Cross-Talk between Human Mast Cells and Epithelial Cells by IgE-mediated Periostin Production in Eosinophilic Nasal Polyps Dong-Kyu Kim, MD, PhD Department.

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Cross-Talk between Human Mast Cells and Epithelial Cells by IgE-mediated Periostin Production in Eosinophilic Nasal Polyps Dong-Kyu Kim, MD, PhD Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea

Introduction Periostin, an extracellular protein, has emerged as a novel mediator of allergic diseases and plays an important role in tissue remodeling.

Role of periostin in the pathogenic process of subepithelial fibrosis

Introduction Serum periostin, as a biomarker, is elevated in severe eosinophilic asthma and aspirin-exacerbated respiratory disease and levels can predict the development of airflow limitation in asthmatic patients on an inhaled corticosteroid as well as responsiveness to omalizumab or lebrikizumab in uncontrolled severe allergic asthma.

Introduction However, despite its clinical significance, the mechanism by which periostin regulates inflammation remains poorly understood in the pathogenesis of airway inflammatory diseases.

Introduction Chronic rhinosinusitis (CRS) is one of the most common chronic rhinologic diseases and can significantly reduce the quality of life of affected subjects. Increased periostin production in sinonasal tissues occurs in subjects with CRS, particularly those with nasal polyps (NP) and allergic fungal sinusitis.

Introduction Periostin expression is also associated with CRS tissue eosinophil and disease severity. However, it is still unclear how periostin contributes to the pathophysiology of CRS with nasal polyps (CRSwNP). Therefore, the expression, cellular origin and function of periostin in NP tissues were investigated according to various subtypes of CRSwNP.

Method Group Control- Uncinate process (UP) : 22 CRS without NP (CRSsNP)-Uncinate process (UP) : 62 CRS with NP (CRSwNP)-Uncinate process (UP) : 68 Nasal polyp (NP) : 34 IHC, double IHC, qRT-PCR, ELISA, Confocal analysis In vitro assay Mast cell culture, hBronchial epithelial cell culture

Expression of periostin Result

Result Relationship between periostin and major cytokines

Result Cellular source of periostin

Periostin expression in human mast cell Result mRNA Protein

Result Periostin expression in human mast cell Rabbit IgG Isotype Control IgE-biotin/SA-periostin staining IgE-biotin/SA-periostin/chymase double staining

Result Expression of periostin receptor (integrin aV) Integrin aV Control-UP Non-eosionphilic NP Eosionphilic NP

Correlation between periostin/integrin aV and innate Th2 cytokines Result r=0.703, p<0.001 TSLP r=0.792, p=0.005 r=0.313, p=0.072 r=0.742, p=0.018

Periostin induced TSLP production in airway epithelium Result

Periostin induced TSLP production in airway epithelium **

Conclusion