Allergy Asthma Immunol Res.  2019 Mar;11(2):201-211. 10.4168/aair.2019.11.2.201.

Comparison Between Signature Cytokines of Nasal Tissues in Subtypes of Chronic Rhinosinusitis

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital and Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Korea.
  • 2Clinical Mucosal Immunology Study Group, Seoul, Korea.
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
  • 4Division of Allergy-Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.


Endotype in chronic rhinosinusitis (CRS) has been established in the last decade. However, the exact immunologic profile of CRS still has controversy because it has a considerable immunologic heterogeneity. Therefore, we investigated various inflammatory mediators according to different nasal tissues in chronic rhinosinusitis and compared them within the same subject.
We collected uncinate process mucosa (UP) and nasal polyp (NP) tissues from controls, CRS without NP (CRSsNP) and CRS with NP (CRSwNP). Expression levels of 28 inflammatory mediators including T helper (Th) 1, Th2, Th17, proinflammatory cytokines and remodeling markers were determined by multiplex immunoassay and were analyzed using paired tests as well as principal component analysis (PCA) to investigate endotype in each subtype of CRS.
Signature inflammatory mediators are interleukin (IL)-5, C-C motif chemokine ligand (CCL)-24, monocyte chemoattractant protein (MCP)-4, and vascular cell adhesion molecule (VCAM)-1 in eosinophilic NP, whereas IL-17A, IL-1β, and matrix metallopeptidase (MMP)-9 were detected as signature inflammatory markers in non-eosinophilic NP. Despite differences in inflammatory cytokine profile between eosinophilic and non-eosinophilic NP, the common upregulation of IL-5, CCL-11, IL-23, IL-2Rα, VCAM-1, MMP-3 and MMP-9 were shown in NP compared to UP within the same subject. In the PCA, we observed that Th2 immune response was helpful in discriminating between nasal tissues in subtypes of CRS and that there was a partial overlap between non-eosinophilic NP and eosinophilic NP in terms of Th2 mediators.
Commonly upregulated mediators in NP were Th2-associated, compared with UP regardless of CRS subtypes, whereas signature markers were distinct in each NP subtype. These findings imply that Th2 inflammatory responses may play a role in the development of NP regardless of CRSwNP subtypes.


Cytokines; rhinitis; sinusitis; nasal polyp

MeSH Terms

Mucous Membrane
Nasal Polyps
Passive Cutaneous Anaphylaxis
Population Characteristics
Principal Component Analysis
Vascular Cell Adhesion Molecule-1
Vascular Cell Adhesion Molecule-1


  • Fig. 1 PCA consists of first and second PCA components of inflammatory mediator levels according to the different sinonasal tissues. UP, uncinate process tissue; NP, nasal polyps; CRSsNP, chronic rhinosinusitis without nasal polyps; E, eosinophilic; NE, non-eosinophilic; CRSwNP, chronic rhinosinusitis with nasal polyps.

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Neutrophils as a Protagonist and Target in Chronic Rhinosinusitis
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Clin Exp Otorhinolaryngol. 2019;12(4):337-347.    doi: 10.21053/ceo.2019.00654.

Can Neutrophils Be a Cellular Biomarker in Asian Chronic Rhinosinusitis?
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Clin Exp Otorhinolaryngol. 2019;12(4):325-326.    doi: 10.21053/ceo.2019.01452.


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