Thymic stromal lymphopoietin as a predictor of hypertrophic changes in the nasal mucosa in children with atopic bronchial asthma and allergic rhinitis

Th2-dependent allergic inflammation in patients with bronchial asthma (BA) and allergic rhinitis (AR) can be associated with nasal mucosa remodeling, accompanied by hypertrophic and hyperplastic processes. Thymic stromal lymphopoietin (TSLP) is a key cytokine produced by epithelial cells and is actively involved in allergic inflammation. Objective of the research: to study TSLP content in nasal secretion of children with atopic BA and AR. Materials and methods: in 43 patients aged 4-17 years with atopic BA and AR, nasal mucosa state was assessed using rhino-endoscopy and TSLP content in nasal secretion by the enzyme immunoassay. Results: hypertrophic or polypouschanges in the nasal mucosa and/or paranasal sinuses were detected in 30% (13/43) of patients. TSLP content in the nasal secretion in these patients was 908, 5 [48, 9; 2098, 7] pg/mg, which is statistically significantly higher than in patients with BA and AR without sinonasal hypertrophy (132, 3 [4, 2; 325, 9] pg/mg, p=0, 036). AR exacerbation was accompanied by a statistically significant increase of TSLP content in the nasal secret compared with the remission period (p=0, 002). Conclusion: hypertrophic changes in the nasal mucosa are accompanied by a statistically significant increase of TSLP content in the nasal secret in children with atopic BA and AR, which allows to consider this biomarker as a potential non-invasive predictor of pathological airway remodeling in patients with chronic allergic airway inflammation. © Springer Nature Switzerland AG 2020.