Inflammatory cell populations and cytokine mRNA expression in the nasal mucosa in aspirin-sensitive rhinitis

Aspirin-sensitive rhinitis is characterized by severe perennial nasal conge stion and discharge. The study questioned whether this disease, like immuno globulin E-mediated rhinitis, might be associated,vith local recruitment an d activation of T-lymphocytes, mast cells and eosinophils with parallel inc reases in "T-helper2-type" cytokines, Nasal biopsies from 10 patients with aspirin-sensitive rhinitis and 12 heal thy controls subjects were studied. Nasal mucosal sections were examined by immunohistochemistry in order to determine cell phenotypes and by in situ hybridization to detect cells expressing messenger ribonucleic acid (mRNA) for cytokines, In aspirin-sensitive rhinitis there were increases in total (CD3+) (p=0.05) and activated (CD25+) T-cells (p=0.007), total (major basic protein (MBP) positive) (p= 0.004) and activated (monoclonal antibody which recognizes th e cleaved form of eosinophil cationic protein (EG2) positive) eosinophils ( p=0.003), tryptase+ mast cells (p=0.04) and CD68+ macrophages (p=0.002), Ne utrophils and cells expressing human leukocyte antigen-DR were no different . Marked increases were observed in the numbers of interleukin (IL)-5 mRNA cells (p=0.004) in aspirin-sensitive patients, whereas lower numbers of IL -4 mRNA+ cells were observed, with a trend for a difference from controls ( p=0.07). No differences were observed for either IL-2 or interferon-gamma. In conclusion, in aspirin-sensitive rhinitis there is intense inflammation of the nasal mucosa characterised by T-lymphocytes, eosinophils and mast ce lls. The predominance of macrophages and disproportionate increase in inter leukin-5 compared to interleukin-4 messenger ribonucleic acid expression su ggests that factors other than "allergic" mechanisms may be important in th is disease.