci E (2009) Evaluation of nasal cytology in subjects with chronic rhinitis: a 7-year study. Am J Otolaryngol 30:312–317

    Article  PubMed  Google Scholar 

  20. Bousquet J, Khaltaev N, Cruz AA et al (2008) Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 63(Suppl 86):8–160

    Article  PubMed  Google Scholar 

  21. Rasp G (1992) Allergic rhinopathy: magic lite SQ allergy screen inhalant and CAP-FEIA SX1–comparison of two allergen-specific screening tests in serum. Laryngorhinootologie 71:298–301

    Article  PubMed  CAS  Google Scholar 

  22. Kramer MF, Burow G, Pfrogner E, Rasp G (2004) In vitro diagnosis of chronic nasal inflammation. Clin Exp Allergy 34:1086–1092

    Article  PubMed  CAS  Google Scholar 

  23. Pipkorn U, Karlsson G, Enerback L (1988) A brush method to harvest cells from the nasal mucosa for microscopic and biochemical analysis. J Immunol Methods 112:37–42

    Article  PubMed  CAS  Google Scholar 

  24. Abu-Ghazaleh RI, Dunnette SL, Loegering DA, Checkel JL, Kita H, Thomas LL, Gleich GJ (1992) Eosinophil granule proteins in peripheral blood granulocytes. J Leukoc Biol 52:611–618

    PubMed  CAS  Google Scholar 

  25. Bystrom J, Garcia RC, Hakansson L, Karawajczyk M, Moberg L, Soukka J, Venge P (2002) Eosinophil cationic protein is stored in, but not produced by, peripheral blood neutrophils. Clin Exp Allergy 32:1082–1091

    Article  PubMed  CAS  Google Scholar 

  26. Sur S, Glitz DG, Kita H, Kujawa SM, Peterson EA, Weiler DA, Kephart GM, Wagner JM, George TJ, Gleich GJ, Leiferman KM (1998) Localization of eosinophil-derived neurotoxin and eosinophil cationic protein in neutrophilic leukocytes. J Leukoc Biol 63:715–722

    PubMed  CAS  Google Scholar 

  27. Bhattacharyya N (2005) Symptom and disease severity differences between nasal septal deviation and chronic rhinosinusitis. Otolaryngol Head Neck Surg 133:173–177

    Article  PubMed  Google Scholar 

  28. Bernstein JM, Gorfien J, Noble B, Yankaskas JR (1997) Nasal polyposis: immunohistochemistry and bioelectrical findings (a hypothesis for the development of nasal polyps). J Allergy Clin Immunol 99:165–175

    Article  PubMed  CAS  Google Scholar 

  29. Jahnsen FL, Haraldsen G, Aanesen JP, Haye R, Brandtzaeg P (1995) Eosinophil infiltration is related to increased expression of vascular cell adhesion molecule-1 in nasal polyps. Am J Respir Cell Mol Biol 12:624–632

    Article  PubMed  CAS  Google Scholar 

  30. Monteseirin J, Vega A (2008) Eosinophil cationic protein is not only a distinctive eosinophil protein. Thorax 63:185

    Article  PubMed  CAS  Google Scholar 

  31. Monteseirin J, Vega A, Chacon P, Camacho MJ, El Bekay R, Asturias JA, Martinez A, Guardia P, Perez-Cano R, Conde J (2007) Neutrophils as a novel source of eosinophil cationic protein in IgE-mediated processes. J Immunol 179:2634–2641

    PubMed  CAS  Google Scholar 

  32. Bryson JM, Tasca RA, Rowe-Jones JM (2003) Local and systemic eosinophilia in patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with and without polyposis. Clin Otolaryngol Allied Sci 28:55–58

    Article  PubMed  CAS  Google Scholar 

  33. Chen ST, Sun HL, Lu KH, Lue KH, Chou MC (2006) Correlation of immunoglobulin E, eosinophil cationic protein, and eosinophil count with the severity of childhood perennial allergic rhinitis. J Microbiol Immunol Infect 39:212–218

    PubMed  CAS  Google Scholar 

  34. Di Lorenzo G, Mansueto P, Melluso M, Candore G, Colombo A, Pellitteri ME, Drago A, Potestio M, Caruso C (1997) Allergic rhinitis to grass pollen: measurement of inflammatory mediators of mast cell and eosinophils in native nasal fluid lavage and in serum out of and during pollen season. J Allergy Clin Immunol 100:832–837

    Article  PubMed  Google Scholar 

  35. Varney VA, Jacobson MR, Sudderick RM, Robinson DS, Irani AM, Schwartz LB, Mackay IS, Kay AB, Durham SR (1992) Immunohistology of the nasal mucosa following allergen-induced rhinitis. Identification of activated T lymphocytes, eosinophils, and neutrophils. Am Rev Respir Dis 146:170–176

    Article  PubMed  CAS  Google Scholar 

  36. Kaliner MA, Osguthorpe JD, Fireman P, Anon J, Georgitis J, Davis ML, Naclerio R, Kennedy D (1997) Sinusitis: bench to bedside. Current findings, future directions. J Allergy Clin Immunol 99:S829–S848

    Article  PubMed  CAS  Google Scholar 

  37. Mygind N (1999) Advances in the medical treatment of nasal polyps. Allergy 54(Suppl 53):12–16

    Article  PubMed  Google Scholar 

  38. Omenaas E, Bakke P, Elsayed S, Hanoa R, Gulsvik A (1994) Total and specific serum IgE levels in adults: relationship to sex, age and environmental factors. Clin Exp Allergy 24:530–539

    Article  PubMed  CAS  Google Scholar 

  39. Zhang Y, Liu C, Han D, Zhang L (2011) Correlation of routine examinations for the diagnosis of house dust mite allergic rhinitis. ORL J Otorhinolaryngol Relat Spec 73:182–188

    Article  PubMed  Google Scholar 

  40. Gevaert P, Holtappels G, Johansson SG, Cuvelier C, Cauwenberge P, Bachert C (2005) Organization of secondary lymphoid tissue and local IgE formation to Staphylococcus aureus enterotoxins in nasal polyp tissue. Allergy 60:71–79

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

  1. Department of Oto-Rhino-Laryngology, Head- and Neck Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistr.15, 81377, Munich, Germany

    Moritz Gröger, Andreas Bernt, Maria Wolf, Brigitte Mack, Elisabeth Pfrogner, Sven Becker & Matthias F. Kramer

Authors
  1. Moritz Gröger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andreas Bernt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brigitte Mack
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elisabeth Pfrogner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sven Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Matthias F. Kramer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Moritz Gröger.

Additional information

M. Gröger and A. Bernt contributed equally to the study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gröger, M., Bernt, A., Wolf, M. et al. Eosinophils and mast cells: a comparison of nasal mucosa histology and cytology to markers in nasal discharge in patients with chronic sino-nasal diseases. Eur Arch Otorhinolaryngol 270, 2667–2676 (2013). https://doi.org/10.1007/s00405-013-2395-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-013-2395-2

Keywords

Search

Navigation