Role of inflammation in nasal polyp
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Role of inflammation in nasal polyp

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

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

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Role of inflammation in nasal polyp Role of inflammation in nasal polyp Presentation Transcript

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