Features of adaptive plasma cell immune response at dofferent stages of polypous rhinosinusitis

Identification of phenotypes/genotypes in development of polypous rhinosinusitis enabled us to understand some mechanisms of remodeling mucous membranes in nasal cavity and paranasal sinuses, and choose optimal and effective treatment strategies. At the same time, the current studies show a continuing trend towards higher incidence of polypous rhinosinusitis, with frequent relapses accompanied by a significant decrease in quality of life. In this regard, the issues of searching markers of endotyping polypous rhinosinusitis remain relevant, thus enabling proper treatment to the patient at an early stage and ensuring clinical prognosis of the disease. Our aim was to analyze the relative density of immunocompetent lymphocytic cells with morphometric confirmation in patients with polypous rhinosinusitis with immune T2-inflammation. The study was conducted in a group of 22 patients with a verified diagnosis of polypous rhinosinusitis who were hospitalized for elective surgery. All patients were divided into the main group, the T2 polypous rhinosinusitis endotypem, and a comparison group which included patients with non-T2 polypous rhinosinusitis endotype. Anamnestic, clinical and laboratory data and morphometric criteria of both groups have been analyzed. In the main group of patients, there was a trend for distinct increase in absolute number of blood eosinophils (from 320 to 1512 cells/mL). The analysis of anamnestic data revealed increased frequency of repeated surgery (21.4%) in the patients from main group as compared to the control group (12.5%). A long disease history (29 years), and long relapse period (up to 27.5 years) was noted in the control group. In the main group, with shorter course of polypous rhinosinusitis (18.2 years), the duration of relapse was more than 4 times shorter compared to the time period of relapses in control group, being only 6 years. Morphometric analysis of intraoperatively taken polyp tissue has shown that the relative density of plasmocytes in the inflammatory polyp stroma in the main group of patients was higher than in the control group and reached 0.06 and 0.04 cells per 1 mm2, respectively. The search for pathogenetic markers of morphometric features and immunological aspects of specific immune response in patients with polypous rhinosinusitis will make it possible to administer effective treatment to the patient and predict the outcome of the disease.