Different activation of toll-like receptors and antimicrobial peptides in chronic rhinosinusitis with or without nasal polyposis

Background: Both up- and down-regulation of the Toll-like receptors (TLRs) and antimicrobial peptides (AMPs) of the sinonasal mucosa have already been associated with the pathogenesis of chronic rhinosinusitis with (CRSwNP) or without (CRSsNP) nasal polyps. Objective: Determination of the expression of all known TLR and several AMP genes and some selected proteins in association with allergy, asthma and aspirin intolerance (ASA) in CRS subgroups. Methods: Patients with CRSsNP (n=19), CRSwNP (ASA[-]:17; ASA[+]:7) and control subjects (n=12) were selected. Sinonasal samples were taken during endonasal surgery and RT-PCR was used to measure mRNA expressions of 10 TLRs, 4 defesins, lysozyme, cathelicidin and lactoferrin (LTF). In several cases immunohistochemistry was performed to evaluate protein expressions. Statistical analysis was done with the Kruskall-Wallis ANOVA, Mann-Whitney U and Student-t-test. Results: TLR2, TLR5, TLR6, TLR7, TLR8, TLR9, β-defensins 1 and 4, cathelicidin and LTF mRNA expressions were significantly (p<0.05) increased in CRSwNP, whereas only TLR2 and LTF were up-regulated in CRSsNP compared to controls. There was no statistical difference in respect of allergy, aspirin intolerance and smoking between CRSsNP, ASA(-) and ASA(+) CRSwNP patients. TLR2, TLR3, TLR4, LTF, β defensin 2 and lysozyme protein expression was found to be increased in CRSwNP stainings (p