p63(+)Krt5(+) basal cells are increased in the squamous metaplastic epithelium of patients with radiation-induced chronic Rhinosinusitis

BACKGROUND: Squamous metaplasia (SM) is an irreversible form of airway epithelial remodeling. Hyperproliferation of basal cells was observed in squamous metaplastic epithelium of chronically inflamed airway. However, the association of such aberrant proliferation of basal cells with SM in the nasal epithelium after radiation damage remains unclear. The aim of this study was to investigate SM and accompanying levels of p63(+)Krt5(+) (basal cell markers) cells in the nasal epithelium of patients with radiation-induced chronic rhinosinusitis (CRSr) and patients with chronic rhinosinusitis without nasal polyps (CRSsNP) compared to healthy controls. METHODS: We assessed the prevalence of SM and the expression of p63(+), Krt5(+), p63(+)Krt5(+), and Ki67(+) cells through immunofluorescence(IF) staining of the inferior turbinate (IT) tissues from patients with CRSr (n = 36), CRSsNP (n = 33) and controls (n = 28). RESULTS: The prevalence of SM and the number of p63(+)Krt5(+) cells were both significantly increased in patients with CRSr compared to patients with CRSsNP and controls. The number of Ki67(+) cells were both significantly increased in patients with CRSr and CRSsNP compared to controls, but the ratio of Ki67(+) cells to p63(+)Krt5(+) cells was significantly lower in patients with CRSr compared to patients with CRSsNP. In patients with CRSr, an increased number of p63(+)Krt5+ basal cells was observed in SM epithelium compared to non-SM epithelium. CONCLUSION: SM is increased in the nasal epithelium of patients with CRSr, in which aberrant levels of p63(+)Krt5(+) basal cells serves as an important pathologic feature in the squamous metaplastic epithelium.