title: Medical treatment reverses cytokine pattern in allergic and nonallergic chronic rhinosinusitis in asthmatic children.
abstract: 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.
authors.affiliation: Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Tosca
authors.forename: Cristina
authors.initials: C
authors.lastname: Cosentino
authors.forename: Eugenio
authors.initials: E
authors.lastname: Pallestrini
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Riccio
authors.forename: Manlio
authors.initials: M
authors.lastname: Milanese
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
mesh_terms: 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
chemical_list: D000730:Androstadienes; D018926:Anti-Allergic Agents; D000900:Anti-Bacterial Agents; D015847:Interleukin-4; D019980:Amoxicillin-Potassium Clavulanate Combination; D007371:Interferon-gamma; D000068298:Fluticasone