engleski

Prognostic value of IL-5 in sinus lavage in patients with chronic maxillary sinusitis

The aim of the study was to evaluate subjective outcomes in patients with chronic rhinosinusitis after steroid/antibiotic endosinusal treatment and to test the hypothesis that pretreatment levels of cytokine interleukin-5 in sinus fluid predict response to endosinusal steroid/antibiotic treatment. Twenty-four patients with symptoms of chronic rhinosinusitis were recruited for the study. Inclusion criteria were sinusitis symptoms persisting for more than three months and maxillary sinus mucosa thickening by >6 mm, considered as maxillary sinusitis. Patients with asthma, polyposis, recent infection, systemic steroid therapy or previous sinus surgery were excluded. Patients were treated endosinusally with 2 mg dexamethasone and 40 mg gentamicin per maxillary sinus daily for 5 days. Patients rated nasal/chronic rhinosinusitis disease-specific symptoms and completed a self-administered questionnaire concerning sinusitis symptoms at inclusion and after 30 days. Sinus lavage collected at inclusion was analyzed for interleukin-5 concentration. Endonasal treatment led to improvement with symptom alleviation in ten (52.6%) patients (responders) whereas unchanged or worsened condition was recorded in nine (47.7%) patients (nonresponders). Significant improvement was noted for overall sinusitis symptom score (p=0.02), and for obstruction, postnasal drip, headache, sneezing and cough (p<0.05) in the study group as a whole. There was a positive correlation of baseline interleukin-5 level in sinus lavage with the improvement rate of overall sinusitis symptom score (p<0.01) and improvement rate of nasal secretion score (p<0.01). Results indicated the increased interleukin-5 levels in sinus fluid to predict good response to endosinusal steroid/antibiotic treatment.

Maxillary sinusitis - drug therapy; Chronic disease; Sinusitis - complications; Cytokines - metabolism

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