IMMUNOTHERAPY IN THE TREATMENT OF RECURRENT RHINOSINUSITIS

Abstract

Recurrent rhinosinusitis occur against the background of immunodeficiencies, latent, long-term, without pain symptom. Background: Determination of indications for immune-therapy of recurrent rhinosinusitis. Materials and methods. The study involved 85 patients with purulent rhinosinusitis without recurrent pain symptoms. All patients underwent a complete clinical examination, immunogram, determining the level of IL-1β, IL-4, IL-6, IL-8, IL-10, TNFα, INFγ and substance P (SP) in the blood serum. To correct the immune deficiency in the standard treatment of purulent rhinosinusitis scheme in some patients with the level of SP <100 pg / mL (n = 30) on the first day included immunotherapy. The control group (n = 24) was treated in the normal way – without immunomodulator. Results. In patients with levels of SP more than 100 pg / mL change display-teley immunogram were typical for a normal immune response to bacterial antigen. Cytokine balance shifted toward anti-inflammatory cytokines was significantly increased concentrations of IL-4 and IL-10. In patients with SP level less than 100 pg / mL identified indicators of immunodeficiency. Cytokine balance shifted toward the anti-inflammatory cytokines, pro-inflammatory cytokines concentration sharply reduced. Inclusion in the scheme of treatment immunomodulator possible to reduce the treatment time for 3–4 days. Conclusions. No pain in recurrent rhinosinusitis is a manifestation of the neuro-immune regulation of the inflammatory process. The indications to the appointment of immune-therapy in patients with recurrent rhinosinusitis may be a decrease in serum SP less than 100 pg / ml. Application results: rhinology, clinical immunology.

Keywords

• рецидивирующий риносинусит
• иммунодефицит
• лечение
• субстанция Р