SPECIFICITY OF THE IMMUNE RESPONSE IN POLYPOUS AND HYPERPLASTIC RHINOSINUSITIS

Background. Chronic rhinosinusitis (CRS) is a serious medical and social problem due to its high prevalence worldwide. According to the literature, approximately 5–12% of the world's population is susceptible to this disease. Particularly complex pathogenetic variants of CRS include polypous rhinosinusitis (PRS) and chronic hyperplastic rhinosinusitis (CHRS).

The significant reduction in quality of life, prolonged periods of disability, and the prevalence of these pathologies necessitate further research into their pathogenesis. Most PRS phenotypes follow the T2 type, but there are also T1, T3, and mixed variants. A dominant endotype has not been established for CHRS.

We believe that patients with PRS and CHRS will have different immune responses. Cytokine profiles and immune response characteristics may vary, specifically influencing mucosal proliferation in the nasal cavity and paranasal sinuses.

The aim of this study was to investigate cytokine regulation in polypous rhinosinusitis and chronic hyperplastic rhinosinusitis.

Materials and Methods: 68 individuals with rhinosinusitis and 43 healthy individuals were examined. The study included patients with polypous rhinosinusitis (PRS, n=33), chronic hyperplastic rhinosinusitis (CHRS, n=35), and a control group (n=43) consisting of apparently healthy individuals. This case-control study was conducted in the Clinical Pathophysiology Laboratory of the Research Institute of the Ministry of Railways. Blood serum and nasal secretions were used for the study. Levels of IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-8, IL-10, IL-13, and IL-17A were determined by ELISA using Vector-Best reagents (Novosibirsk) and a Muitiskan FC spectrophotometer. Statistical analysis was performed using Statistica 10.0. Sample description included calculation of the median and interquartile range (IQR) at the 25th and 75th percentiles, the Mann-Whitney test, and a significance level of <0.05.

Results.

A study of cytokine concentrations revealed significant intergroup differences at the local and systemic levels. Patients in the control group had low levels of all studied cytokines, both locally and systemically. Consistent changes were identified for each CRS phenotype. Thus, high concentrations of IL-4, IL-5, and IL-13 were detected locally and systemically in PRS compared to the control group and the chronic hyperplastic rhinosinusitis group. For chronic hyperplastic rhinosinusitis, increased levels of IFN-γ, IL-2, IL-10, IL-17A, IL-8, and IL-1β were detected locally and systemically compared to the control and PRS.

Conclusions.

A T2 immune response was detected locally and systemically in PRS, while a mixed T1/T3 immune response was demonstrated locally and systemically in PRS.

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