The Impact and Nature of Inflammation in the Olfactory Cleft On Olfaction in Patients with Chronic Rhinosinusitis

S A T U R D A Y 210 Excessive Fibrin Deposition Caused by a Fibrinolytic Disorder Associated with Reduction of Tissue Plaminogen Activator Expression in Nasal Polyps Tetsuji Takabayashi, MD, Atsushi Kato, PhD, Anju Peters, MD, Kathryn E. Hulse, PhD, Lydia Suh, BSc, Roderick Carter, BSc, James Norton, MS, Leslie C. Grammer, MD, FAAAAI, Seong Ho Cho, MD, Bruce Tan, MD, Rakesh Chandra, MD, David Conley, MD, Robert Kern, MD, Shigeharu Fujieda, MD, Robert P. Schleimer, PhD, FAAAAI; Northwestern University Feinberg School Medicine, Chicago, IL, Northwestern University Feinberg School of Medicine, Chicago, IL, Department of Medicine, Division of Allergy-Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, Northwestern University Feinberg School of Medicine, Chicago, IL, University of Fukui, Fukui, Japan. RATIONALE: Nasal polyps (NP) are characterized by intense edema or pseudocyst formation with a high content of plasma proteins, mainly albumin. However, the mechanisms underlying NP retention of plasma proteins in submucosa remain unclear. We hypothesized that formation of fibrin mesh retains plasma proteins in NP.We assessed the fibrin deposition and expression of the fibrinolytic components in patients with chronic rhinosinusitis (CRS). METHODS: We collected nasal tissue from patients with CRS and control subjects. We assessed fibrin deposition by means of immunofluorescence. Fibrinolytic components, d-dimer and plasminogen activators were measured using ELISA, real-time PCR, and immunohistochemistry. We also performed gene expression and protein quantification analysis in primary airway epithelial cells. RESULTS: Immunofluorescence data showed profound fibrin deposition in NP compared with uncinate tissue (UT) from CRS and control subjects (6.6 fold increase, p