Medical treatment reverses cytokine pattern in allergic and nonallergic chronic rhinosinusitis in asthmatic children.
A Th2 cytokine pattern has recently been reported both in allergic and nonallergic chronic rhinosinusitis in asthmatic children. The aim of the study was to evaluate the cytokine pattern in chronic rhinosinusitis in allergic and nonallergic asthmatic children before and after medical treatment. Thirty asthmatic children were evaluated, 18 males and 12 females (mean age 9.1 years). Sixteen were allergic and 14 were nonallergic. All children were asthmatic and suffered from chronic rhinosinusitis, whose diagnosis was confirmed by endoscopy. All of them were treated with amoxicilline-clavulanate (20 mg/kg b.i.d.) and fluticasone propionate aqueous nasal spray (100 microg daily) for 14 days; a short course of oral corticosteroid was also prescribed (deflazacort 1 mg/kg daily for 2 days, 0.5 mg/kg daily for 4 days and 0.25 mg/kg daily for 4 days). Rhinosinusal lavage and nasal cytology were performed in all subjects before and after medical treatment. IL4 and IFNgamma were measured by immunoassay and inflammatory cells were counted by conventional staining. Thirteen allergic children and 12 nonallergic children showed a negative endoscopy after the treatment. Allergic subjects showed a significant decrease of IL4 (p = 0.0002) and a significant increase of IFNgamma (p = 0.03) after the treatment. Nonallergic children showed a significant decrease of IL4 (p = 0.0007) and a nonsignificant increase of IFNgamma. A significant reduction of the inflammatory infiltrate was detected in all asthmatic children (p < 0.05). This study confirms a Th2 polarization in chronic rhinosinusitis both in allergic and nonallergic asthmatic children. Moreover, the medical treatment of chronic rhinosinusitis reversed the cytokine pattern from a Th2 towards a Th1 profile both in allergic and nonallergic children.
Tosca
Maria Angela
MA
Department of Internal Medicine, University of Genoa, Genoa, Italy.
Cosentino
Cristina
C
Pallestrini
Eugenio
E
Riccio
Anna Maria
AM
Milanese
Manlio
M
Canonica
Giorgio Walter
GW
Ciprandi
Giorgio
G
D019980:Amoxicillin-Potassium Clavulanate Combination / Q000494:pharmacology / Q000627:therapeutic use*; D000730:Androstadienes / Q000494:pharmacology / Q000627:therapeutic use*; D018926:Anti-Allergic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001249:Asthma / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D000068298:Fluticasone; D006801:Humans; D007371:Interferon-gamma / Q000187:drug effects* / Q000378:metabolism; D015847:Interleukin-4 / Q000378:metabolism*; D008297:Male; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D018418:Th2 Cells / Q000187:drug effects / Q000378:metabolism; D016896:Treatment Outcome
D000730:Androstadienes; D018926:Anti-Allergic Agents; D000900:Anti-Bacterial Agents; D015847:Interleukin-4; D019980:Amoxicillin-Potassium Clavulanate Combination; D007371:Interferon-gamma; D000068298:Fluticasone