Role of inflammation in nasal polyp

2,652 views

Published on

This presentation discusses the role played by inflammation in the pathogenesis of nasal polyp

Published in: Health & Medicine
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,652
On SlideShare
0
From Embeds
0
Number of Embeds
38
Actions
Shares
0
Downloads
63
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Role of inflammation in nasal polyp

  1. 1. Role of inflammation in nasal polyposis Dr T Balasubramanian
  2. 2. Introduction <ul><li>Nasal polyp is not simple oedema of mucous membrane of lateral nasal wall
  3. 3. These are denovo inflammatory growth of nasal mucosa of the lateral nasal wall
  4. 4. Commonly involves mucosa over uncinate area and bulla </li></ul>
  5. 5. Features of Nasal poyp <ul><li>Basal cell hyperplasia
  6. 6. Goblet cell hyperplasia
  7. 7. Squmaous metaplasia
  8. 8. Features shown by lamina propria include: oedema, lymphocytosis, eosinophils and degenerated cystic glands filled with mucin </li></ul>
  9. 9. Chromosomal role <ul><li>Risk of nasal polypi resides ? In the short arm of chromosome 6
  10. 10. This area of chromosomes contains genes which play a role in inflammation
  11. 11. The HLA genes and proinflammatory genes are transmitted together from parent to offspring </li></ul>
  12. 12. Components of short arm of chromosome 6 <ul><li>HLA antigens
  13. 13. Complement
  14. 14. Heat shock protein
  15. 15. Pro inflammatory gene – TNF alpha </li></ul>
  16. 16. Role played by S aureus exotoxins <ul><li>They act as super antigens
  17. 17. They stimulate IgE response against them
  18. 18. In combination they trigger the nasal mucosa in to developing polyp
  19. 19. TNF alpha levels are 4 times more than normal individuals </li></ul>
  20. 20. TNF - alpha <ul><li>This is a potent immuno mediator
  21. 21. It is a proinflammatory cytokine
  22. 22. Produced by macrophages and T cells
  23. 23. Its concentration in the nasal mucosa is 4 times higher
  24. 24. Attracts eosinophils and activates it
  25. 25. Known for its anti tumor cytotoxic activity
  26. 26. Evokes inflammation </li></ul>
  27. 27. Cytokines & nasal polyp <ul><li>TNF – alpha
  28. 28. IL1 – beta
  29. 29. VCAM1
  30. 30. RANTES
  31. 31. Cotaxin </li></ul>
  32. 32. TNF-alpha & VCAM 1 <ul><li>TNF alpha upregulates VCAM 1 in fibroblasts present in the nasal mucosa
  33. 33. This upregulation intitiates the cascade of immune mechanism
  34. 34. TNF alpha also increases secretion of cotaxin and expression of RANTES </li></ul>
  35. 35. Role of eosinophils <ul><li>Substances secreted by eosinophils include: Eosinophilic mediator, and major basic protein
  36. 36. They increase the permeability of nasal mucosa to water
  37. 37. Changes in sodium gate mechanism is responsible for the increase in permeability </li></ul>
  38. 38. Thank you

×