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Perić A, Gaćeša D, Kovačević SV, Perić AV, Vojvodić D, Georgiou S, Protopapadakis E, Alevizopoulos K. The effect of nasal douching by hypertonic 2.3 per cent sea water with algae extracts on the concentration of epidermal growth factor, transforming growth factor-α and interleukin-8 in nasal secretions of patients with nasal polyposis following endoscopic surgical treatment. J Laryngol Otol 2024; 138:520-526. [PMID: 38380493 PMCID: PMC11063653 DOI: 10.1017/s0022215123001974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To investigate epidermal growth factor, transforming growth factor-α and interleukin-8 production in nasal mucosa irrigated with hypertonic 2.3 per cent solution with algae extracts, in comparison to 0.9 per cent NaCl during the first two weeks after surgery for nasal polyposis, in relation to symptoms and local findings. METHODS This prospective study included 20 nasal polyposis patients postoperatively irrigated with hypertonic solution and 20 nasal polyposis patients postoperatively irrigated with isotonic solution. We evaluated nasal symptom score, endoscopic score and mediator levels in nasal secretions before and after irrigation. RESULTS Following treatment, nasal symptom score and endoscopic score were significantly lower in the hypertonic solution group (p = 0.023; p < 0.001, respectively). The increase in the epidermal growth factor and the decrease in the transforming growth factor-α and interleukin-8 concentration were higher in the hypertonic group (p < 0.001 for all mediators). CONCLUSION Irrigation with a hypertonic solution was found to be more effective than an isotonic solution in nasal mucosa reparation.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia
| | | | - Sandra Vezmar Kovačević
- Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Pharmacy, University in Belgrade, Belgrade, Serbia
| | - Aneta V. Perić
- Institute for Pharmacy, Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Danilo Vojvodić
- Institute for Medical Research, Division of Clinical and Experimental Immunology, University of Defense, Belgrade, Serbia
| | - Stella Georgiou
- Research and Development Department, Gerolymatos International S.A., Athens, Greece
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Perić A, Vezmar Kovačević S, Barać A, Perić AV, Vojvodić D. Effects of Pelargonium sidoides extract vs roxithromycin on chemokine levels in nasal secretions of patients with uncomplicated acute rhinosinusitis. Laryngoscope Investig Otolaryngol 2021; 6:25-33. [PMID: 33614926 PMCID: PMC7883607 DOI: 10.1002/lio2.514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/12/2020] [Accepted: 12/14/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Previous investigations suggest the use of extract from the roots of Pelargonium sidoides (EPs 7630) for the therapy of uncomplicated rhinosinusitis. The aim of this prospective study was to compare the effects of herbal drug EPs 7630 and antibiotic roxithromycin on chemokine production in nasal mucosa and clinical parameters in patients with uncomplicated acute bacterial rhinosinusitis (ABRS). METHODS Seventy-eight ABRS patients were divided into 26 patients receiving EPs 7630 tablets, 3 × 20 mg/day per os (group 1), 26 patients receiving roxithromycin tablets, 2 × 150 mg/day per os (group 2), both for 10 days, and 26 patients who received no therapy (Control group). We measured chemokine levels in nasal secretions by flow cytometry and assessed clinical parameters on day 0 and day 10 of investigation. RESULTS EPs 7630 increased concentrations of MCP-1 (P = .001) and IP-10 (P = .049) and decreased levels of MIP-1α (P < .001), ENA-78 (P < .001), and IL-8 (P < .001). Roxithromycin increased levels of IP-10 (P = .049) and decreased levels of MCP-1 (P < .001), MIP-1α (P < .016), ENA-78 (P < .001), and IL-8 (P < .001). Comparison of the non-treated patients' group with groups 1 and 2 revealed significant improvement of all clinical parameters in treated patients (P < .001), but therapy with roxithromycin resulted in better improvement in nasal symptoms and endoscopic findings than therapy with EPs 7630. CONCLUSION Our results suggest the presence of similar modulatory effects of both therapies on production of chemokines that regulate the function of neutrophils and monocytes in nasal mucosa. Roxithromycin shows better clinical efficacy than EPs 7630 in patients with uncomplicated ABRS. LEVEL OF EVIDENCE 1b.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy Faculty of MedicineUniversity of DefenceBelgradeSerbia
- MediGroup General HospitalBelgradeSerbia
| | - Sandra Vezmar Kovačević
- Department of Pharmacokinetics and Clinical Pharmacy, Faculty of PharmacyUniversity in BelgradeBelgradeSerbia
| | - Aleksandra Barać
- Clinical Center of Serbia, School of MedicineUniversity in BelgradeBelgradeSerbia
| | - Aneta V. Perić
- Institute for Pharmacy, Military Medical Academy Faculty of MedicineUniversity of DefenceBelgradeSerbia
| | - Danilo Vojvodić
- Institute for Medical Research, Division of Clinical and Experimental Immunology, Military Medical Academy Faculty of MedicineUniversity of DefenceBelgradeSerbia
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Perić A, Vezmar Kovačević S, Barać A, Gaćeša D, Perić AV, Vojvodić D. Effects of Pelargonium sidoides extract on chemokine levels in nasal secretions of patients with non-purulent acute rhinosinusitis. J Drug Assess 2020; 9:145-150. [PMID: 33209511 PMCID: PMC7646548 DOI: 10.1080/21556660.2020.1838176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective Previous investigations suggest the use of extract from the roots of Pelargonium sidoides (EPs 7630) for improvement of the symptoms of uncomplicated upper airway inflammations, due to its antimicrobial and immunomodulatory actions. The aim of this investigation was to evaluate the effects of EPs 7630 on chemokine production in nasal mucosa and clinical parameters of patients with acute postviral rhinosinusitis (APRS). Methods Twenty-six (n = 26) APRS patients and 25 (n = 25) control subjects were included in this prospective study. We measured the concentrations of thirteen chemokines in nasal secretions of APRS patients and controls by flow cytometry. The patients with APRS were treated by EPs 7630 20 mg oral tablets, three times daily for 10 days. We compared the chemokine levels in nasal secretions, nasal symptoms and endoscopic findings in patients, before and after therapy. Results We found higher Total Symptom Score (TSS) and higher concentrations of MCP-1, MIP-1α, MIP-1β, MIP-3α, ENA-78 and IL-8 in nasal secretions of APRS patients than in controls. After therapy by EPs 7630, we found significant improvement in all symptoms and endoscopic findings of APRS. The concentrations of MCP-1, IP-10 and MIP-1β were significantly increased and levels of MIP-1α, ENA-78, GROα and IL-8 significantly decreased in nasal fluid samples after therapy. No adverse effects were reported during the treatment. Conclusion Our results suggest the presence of modulatory effects of EPs 7630 on production of chemokines regulating the function of neutrophils and monocytes in the site of inflammation of the nasal mucosa in patients with APRS.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, University of Defense, Belgrade, Serbia.,Medigroup General Hospital, Belgrade, Serbia
| | - Sandra Vezmar Kovačević
- Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Pharmacy, University in Belgrade, Belgrade, Serbia
| | - Aleksandra Barać
- Clinical Center of Serbia, School of Medicine, University in Belgrade, Belgrade, Serbia
| | | | - Aneta V Perić
- Institute for Pharmacy, Military Medical Academy Faculty of Medicine, University of Defense, Belgrade, Serbia
| | - Danilo Vojvodić
- Institute for Medical Research, Division of Clinical and Experimental Immunology, Military Medical Academy Faculty of Medicine, University of Defense, Belgrade, Serbia
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Perić A, Gaćeša D, Aleksić A, Kopacheva-Barsova G, Perić AV. Herbal Drug BNO 1016 Versus Fluticasone Propionate Nasal Spray in the Treatment of Chronic Rhinosinusitis without Nasal Polyps: A Preliminary Report. Eur J Ther 2020. [DOI: 10.5152/eurjther.2020.19117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Perić A, Gaćeša D, Aleksić A, Kopacheva-Barsova G, Perić AV. Herbal Drug BNO 1016 Versus Fluticasone Propionate Nasal Spray in Therapy of Chronic Rhinosinusitis without Nasal Polyps: A Preliminary Report. Eur J Ther 2020. [DOI: 10.5152/eurjther.2020.190117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Perić A, Gaćeša D, Barać A, Sotirović J, Perić AV. Herbal Drug EPs 7630 versus Amoxicillin in Patients with Uncomplicated Acute Bacterial Rhinosinusitis: A Randomized, Open-Label Study. Ann Otol Rhinol Laryngol 2020; 129:969-976. [PMID: 32456442 DOI: 10.1177/0003489420918266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Previous investigations suggest the use of extract from the root of Pelargonium sidoides (EPs 7630) for the therapy of uncomplicated acute upper airway inflammations, due to its strong antimicrobial and immunomodulatory effect. We aimed to compare clinical efficacy, safety and bactericidal effect of EPs 7630 and amoxicillin monotherapy in treatment of patients with mild to moderate acute bacterial rhinosinusitis (ABRS). METHODS Fifty ABRS patients were divided into two groups by randomization. Group 1 (n = 25) received EPs 7630 tablets, 3 × 20 mg/day per os for 10 days. Group 2 (n = 25) received amoxicillin tablets 3 × 500 mg/day per os, for 10 days. We assessed total symptom score (TSS), individual symptom scores for each symptom (nasal obstruction, rhinorrhea, postnasal drip, facial pain/pressure, loss of the sense of smell), endoscopic findings, including total endoscopic score (TES) and individual endoscopic signs (mucosal edema, mucopurulent secretion), before and after treatment. Samples of discharge taken from the middle meatus of all patients were cultivated for bacteria before and after therapy. RESULTS Higher absolute improvement after treatment was found for TSS, nasal obstruction, facial pain/pressure, impaired sense of smell, TES, mucosal edema and mucopurulent secretion in EPs 7630 group compared to amoxicillin group (P < .001 for all parameters). However, there were no differences in absolute improvement of rhinorrhea score and postnasal drip score between groups (P = .248; P = .679, respectively). Fewer types of bacteria grew on culture from middle meatal samples in EPs 7630 group compared to amoxicillin group. There were no reported adverse events from patients from either group. CONCLUSION Our results demonstrated better clinical and antimicrobial efficacy of EPs 7630 than amoxicillin. EPs 7630 was shown as a potent agent and good alternative to antibiotic treatment of uncomplicated ABRS.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia.,General Hospital "Medigroup", Belgrade, Serbia
| | | | | | - Jelena Sotirović
- Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia
| | - Aneta V Perić
- Institute for Pharmacy, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia
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Perić A, Kovačević SV, Barać A, Gaćeša D, Perić AV, Jožin SM. Efficacy of hypertonic (2.3%) sea water in patients with aspirin-induced chronic rhinosinusitis following endoscopic sinus surgery. Acta Otolaryngol 2019; 139:529-535. [PMID: 31035841 DOI: 10.1080/00016489.2019.1605454] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Aspirin-induced chronic rhinosinusitis (CRS) is a severe progressive persistent disease, usually associated with nasal polyps (NPs). AIM/OBJECTIVE To compare effect of hypertonic (2.3% NaCl) sea water and isotonic 0.9% NaCl on symptoms and endoscopic findings in those patients in the period of 1 month after endoscopic sinus surgery (ESS). MATERIAL AND METHODS This prospective, randomized study included 30 patients with aspirin-induced CRS undergoing ESS. Patients were divided into two groups of 15 subjects and one of the two nasal irrigation solutions was administered in each group. Intensity of 5 symptoms (nasal obstruction, nasal discharge/postnasal drip, facial pain/pressure, headache and trouble sleeping) and endoscopic findings were assessed during the 1st, 7th, 14th, 21st and 28th days after the nasal packs removal. RESULTS We found significantly lower total symptom score (TSS) during the 7th (p = .009), 14th (p = .003), 21st (p < .001) and the 28th day (p = .001), lower total endoscopic score (TES) on the 21st (p = .002) and 28th day (p = .001), lower nasal obstruction, facial pain/pressure, headache and trouble sleeping, and lower nasal mucosal edema, nasal secretion and nasal crusting in patients treated by hypertonic sea water. CONCLUSION AND SIGNIFICANCE Hypertonic sea water should be recommended douching solution in the early postoperative care of patients with aspirin-induced CRS.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Faculty of Medicine, Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Sandra Vezmar Kovačević
- Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Pharmacy, University in Belgrade, Belgrade, Serbia
| | - Aleksandra Barać
- Clinical Center of Serbia, School of Medicine, University in Belgrade, Belgrade, Serbia
| | | | - Aneta V. Perić
- Institute for Pharmacy, Faculty of Medicine, Military Medical Academy, University of Defense, Belgrade, Serbia
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Perić A, Mirković CŠ, Đurđević BV, Perić AV, Vojvodić D. Eosinophil Chemokines and Clara Cell Protein 16 Production in Nasal Mucosa of Patients with Persistent Allergic Rhinitis. Eurasian J Med 2017; 49:178-182. [PMID: 29123440 DOI: 10.5152/eurasianjmed.2017.17203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective Eotaxin-2 and regulated on activation normal T cell expressed and secreted (RANTES) are involved in the eosinophil trafficking in patients with persistent allergic rhinitis (PAR). Clara cell protein 16 (CC16) is an anti-inflammatory protein mainly produced by the epithelial non-ciliated Clara cells. The aim of this study was to investigate the production of CC16 and chemokines eotaxin-2 and RANTES in nasal mucosa of patients with PAR. Materials and Methods Twenty-one PAR patients and 20 healthy participants were included. CC16, eotaxin-2, and RANTES concentrations were measured in nasal secretions. PAR patients were administered fluticasone furoate nasal spray (220 μg daily for 14 days). We performed nasal cytology, symptom score assessment, and inflammatory mediator detection before and after the therapy. Results The level of CC16 in patients with PAR was lower than in the healthy subjects (p=0.023). The eosinophil counts and local concentrations of eotaxin-2 and RANTES were higher in patients with PAR in comparison with controls (p=0.008, p=0.001, p=0.031, respectively). We also found a negative correlation between the CC16 and eotaxin-2 levels in nasal secretions of PAR patients (r=-0.492, p=0.023). After corticosteroid therapy, the patients with PAR had lower nasal symptoms, eosinophil counts, eotaxin-2, and RANTES levels and higher levels of CC16 (p<0.001 for all parameters). Conclusion Our results suggest the presence of a negative correlation in production of CC16 and eotaxin-2 in nasal mucosa of patients with PAR. Intranasal corticosteroids have a suppressive effect on mucosal eosinophilic inflammation and a stimulating effect on local CC16 production.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy School of Medicine, Belgrade, Serbia
| | - Cveta Špadijer Mirković
- Department of Otorhinolaryngology, Military Medical Academy School of Medicine, Belgrade, Serbia
| | | | - Aneta V Perić
- Institute for Pharmacy, Military Medical Academy School of Medicine, Belgrade, Serbia
| | - Danilo Vojvodić
- Institute for Medical Research, Division of Clinical and Experimental Immunology, Military Medical Academy School of Medicine, Belgrade, Serbia
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Perić A, Sotirović J, Špadijer-Mirković C, Matković-Jožin S, Perić AV, Vojvodić D. Nonselective chemokine levels in nasal secretions of patients with perennial nonallergic and allergic rhinitis. Int Forum Allergy Rhinol 2015; 6:392-7. [DOI: 10.1002/alr.21684] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 10/20/2015] [Accepted: 10/24/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Rhinology Unit, Faculty of Medicine; Military Medical Academy; Belgrade Serbia
| | - Jelena Sotirović
- Department of Otorhinolaryngology, Rhinology Unit, Faculty of Medicine; Military Medical Academy; Belgrade Serbia
| | - Cveta Špadijer-Mirković
- Department of Otorhinolaryngology, Rhinology Unit, Faculty of Medicine; Military Medical Academy; Belgrade Serbia
| | | | - Aneta V. Perić
- Institute for Pharmacy, Faculty of Medicine; Military Medical Academy; Belgrade Serbia
| | - Danilo Vojvodić
- Institute for Medical Research, Division of Clinical and Experimental Immunology, Faculty of Medicine; Military Medical Academy; Belgrade Serbia
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Perić A, Bijelić D, Vukomanović-Đurđević B, Perić AV. Huge Respiratory Epithelial Adenomatoid Hamartoma Originating from the Inferior Nasal Turbinate: A Case Report. Indian J Otolaryngol Head Neck Surg 2015; 68:100-3. [PMID: 27066422 DOI: 10.1007/s12070-015-0849-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 04/15/2015] [Indexed: 11/29/2022] Open
Abstract
Respiratory epithelial adenomatoid hamartoma (REAH) is a recently described entity consisted of benign glandular proliferations lined by pseudostratified respiratory epithelium. We report a case of a 22-year-old male patient with 7-year history of nasal obstruction and headache resulting from a huge left-sided nasal lesion. Computed tomography, magnetic resonance and biopsy were performed to make a provisional diagnosis of REAH originating from the left-sided inferior turbinate. The definitive diagnosis of REAH was made by histopathological examination of the removed mass. We also discuss the origin and differential diagnosis of these rare lesions.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy, Crnotravska 17, 11040 Belgrade, Serbia
| | - Dušan Bijelić
- Department of Otorhinolaryngology, Military Medical Academy, Crnotravska 17, 11040 Belgrade, Serbia
| | | | - Aneta V Perić
- Institute for Pharmacy, Military Medical Academy, Belgrade, Serbia
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Perić A, Vojvodić D, Perić AV, Radulović V, Miljanović O. Correlation between cytokine levels in nasal fluid and scored clinical parameters in patients with nasal polyposis. Indian J Otolaryngol Head Neck Surg 2012; 65:295-300. [PMID: 24427664 DOI: 10.1007/s12070-011-0447-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 12/26/2011] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to compare the cytokine levels in nasal fluid in subjects with nasal polyposis (NP) and co-morbid asthma and NP patients without asthma and to correlate these levels with clinical parameters of severity of disease. Forty NP patients (20 asthmatic and 20 nonasthmatic) were enrolled. Nasal secretion samples were collected from nasal cavities of all 40 subjects. The levels of Th1 cytokines IL-2, IL-12 and IFN-γ, Th2 cytokines IL-4, IL-5, IL-6, and IL-10, chemokine IL-8, and proinflammatory cytokines IL-1β, TNF-α and TNF-β were measured using flow cytometric method. Each of the 40 patients was staged clinically according to global nasal symptom score, endoscopic score, and Lund-Mackay computed tomography (CT) score. The concentrations of Th2 cytokines IL-5, IL-6 and IL-10 were significantly higher (P < 0.01, P < 0.01, P < 0.05) in patients with NP and asthma compared with NP patients without asthma. Positive correlations were observed between concentration of IL-2 in nasal secretions and global nasal symptom score, endoscopic score, and Lund-Mackay score only in NP patients without asthma. We also found positive correlation between CT score and the levels of IL-8, IL-4, and IL-1β in nonasthmatic patients. Finally, our results showed a positive correlation between IL-5 levels in nasal fluid and endoscopic score only in asthmatic patients. NP in asthmatic patients have different immunological patterns compared to those without asthma. We also concluded that concentrations of cytokines measured in nasal fluid were not sensitive enough to determine the severity of disease.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Rhinology Unit, Military Medical Academy, Crnotravska 17, 11040 Belgrade, Serbia
| | - Danilo Vojvodić
- Division of Clinical Immunology, Institute of Medical Research, Military Medical Academy, Belgrade, Serbia
| | - Aneta V Perić
- Institute of Pharmacy, Military Medical Academy, Belgrade, Serbia
| | - Vesna Radulović
- Municipal Institute for Lung Diseases and Tuberculosis, Belgrade, Serbia
| | - Olivera Miljanović
- Center of Human Genetics and Immunology, Clinical Center of Montenegro, Podgorica, Montenegro
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Perić A, Vojvodić D, Radulović V, Vukomanović-Durdević B, Perić AV, Miljanović O. Proinflammatory cytokine levels in nasal fluid as indicators of severity of nasal polyposis. Acta Clin Croat 2010; 49:395-403. [PMID: 21830450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
The aim of this prospective study was to evaluate whether cytokine levels in nasal secretions may be clinical parameters of severity of nasal polyposis. Forty nasal polyp patients (20 asthmatic and 20 nonasthmatic) requiring surgical treatment were included. Nasal secretion samples were collected from nasal cavities of all 40 subjects. The levels of T-helper type 1 (Th1) proinflammatory cytokines IL-2, IL-12, IFN-gamma, IL-1beta, TNF-alpha and TNF-beta, Th2 cytokines IL-4, IL-5 and IL-6, antiinflammatory cytokine IL-10 and chemokine IL-8 were measured using flow cytometric method. Each of the 40 patients was staged clinically according to global nasal symptom score, endoscopic score, and Lund-Mackay computed tomography (CT) score. Eosinophils were counted in hematoxylin-eosin stained sections of all nasal polyp samples. The concentrations of Th2 proinflammatory cytokines IL-5 and IL-6 were significantly higher (P < 0.05 and P < 0.01, respectively) in patients with nasal polyposis and asthma compared with nasal polyp patients without asthma. Positive correlations were observed between IL-2 concentration in nasal secretions and nasal symptom score, endoscopic score, and Lund-Mackay score only in nasal polyp patients without asthma. We also found positive correlation between Lund-Mackay score and the levels of IL-8, IL-4, and IL-1beta in nonasthmatic patients. A positive correlation between IL-5 levels in nasal fluid and endoscopic score was found only in asthmatic patients. Eosinophil counts were higher in asthmatic patients' polyps compared with nonasthmatic ones, but without statistical significance. Nasal polyposis in asthmatic patients has different immunological patterns compared to those without asthma. The concentrations of cytokines measured in nasal fluid were not sensitive enough to be universal criteria to determine the severity of all forms of nasal polyposis.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia.
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