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KISEP Rhinology Korean J Otolaryngol 1999;42:720-6 비용조직에서 비반세포 및 호산구의 침윤과 접착분자의 발현: 중비갑개 및 하비갑개 점막과의 비교 이봉재 김홍철 신현수 Mast Cells, Eosinophils, and ICAM-1 Expression in the Nasal Polyps Comparison with the Middle and the Inferior Turbinate Mucosae Bong-Jae Lee, MD, Hong-Chul Kim, MD and Hyun-Soo Shin, MD Department of Otorhinolaryngology, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea ABSTRACT ObjectivesWe aimed to investigate the contribution of eosinophils, mast cells, ICAM-1, and coexisting allergic rhinitis in the pathogenesis of nasal polyps by comparing with turbinate mucosae. Materials and MethodsNasal polyps NP, middle turbinate mucosa MT and inferior turbinate mucosa IT were taken from 18 patients with chronic sinusitis and nasal polyps. Among them, 8 patients had concomitant allergic rhinitis. Specimens were immunohistochemically stained to quantify mast cells, eosinophils, and ICAM-1 in the unit area of tissues. ResultsNP were infiltrated by significantly higher number of eosinophils as compared with MT and IT median EG2 positive cellsmm 2 153 in NP, 37 in MT, 11 in IT p 0.005. Numbers of mast cells tryptase positive cells in NP were significantly decreased as compared with those of IT median21 vs. 49mm 2, p0.05. NP revealed significantly higher ICAM-1 expression both in the vessels and in the epithelia than IT p0.05. Presence of concomitant allergic rhinitis did not make any significant difference. There was no significant difference in eosinophils, mast cells, and ICAM-1 expression between MT and IT. ConclusionNP revealed more eosinophils and ICAM-1 expression compared to the turbinate mucosa, regardless of concomitant allergic rhinitis. Though NP develops more frequently in the MT than in the IT, there are no significant differences in the number of eosinophils, mast cells, and the expression of ICAM-1 between them. Korean J Otolaryngol 1999;42:720-6 KEY WORDSNasal polyp Eosinophils Mast cell ICAM-1. 720

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비용조직에서 비반세포, 호산구, ICAM-1 A B C D Fig. 1. Examples of immunohistochemical staining of (A)eosinophils (EG1 cells arrowheads original magnification, 400), (B) mast cells (tryptase+ cells arrowheads original magnification, 400), (C) vascular endothelial expression of ICAM-1 (arrows original magnification, 100), and (D) epithelial ICAM-1 expression (arrowheads original magnification, 200). 경우 0, 약 염색은 1, 중등도 염색은 2, 강 염색은 3으로 분 류하여 전체적으로 상피층에서의 ICAM-1의 발현은 0 9 로 반정량적으로 측정하였다. 통계처리는 Statview Ⅱ software(abacus Concepts, Berkley, CA, USA)를 이용하여, 동일환자에서 비용조직, 중비갑개 및 하비갑개 점막간의 비교는 Wilcoxon signedrank test, 알레르기성비염을 동반한 군과 동반하지 않은 군간의 비교는 Mann-Whitney U test를 사용하였다. 상관 관계 검증에는 Spearman s rank correlation coefficient 를 이용하였다. 대표값으로는 median(중앙값)을 이용하였 으며 유의성 검증은 p <0.05를 기준으로 하였다. Fig. 2. EG1+ cells and EG2+ cells in the nasal polyp (NP), middle (MT) and inferior turbinate mucosae (IT) (n=18). Number of EG1+ and EG2+ cells increased significantly in the nasal polyps compared with turbinates, but there was no significant difference between middle and inferior turbinate mucosae. Individual data were shown as circles, with the solid bars representing median values. 결 과 호산구의 침윤 및 활성도 EG1 (EG1양성) 세포는 주로 고유층에 분포하였는데 그 중에서도 기저막 바로 아래에서 가장 밀집된 양상을 보였으 나 상피층에서도 간헐적으로 관찰되었고, EG2 세포도 역 722 Korean J Otolaryngol 1999;42:720-6

Fig. 3. Tryptase cells mast cells in the nasal polyps NP, middle MT and inferior turbinate mucosae IT n18. Number of tryptase cells in nasal polyps is significantly lower than that in inferior turbinates. Individual data are shown as circles, with the solid bars representing median values. Fig. 4. Comparison of expression of ICAM-1 in the nasal polyps NP, middle MT and inferior turbinate mucosae IT of the polyp patients n18. Data are presented as the percentage of vessels expressing ICAM-1 of the total vessels in 1mm 2 of tissues. Individual data are shown as circles with the solid bars representing median values. Fig. 5. Comparison of ICAM-1 expression in the epithelia of the nasal polyp NP, middle MT and inferior turbinate mucosae IT of 18 patients with nasal polyps. Circles indicate individual data, with the solid bars representing median values. 723

Table 1. Comparison of eosinophils, mast cells and ICAM- 1 expression between patients with allergic rhinitis AR and those without allergic rhinitis AR Parameters AR AR p-value Eosinophils EG2 cells countsmm 2 Nasal polyps 150 34635 152 41732 0.86 Inferior turbinate 9 0213 20 0 48 0.59 Middle turbinate 43 1305 32 0-508 0.92 Mast cells Tryptase cells countsmm 2 Nasal polyps 22 0 98 20 1155 0.83 Inferior turbinate 47 1166 56 23150 0.92 Middle turbinate 83 1115 27 3200 0.10 Endothelial ICAM1 % Nasal polyps 83 62100 73 58100 0.56 Inferior turbinate 55 33 95 58 23 82 0.93 Middle turbinate 66 37100 65 24100 0.86 Epithelial ICAM1 Nasal polyps 6 49 6 29 0.84 Inferior turbinate 1 06 2.5 06 0.20 Middle turbinate 3.5 26 2.5 19 0.34 724 Korean J Otolaryngol 1999;42:720-6

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