内镜鼻窦手术后外周免疫细胞亚群的变化在CRSwNP与AERD之间存在差异

文献信息

中文摘要

引言： 外周血嗜酸性粒细胞的变化在伴鼻息肉的慢性鼻窦炎（CRSwNP）患者中会随内镜鼻窦手术（ESS）而改变，无论患者是否对阿司匹林敏感。飞行时间流式细胞术（CyTOF）较传统检测或临床检验能识别更多免疫细胞亚群。我们假设，经CyTOF检测，ESS相关的外周免疫细胞亚群变化在阿司匹林耐受（AT）-CRSwNP与阿司匹林加重性呼吸系统疾病（AERD）之间存在差异。
方法： 采用包含37个标志物的CyTOF panel，对CRSwNP（n=13）或AERD（n=15）患者ESS前后的外周血进行免疫细胞群体分析。CITRUS分析用于识别最能预测患者分组或样本时间点的细胞簇。
结果： 在28例患者的合并队列中，ESS后循环CD4+初始T细胞和CD194+中性粒细胞增加，而嗜酸性粒细胞减少。按疾病分层后，CD4+初始T细胞在AERD和CRSwNP中于ESS后均增加；然而，嗜酸性粒细胞仅在CRSwNP中于ESS后减少。中性粒细胞亚群在两组患者ESS后均呈混合性反应。树突状细胞在CRSwNP中于ESS后增加，但在AERD中未增加。各时间点分析显示，CRSwNP中CD141+单核细胞来源树突状细胞（moDCs）在ESS前后均多于AERD。ESS前，AERD中CD185+和CD194+中性粒细胞均高于CRSwNP。
结论： CD141+ moDCs在CRSwNP中较AERD更常见，且在ESS前后均如此。ESS后所有组中初始CD4+ T细胞均增加、中性粒细胞亚群均发生变化，但嗜酸性粒细胞仅在CRSwNP中减少。我们的研究提示ESS可能具有全身免疫效应，并提示CRSwNP和AERD的候选免疫特征。

英文摘要

INTRODUCTION: Changes in peripheral eosinophils follow endoscopic sinus surgery (ESS) in chronic rhinosinusitis with nasal polyps (CRSwNP), with and without aspirin sensitivity. Cytometry by time-of-flight (CyTOF) identifies more immune cell subsets than conventional assays or clinical testing. We hypothesized that ESS-associated changes in peripheral immune cell subsets differ between aspirin-tolerant (AT)-CRSwNP and aspirin-exacerbated respiratory disease (AERD) as measured by CyTOF.
METHODS: Pre- and post-ESS peripheral blood from patients with CRSwNP (n = 13) or with AERD (n = 15) was analyzed for immune cell populations using a 37-marker CyTOF panel. CITRUS analysis identified cell clusters most predictive of patient group or sample timepoint.
RESULTS: In the combined cohort of 28 patients, circulating CD4+ naïve T cells and CD194+ neutrophils increased after ESS, while eosinophils decreased. When stratified by disease, CD4+ naïve T cells increased in both AERD and CRSwNP post-ESS; however, eosinophils decreased after ESS only in CRSwNP. Neutrophil subsets showed a mixed response in both patient groups after ESS. Dendritic cells increased in CRSwNP but not in AERD after ESS. Individual timepoint analyses showed more CD141+ monocyte-derived DCs (moDCs) in CRSwNP than in AERD pre- and post-ESS. Pre-ESS, both CD185+ and CD194+ neutrophils were higher in AERD compared to CRSwNP.
CONCLUSION: CD141+ moDCs were more prevalent in CRSwNP versus AERD, both before and after ESS. Naïve CD4+ T cells increased, and neutrophil subsets changed in all groups after ESS, but eosinophils decreased only in CRSwNP. Our study points to possible systemic immune effects of ESS and candidate immune signatures in CRSwNP and AERD.