Study of Relation between Vitamin D Serum Level and Biomarkers of Human Sinonasal Fibroblast Proliferation in Patient with Chronic Rhinosinusitis with Nasal Polyposis

Introduction: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammatory disease of paranasal sinuses and nasal coverage, which reduces the quality of life and overall health. Vitamin D regulates many cellular functions, including anti-inflammatory and immune-modulating functions. There is an increasing evidence of the relative role of fibroblasts in the accumulation of inflammatory cells in chronic rhinosinusitis. The aim of this study was to investigate the relationship between vitamin D levels and the proliferation of sinonasal fibroblasts in patients with chronic rhinosinusitis with nasal polyposis and its therapeutic role. Material and Method: In this case-control study blood and tissue samples were extracted from patients with CRSwNP (n=30). Control subjects with non-inflammatory conditions underwent endoscopic and non-endoscopic surgery (n=30). The serum level of 1,25 dihydroxyvitamin D (1,25(OH)2D) and proliferation of fibroblasts sampled from nasal and sinus tissue using ki 67 and vimentin were evaluated and analyzed using SPSS® 23 software. Results: The average level of vitamin D was 23.1±7.36 ng/ml in the case group and 31.19±7.02 ng/ml in control group, which was significantly lower in case group (P=0.008). The proliferation of sinonasal fibroblasts were positive in all cases patients and only in 20% of control patients using vimentin. The proliferation of sinonasal fibroblasts were negative in all control patients while only 10% of the case patients were negative using Ki 67. The level of vitamin D decreased with the increased rate of Ki 67. Conclusion: The results of this study indicate a reversed relation between vitamin D levels and the proliferation of sinonasal fibroblasts.Thus vitamin D has both prophylactic and therapeutic effects in chronic rhinosinusitis with nasal polyposis.