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

1. Role of inflammation in nasal polyposis Dr T Balasubramanian

3. These are denovo inflammatory growth of nasal mucosa of the lateral nasal wall

4. Commonly involves mucosa over uncinate area and bulla

6. Goblet cell hyperplasia

7. Squmaous metaplasia

8. Features shown by lamina propria include: oedema, lymphocytosis, eosinophils and degenerated cystic glands filled with mucin

10. This area of chromosomes contains genes which play a role in inflammation

11. The HLA genes and proinflammatory genes are transmitted together from parent to offspring

13. Complement

14. Heat shock protein

15. Pro inflammatory gene – TNF alpha

17. They stimulate IgE response against them

18. In combination they trigger the nasal mucosa in to developing polyp

19. TNF alpha levels are 4 times more than normal individuals

21. It is a proinflammatory cytokine

22. Produced by macrophages and T cells

23. Its concentration in the nasal mucosa is 4 times higher

24. Attracts eosinophils and activates it

25. Known for its anti tumor cytotoxic activity

26. Evokes inflammation

28. IL1 – beta

29. VCAM1

30. RANTES

31. Cotaxin

33. This upregulation intitiates the cascade of immune mechanism

34. TNF alpha also increases secretion of cotaxin and expression of RANTES

36. They increase the permeability of nasal mucosa to water

37. Changes in sodium gate mechanism is responsible for the increase in permeability

38. Thank you