1. 蔡易錚 MD. PhD. 新光醫院耳鼻喉科 輔仁大學醫學系
The Role of CTGF in Remodeling Process of Chronic Rhinosinusitis without Nasal Polyp
蔡易錚 MD. PhD.
新光醫院耳鼻喉科
輔仁大學醫學系

2. Pathogenesis of CRSwNP
From a pathogenesis point of view, induction of chemokines is necessary for activation of downstream adaptive immune and associated effector cells.

3. Pathogenesis of CRSsNP
In the pathogenesis of another phenotype-CRSsNP, we also noted that the activation of downstream inflammation won’t happen unless there is chemokine activation.
J Allergy Clin Immunol Pract ; 4(4): 575–582. doi: /j.jaip

4. The CRS can be distinguished into 2 phenotype according to the tissue remodeling type, sNP and cNP
The TGF-B1 is the universal consensus remodeling marker, sNP express high conc. of TGF-B, TGF-B is well known that can
increase collagen deposition and activate fibrosis, on the other hand, the conc of TGF is quite low in tissue of wNP. NP express the remodeling
Pattern with pseudocyst formation and intense stroma edema.
藉由TGF-B (remodeling pattern) and phenotype 分成兩型
TGF-B 可以用來區分sNP/wNP, TGF-B 是一個remodelling key factor, increase Fblast collagen deposition, fibrosis---sNP 的特徵
在NP pts, TGF decrease than contrl, 顯示是不同 remodelling process, NP比較focus pseudocyst formation, intense edema………
Phenotyping of CRS. CRSsNP and CRSwNP are regarded as distinct clinical entities based on diverse inflammatory and remodeling parameters.
Th2+, IL-5 positive, TH2-skewed tissues; Th2−, IL-5 negative TH2-skewed tissues; SE-IgE, IgE antibodies to Staphylococcus aureus enterotoxins (SE). Arrows do not suggest causality.
Journal of Allergy and Clinical Immunology  , DOI: ( /j.jaci )

5. Fig 1. Fibroblast distribution in mucosa specimens and characterization of NMDFs.
First, we found fibroblast is dominant in CRSsNP specimen--- showed a Fibrosis pattern of remodeling process
Tsai YJ et al., 2015 PLOS ONE

6. Specific Aims
TGF-β Fibrosis (collagen expression)
CTGF??

7. Material and Methods Exp group: 14 patients w/ CRSsNP
Control group: 13 patients w/ NSD
allergy, asthma, or aspirin sensitivity Hx
treated w/ oral/topical anti-allergic agent or steroid for at least 2 months

8. Western

14. Conclusion

15. 感謝聆聽