Razi Journal of Medical Sciences

    Background & Aim: There are many suggestions for nasal polyp formation mechanism. The present study was carried out to evaluate T-cell infiltration in nasal mucosa and specific allergic reactions in context of probable irregular systemic immune responses in nasal polyp disease. Patients & Methods: 60 patients with nasal polyps who referred to ENT ward of Rasoul-e-Akram Hospital were studied in this cross-sectional study. Median age was 34 years(range 13 to 69 years) and 59.3% of patients were male. Blood and polyp specimen from each patient were sent to laboratory to measure serum IgE and specific IgE(by ELISA method) and count immune cells and subsets [by APAAP(Alkaline Phosphatase Anti Alkaline Phosphatase) and LSAB(Labeled Streptavidin Biotin) methods]. Results: 56.7% of patients had total serum IgE equal or more than 100IU/ml and others (43.3%) had total IgE lower than 100Iu/ml. 45% of the patients had at least one positive test from specific tests. Patients with positive specific IgE had more CD8+cells in comparison to others(P=0.04). They also had further serum IgE(P=0.001). Multivariable analysis showed that serum IgE, CD4/CD8 ratio and age were correlated with specific IgE result in patients with nasal polyp(R2=1 P<0.001). Conclusion: Immunopathologically IgE synthesis in allergic patients is biphasic. Total IgE increased as a response to primary immune system stimulation and then according to affinity maturation phenomenon, specific IgE increased. Therefore, patients with specific IgE have continuously high IgE level. In this study low CD4+cells may be due to low regulatory cells for Th1 lymphocytes and increased CD8+cells may be related to increased cells which secrete cytokines affecting Th1 or Th2 lymphocytes. To understand definite roles of immune cells in nasal polyp formation, more studies are needed to measure T lymphocyte subsets, Th1 and Th2 lymphocytes.