Abstract
Background: The histopathology of pediatric chronic rhinosinusitis with
nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) is rarely
reported due to their low prevalence or the unavailability of tissue
samples. Hence, we aimed to characterize and compare the histologic
features and protein expression of Th1/Th2/Th17-related cytokines in
pediatric CRSsNP and CRSwNP. Methods: The histologic characteristics of
15 children with CRSsNP, 52 children with CRSwNP, and 12 control
participants were analyzed using hematoxylin and eosin staining. The
expression of Th1/Th2/Th17-related cytokines were examined using
immunohistochemistry and the enzyme-linked immunosorbent assay. Results:
Pediatric subjects with CRSwNP had more intact epithelium and less
submucosal mucous glands compared to those with CRSsNP. Tissue
eosinophils were more prevalent in the young CRSwNP group compared to
the old CRSwNP or the CRSsNP groups. The protein concentrations of Th2
cytokines were significantly higher in the CRSwNP group than the CRSsNP
group or the control group. Moreover, the protein concentrations of Th17
cytokines were significantly higher in the young CRSwNP group than the
old CRSwNP group or the CRSsNP and control groups. The protein
concentrations of Th1 and Th17 cytokines were also significantly higher
in the CRSsNP group than the control group. Compared with
non-eosinophilic CRSwNP, eosinophilic CRSwNP presented with elevated
protein concentrations of Th1 and Th17 cytokines. Conclusion: For the
first time, we showed that pediatric CRSwNP presents as eosinophilic
with Th2/Th17 inflammation, whereas CRSsNP presents as Th1/Th17
inflammation. Our study may provide a theoretical basis for the precise
treatment of pediatric CRS in the future.