Features of the cytokine profile repolarization in the patients with chronic rhinosinusitis and comorbid conditions

Rhinosinusitis is one of the most common diseases in otolaryngology which manifests itself as nasal congestion, headache, nasal discharge and other symptoms. Sometimes rhinosinusitis accompanies seasonal acute respiratory viral infections, being a manifestation of seasonal and year-round allergies, and develops with dysfunction of the immune response. Chronic rhinosinusitis (CRS) is diagnosed if the symptoms of rhinosinusitis last for >12 weeks. Comorbid conditions (curvature of the nasal septum, bronchial asthma, etc.) increase the manifestations of CRS. The purpose of our work was to study the features of cytokine regulation in CRS with comorbid diseases. 84 persons with rhinosinusitis and 100 healthy controls were involved. The study included patients with CRS (n = 29), CRS and deviated septum (n = 24), CRS with bronchial asthma (n = 31) and a control group (n = 100) consisting of practically healthy individuals. The case–control study was performed in Laboratory of Clinical Pathophysiology at the Research Institute of the Railway Ministry. The studied materials were venous blood and nasal discharge. The content of TNFα, IFNγ, IL-2, IL-6, IL-4, IL-10 was determined by ELISA technique using JSC "Vector-Best" reagents (Novosibirsk, Russia) and a Muitiskan FC spectrophotometer. Statistical processing was performed using the Statistica 10.0 program. To describe samples with a distribution different from normal, we used the median (Me) and interquartile range (IQR), defined as the difference between the 25^th (Q_0.25) and 75^th (Q_0.75) percentiles. This approach allows us to present the central tendency and measure of data dispersion, minimizing the impact of outliers (Wilcox, 2012). All patients with CRS and comorbid conditions systemically and locally show unidirectional changes manifesting as an increase in proand anti-inflammatory cytokines, thus suggesting the development of immune responses by Th1/Th2 mechanisms. The presence of comorbid conditions (curvature of the nasal septum, bronchial asthma) enhances the immune response. In comorbid conditions, the content of cytokines is statistically significantly increased relative to both control group and patients with CRS. Maximum concentrations of cytokines are detected when CRS was combined with bronchial asthma.

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