Development of anovel treatment for eosinophilic chronic rhinosinusitis with osteitis

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K16929
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56050:Otorhinolaryngology-related
• Research Institution: Osaka University
• Principal Investigator: Tsuda Takeshi 大阪大学, 大学院医学系研究科, 助教 (00778631)
• Project Period (FY): 2022-04-01 – 2024-03-31
• Keywords: MMP-9 / 中鼻甲介 / 好酸球性副鼻腔炎 / RNA-seq

Outline of Final Research Achievements

In the middle turbinate of patients with eosinophilic chronic rhinosinusitis (ECRS), the IL-4 pathway was upregulated, as were fibrosis-related pathways. MMP-9 was a common gene in fibrosis-related pathways, and MMP-9 was also increased at the protein level in the middle turbinate of ECRS. Comprehensive analysis of MMP-9 stimulation of nasal epithelial cells showed that the IL-6 and IL-17 pathways were enhanced by stimulation. Taken together, these findings suggest that the middle nasal turbinate induces complex inflammation via MMP-9 production in the pathogenesis of ECRS.

Free Research Field

免疫、アレルギー

Academic Significance and Societal Importance of the Research Achievements

好酸球性副鼻腔炎(ECRS)について病態は解明が進みつつあるが、増悪メカニズムについてはまだ不明な点が非常に多い。今回の研究からこれまでに中鼻甲介が浮腫性変化をきたした症例ではより重症度が高く治療後の再発が多いという事象を説明しうるメカニズムとして中鼻甲介のsilent Type2炎症およびMMP-9産生による線維化の亢進と複合炎症の誘導というものが新たに示唆された。このような症例において例えば今後、中鼻甲介に対しても積極的な手術アプローチなどを行うことが重要になると考えられこれによりコントロールが良好になれば患者QOLの改善につながる。