Human Rhinovirus Infection Enhances the Th2 Environment in Allergic and Non-allergic Patients with Chronic Rhinosinusitis.

Ko, Young-Kyung; Zhang, Yu-Lian; Wee, Jee Hye; Han, Doo Hee; Kim, Hyun Jik; Rhee, Chae-Seo

Objectives This study was conducted to determine whether patients with allergy might be more susceptible to human rhinovirus (HRV) infection and whether the effects of infection on the elicited immune responses are different in allergic and non-allergic patients with chronic rhinosinusitis (CRS). Methods Uncinate process tissues were obtained from 61 chronic rhinosinusitis patients (of which, 39 had allergy and 22 did not) who were infected with HRV16 using an air-liquid interface organ culture system. The expression levels of programmed cell death-ligand (PD-L)1, PD-L2, intracellular adhesion molecule 1 (ICAM-1), IFN-γ, IL-4, IL-5, and IL-10 were evaluated in the infected nasal mucosa. Results The HRV infection rates were not significantly different between allergy (74.4 %) and non-allergy (72.7 %) groups. In the allergy group, the expression of PD-L1 (P=0.013) and IL-10 (P=0.040) was significantly elevated in the HRV-infected tissues; there was a strong correlation between PDL1 and IL-10 (r= 0.868, P<0.001). In contrast, infected tissues from the non-allergy group displayed increased levels of IL-4 (P=0.039), IL-5 (P=0.023), and IFN-γ (P=0.031) as well as an increased IL-4/IFN-γ ratio after HRV infection (P=0.043). Conclusion This study shows that, regardless of the presence of allergy, HRV infection rates are similar in the nasal mucosa of patients with CRS. HRV infection enhances the Th2 environment by modulating PD-L1 and PD-L2 expression levels in allergic mucosa and by increasing the IL-4/IFN-γ ratio in non-allergic mucosa.