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Endothelial L-Selectin Ligands in Sinus Mucosa during Chronic Maxillary Rhinosinusitis

Department of Eye, Ear, and Oral Diseases, Tampere University Hospital and University of Tampere, Tampere; Department of Otorhinolaryngology, Mikkeli Central Hospital, Mikkeli; Transplantation Laboratory, Departments of Pathology and Bacteriology and Immunology, Haartman Institute, Helsinki; Rational Drug Design Program, Biomedicum, University of Helsinki, Helsinki; and Laboratory Diagnostics, Helsinki University Central Hospital, Helsinki, Finland

Correspondence and requests for reprints should be addressed to Risto Renkonen, M.D., Biomedicum and Haartman Institute, P.O. Box 63, Haartmaninkatu 8, University of Helsinki, FIN-00014 Helsinki, Finland. E-mail: risto.renkonen{at}helsinki.fi

Rationale: Chronic rhinosinusitis is characterized by persistent inflammation of the nasal and paranasal mucosa with numerous emigrated leukocytes. L-selectin on leukocytes and its endothelial glycosylated ligands initiate organ-specific leukocyte infiltration into inflamed tissues. Objectives: The purpose of this study was to evaluate the endothelial expression of functionally active endothelial L-selectin ligands, sulfated sialyl Lewis x, in maxillary sinus mucosa from patients with chronic rhinosinusitis and from normal control subjects. Methods: Maxillary sinus mucosa specimens (116) were obtained surgically and immunohistochemically stained with monoclonal antibodies detecting sialyl Lewis x or sulfated extended core 1 lactosamines. The severity of the inflammation was determined by intraoperative endoscopic findings, computed tomography scans, and histopathologic assessment of the specimens. Measurements and Main Results: The percentage of vessels expressing endothelial sulfated sialyl Lewis x epitopes increased during chronic rhinosinusitis compared with uninflamed control tissue, especially in patients with additional allergic rhinitis, and decreased in specimens from aspirin-intolerant patients with preoperative oral corticosteroid treatment. In addition, the expression level of endothelial sulfated sialyl Lewis x epitopes and the number of mucosal eosinophils correlated with the severity of the inflammation, and decreased in specimens taken 9 months postoperatively compared with intraoperative samples, especially in patients with intranasal corticosteroid treatment. Conclusions: Our results suggest that functionally active L-selectin ligands might guide leukocyte traffic into maxillary sinus mucosa preferentially in patients with severe findings of chronic maxillary rhinosinusitis, thus leading to aggravation of the inflammation.

Key Words: adhesion molecules • L-selectin • maxillary rhinosinusitis • sialyl Lewis x

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