RANTES is more prevalent in bacterial than in nonbacterial maxillary sinusitis: and P-selectin is preferentially up-regulated in diseased mucosae.
OBJECTIVE
To investigate the relationship of the clinical appearance, histological characteristics, bacterial culturing, and messenger RNA (mRNA) expression of RANTES, interleukin 6, and interleukin 12, as well as the occurrence of endothelial adhesion molecules, in inflammatory diseased maxillary sinus mucosa in critically ill patients.


METHODS
Prospective case series.


METHODS
General intensive care unit and neurosurgical intensive care unit of a tertiary care hospital.


METHODS
Seven critically ill patients, nasotracheally intubated or tracheotomized, who received ventilator treatment for more than 7 days and treatment with antibiotics.


METHODS
Bilateral biopsy specimens of antral mucosa were obtained at sinoscopy. Reverse transcriptase-polymerase chain reaction was used to detect the cytokine mRNAs in situ on paraformaldehyde-fixed tissue, and intercellular adhesion molecule 1, vascular cell adhesion molecule 1, E-selectin, and P-selectin were analyzed by immunochemistry on frozen sections. Sampling of secretion and tissue from the antra was performed for bacterial culturing.


RESULTS
Macroscopic and histological appearance varied and showed moderate to pronounced inflammation in 6 antra. All 4 bacterially infected antra showed mRNA RANTES (P=.005). No correlation was found for interleukin 6 and interleukin 12. Up-regulation of P-selectin in all cases and sparse expression of vascular cell adhesion molecule 1 indicate that the inflammation is chronic but nonallergic in type.


CONCLUSIONS
We find an indication that RANTES is more prevalent in bacterial sinusitis.
Westergren
V
V
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska Hospital, Stockholm, Sweden. viveka.westergren@ood.ki.se
Viale
G
G
Dell'Orto
P
P
Pellegrini
C
C
Hellquist
H B
HB
D000328:Adult; D018946:Chemokine CCL5 / Q000378:metabolism*; D003422:Critical Care; D016638:Critical Illness; D019040:E-Selectin / Q000378:metabolism; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D018664:Interleukin-12 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D015523:Maxillary Sinusitis / Q000378:metabolism* / Q000382:microbiology* / Q000473:pathology*; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism* / Q000382:microbiology / Q000473:pathology*; D019007:P-Selectin / Q000378:metabolism; D016133:Polymerase Chain Reaction / Q000379:methods; D011446:Prospective Studies; D012194:RNA-Directed DNA Polymerase; D015854:Up-Regulation; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism
D018946:Chemokine CCL5; D019040:E-Selectin; D015850:Interleukin-6; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D018664:Interleukin-12; D012194:RNA-Directed DNA Polymerase