Medical treatment reverses cytokine pattern in allergic and nonallergic chronic rhinosinusitis in asthmatic children (original) (raw)
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Local cytokines and clinical symptoms in children with allergic rhinitis after different treatments
Biologics: Targets & Therapy, 2009
Background: Therapy for allergic rhinitis aims to control symptoms and improve the quality of life. The treatment of allergic rhinitis includes allergen avoidance, environmental controls, pharmacologic treatment, and specific immunotherapy. Objectives: The aim of this study is to evaluate the clinical changes and the levels of interferon-γ (IFN-γ) and interleukin-5 (IL-5) in nasal lavage fluid from children with allergic rhinitis after different types of pharmacologic treatment (mometasone, montelukast, or desloratadine). Methods: Twenty-four children aged from six to 12 years with moderate persistent allergic rhinitis were randomized into three groups receiving monotherapy treatment over four weeks: nasal corticosteroid (mometasone), leukotriene modifier (montelukast), or antihistamine (desloratadine). The perception of symptom improvement during the medication use was evaluated at the end of the treatment. Samples of nasal lavage fluid were collected before and after treatment for measuring IFN-γ and IL-5 cytokines by ELISA. Results: All parents perceived an improvement in symptoms. Significant enhancement was seen in the mometasone group compared to those with montelukast (P = 0.01) and desloratadine (P = 0.02). No significant differences were found among the three groups in the levels of IL-5 and IFN-γ in nasal fluid at baseline or after treatment. Only the group treated with mometasone showed a slight but significant reduction in IL-5 levels after the treatment period as compared with levels before the treatment (P = 0.0469). Conclusion: The group treated with mometasone showed better improvement of clinical symptoms and a slight reduction in IL-5 levels in the nasal fluid. This may indirectly reflect the relative immunomodulatory effects of the drugs tested.
Sinus and adenoid inflammation in children with chronic rhinosinusitis and asthma
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2015
Chronic rhinosinusitis (CRS) and asthma frequently coexist in children and adults. However, the precise pathophysiologic mechanism of this interaction is still poorly understood, especially in children, owing to the lack of direct measurements of mucosal inflammation in the upper airways. To determine the pathophysiologic mechanism by analyzing the expression of a large array of inflammatory cytokines and chemokines in the sinus and adenoid tissues surgically removed from pediatric patients with CRS refractory to medical management. Twenty-eight children 2 to 12 years old diagnosed with CRS with or without asthma and 10 controls were included in this prospective, nonrandomized study. Mucosal expression of 40 inflammatory cytokines was measured with a multiplex assay and was normalized to total tissue protein. Compared with children with CRS and without asthma, children with CRS and asthma had significantly higher sinus levels of tumor necrosis factor-α and adenoid levels of epiderma...
Local IgE and inflammation in chronic rhinosinusitis of asthmatics and non-asthmatics
European Archives of Oto-Rhino-Laryngology, 2008
The aim of the study was to show the diVerence in the pattern of inXammation, and Th1/Th2 polarization between asthmatic and non-asthmatic patients with CRS, speciWcally eosinophil activation, local IgE levels in the sinus Xuid and tissue, and the severity of inXammation were measured. The maxillary sinus lavages, mucosal biopsies and bacteriological swabs were taken in 17 asthmatic and 36 non-asthmatic adult patients with CRS. The concentrations of IgE, eosinophil cationic protein (ECP), myeloperoxidase (MPO), and tryptase were analyzed and IgE+ cells, eosinophils, lymphocytes and plasma cells were counted. The granulocyte activation markers and IgE in sinus lavages, and the inXammatory and IgE+ cells counts were signiWcantly higher in the asthmatics with the greatest diVerence in ECP and IgE concentrations. The tryptase concentrations did not diVer, but only in the asthmatics they correlated signiWcantly with the IgE concentrations and IgE+ cells count. Asthmatic patients present a distinct subgroup among the patients with chronic rhinosinusitis (CRS). The levels of the cellular markers and IgE in the sinus Xuid diVer from those of non-asthmatic patients with CRS. The activation of granulocytes (especially eosinoph-ils), local IgE concentrations and the inXammatory cells inWltration are signiWcantly higher in the asthmatics.
Particularities in the Child Chronic Rhinosinusitis
Romanian Journal of Pediatrics, 2016
Chronic rhinosinusitis is a rare pathology in pediatric pathology versus adult patients. Clinical manifestations are related, on the one hand, with the anatomical particularities and, on the other hand, with the immune response correlated with the age of the child. Allergy is the main cause in 50% of child rhinitis, 40% of them debuting early until the age of 6 years. The clinical expression of allergic rhinosinusitis in children can sometimes be accompanied by comorbidity manifestations or complications. Impaired mucociliary clearance can be induced by other rare pathological situations that produce mucus rheology modification, as in cystic fibrosis (CF). Through, the clinical heterogenicity of expression is in relation, on the one hand, with immunogenic response and anatomical particularities relative to age of the child, and secondly with the diversity of inducing factors (from very frequent like allergy to the least frequent, CF). It requires a correct diagnosis, early and appropriate treatment by a multidisciplinary team collaboration.
Canadian respiratory journal, 2018
In children with asthma, the viral infection of airways is usually a main cause of acute asthma exacerbation and hospitalization. However, few studies on clinical and biomolecular characteristics of asthmatic children in this field have been done, especially in emergent countries. This study described the clinical and biological characteristics of asthmatic children who had acute asthma exacerbation and rhinovirus (RV) infection. Children under 15 years of age hospitalized for acute asthma exacerbation were included. They underwent clinical examination and peripheral blood analyses for the cytokine profile. The severity of acute asthma exacerbation was evaluated by Pediatric Asthma Score (PAS). Healthy children under 15 years of age were also invited in this study. One hundred fifteen asthmatic children were included in this study. There were 18.2% of mild PAS, 37.4% of moderate PAS, and 44.4% of severe PSA. Among them, 63/115 (54.8%) asthmatic children had positive RV infection (RV...
Immunological Aspects of Chronic Rhinosinusitis
Diagnostics
Chronic rhinosinusitis (CRS) is related to persistent inflammation with a dysfunctional relationship between environmental agents and the host immune system. Disturbances in the functioning of the sinus mucosa lead to common clinical symptoms. The major processes involved in the pathogenesis of CRS include airway epithelial dysfunctions that are influenced by external and host-derived factors which activate multiple immunological mechanisms. The molecular bases for CRS remain unclear, although some factors commonly correspond to the disease: bacterial, fungal and viral infections, comorbidity diseases, genetic dysfunctions, and immunodeficiency. Additionally, air pollution leads increased severity of symptoms. CRS is a heterogeneous group of sinus diseases with different clinical courses and response to treatment. Immunological pathways vary depending on the endotype or genotype of the patient. The recent knowledge expansion into mechanisms underlying the pathogenesis of CRS is lead...
Nasal fluid sample as a reliable matrix for determination of cytokine levels in childhood asthma
Turkish Journal of Biochemistry
Objectives Childhood asthma is a chronic disease with high incidence worldwide. As a lifelong disease, asthma has episodes. Inflammation continues to occur in the clinical remission of asthma. It can be difficult to diagnose childhood asthma, especially in clinical remission. We hypothesized that some cytokines secreted to nasal fluid from the airway during inflammation might help diagnose clinical remission of asthma. Moreover, sampling nasal fluid is an easy and non-invasive procedure, so it may be a preferable sampling method. Methods We measured levels of some interleukins (ILs), which are IL-4, IL-5, IL-6, IL-12p70, IL-13, IL-33, granulocyte-macrophage colony-stimulating factor (GM-CSF), periostin and thymic stromal lymphopoietin (TSLP) by Luminex magnetic bead-based immunoassay in nasal fluid and in serum of asthmatic children in clinical remission. Results We found that IL-5, IL-6, IL-33, and periostin had elevated levels in nasal fluid. IL-5 and IL-33 had increased levels in...
Cytokine secretion in nasal mucus of normal subjects and patients with allergic rhinitis
Biomedicine & Pharmacotherapy, 2003
Allergic rhinitis is regulated by the local production and release of several cytokines. The levels of Th2 cytokines IL-4, IL-6, IL-10 and the Th1 cytokine IFN-c were studied in nasal mucus from 30 subjects with allergic rhinitis and 45 non-atopic healthy controls. In this study a sampling technique for collecting nasal mucus, well tolerated by the subjects and with a minimal stimulation of the mucosa, was performed. The cytokine concentrations in nasal mucus samples were detected and quantitated by a new paramagnetic particle-based immunofluorescent assay system more sensitive than the conventional ELISA techniques. The new technique showed reliable values of the measured parameters. The nasal mucus from allergic patients contained significantly higher concentrations of IL-4 (25.5 ± 3.6 pg/ml; P < 0.001) and IL-10 (1300 ± 190 pg/ml; P < 0.05) compared to the nasal mucus from control subjects (15.2 ± 2.3 and 532 ± 28 pg/ml, respectively, for IL-4 and IL-10). No significant modification in IFN-c levels of allergic patients was found when compared to control group (respectively, 19.9 ± 3.3 vs. 25.7 ± 5.1 pg/ml; P > 0.05). Moreover, the allergic patients showed lower levels of IL-6 concentrations in the nasal mucus compared to control subjects (64.8 ± 9.1 vs. 129.0 ± 18.1 pg/ml; P = 0.0099). These data can be interpreted by the hypothesis that in response to environmental allergens there is a preferential Th2 polarity by activated CD4+ T cells and that the cytokines IL-6 and IL-10 have, respectively, an important anti-inflammatory and counterregulatory action in the pathogenesis of allergic rhinitis.
Effects of biological therapies on chronic rhinosinusitis in severe asthmatic patients
2020
SUMMARY Objective The introduction of monoclonal antibody (mAb) therapies represents a promising treatment for refractory chronic rhinosinusitis (CRS). We assessed the effects of selected mAbs (omalizumab, mepolizumab, benralizumab) on CRS in severe asthmatic patients in a real-life setting. Methods A prospective observational study on severe asthmatic patients, treated with 3 different mAb (omalizumab, mepolizumab, benralizumab), and comorbid CRS was conducted. All patients were followed for 52 weeks. The degree of nasal control, SinoNasal Outcome Test (SNOT) 22, Nasal Polyp Score (NPS), Lund Kennedy Score (LKS) were collected at baseline and at 52-week. Results 40 patients (33 with nasal polyps) were studied. 33 patients (82.5%) had uncontrolled nasal disease at baseline, and 15 (37.5%) were uncontrolled after 52 weeks. Significant improvement was observed for SNOT 22 (P < 0.001), SNOT 1-12 (P < 0.001) and degree of nasal control (P < 0.001). Differences in NPS (P = 0.130...