The Expression of Fibrinolytic Components in Chronic Paranasal Sinus Disease

Abstract

Background Fibrinolytic components, their receptors, and inhibitors are considered to play an important role in inflammation and tissue remodeling including chronic rhinosinusitis (CRS). To clarify the relationship between these components and the pathology of CRS, we analyzed fibrinolytic components in sinonasal mucosa of CRS. Methods Sinonasal mucosa samples from 12 patients with CRS without nasal polyp (CRSsNP), 14 patients with CRS with nasal polyp (CRSwNP), and 12 control patients were prepared. By immunohistochemistry and ELISA, samples were studied with respect to urokinase-type plasminogen activator (uPA), uPA receptor (uPAR), plasminogen activator inhibitor-1 (PAI-1) and key mediators in sinus disease, TGF-beta1 and eosinophil cationic protein (ECP). Results uPA- or uPAR-positive inflammatory cells were increased in CRSwNP compared to controls and CRSsNP, whereas PAI-1-positive cells were increased in CRSsNP compared to CRSwNP and controls. ELISA measurements revealed that uPAR concentrations were increased in both CRSsNP (16.1 ng/mL; 10.4–22.9; p < 0.05) and CRSwNP (20.8 ng/mL; 9.62–25.9; p < 0.01) compared to controls (8.7 ng/mL; 7.9–12.9), and PAI-1 concentrations were increased in CRSsNP (198.8 ng/mL; 147.4–234.1) compared to controls (107.3 ng/mL; 92.6–175.3; p < 0.01) and CRSwNP (113.5 ng/mL; 105.1–193.5; p < 0.05). Moreover, the concentrations of TGF-beta1 correlated with PAI-1 in CRSsNP, and ECP correlated with uPAR protein in CRSwNP. Conclusion Fibrinolytic components were highly expressed in CRSwNP compared to normal controls, whereas the inhibiting protein was up-regulated in CRSsNP. Furthermore, correlations between the expressions of fibrinolytic components and key mediators in CRS were found.