In patients with eosinophilic chronic rhinosinusitis (ECRS), viral infection of the upper respiratory tract tends to exacerbate the symptoms.

To clarify the effect of the cytokines during viral infection in ECRS patients, we investigated the production of thymic stromal lymphopoietin (TSLP) in the sinus mucosa of ECRS patients in the presence of polyinosinic: polycytidylic acid, or poly(I:C), which mimics viral infection, with or without interleukin-4 (IL-4) or IL-13.

The ECRS patients were classified into mild, moderate, and severe groups based on the scoring system of the Japanese Epidemiological Study of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC). We obtained paranasal sinus mucosa from patients with ECRS through endoscopic sinus surgery, as well as nasal epithelial cells. The cells were stimulated with poly(I:C) in the presence or absence of IL-4 or IL-13. The TSLP concentrations in the culture supernatants were measured using enzyme-linked immunosorbent assay (ELISA) after 24 hours of stimulation.

Nasal epithelial cells from patients with ECRS or healthy controls produced TSLP upon stimulation with poly(I:C) alone, and the addition of IL-4 or IL-13 increased TSLP production. Notably, the increase in poly(I:C)-induced TSLP production from nasal epithelial cells in the presence of IL-4 or IL-13 was greater among the severe group compared to the other groups.

In the sinus mucosa of patients with severe ECRS, TSLP production was enhanced more when poly(I:C) stimulation was combined with IL-4 or IL-13 stimulation. Thus, the Th2-skewed condition of the sinus mucosa during viral infection in patients with more severe ECRS may accelerate disease exacerbation.

The study protocol was approved by the Ethics Committee of Faculty of Medicine, Toho University (approval number: 27028, A18086_27028).

Akiko Inoue contributed to the study idea; participated in the study design, cell culture, stimulation, and data analysis: wrote the initial draft of the manuscript. Yuriko Tanaka contributed to the evaluation of examination and wrote the manuscript based on the suggestion. Hidehito Matsui and Akira Fukuo contributed to the collecting samples. Motonari Kondo contributed to the study idea, supervised experiments and wrote the manuscript. Kota Wada contributed to the study idea and study design, collected samples, and clinically wrote the manuscript and assisted with data analysis. All authors discussed the results and commented the manuscript.

Received: 28 November 2024

Accepted: 24 March 2025

Article published online:
10 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Akiko Inoue, Yuriko Tanaka, Hidehito Matsui, Akira Fukuo, Motonari Kondo, Kota Wada. TSLP Production Induced by Poly(I:C) Stimulation Increased in the Presence of Th2 Cytokines in Patients with Severe ECRS. Int Arch Otorhinolaryngol 2025; 29: s00451809159.
DOI: 10.1055/s-0045-1809159