Purpose: to determine the role of a pain symptom in the diagnosis of rhinosinusitis on the background of immune deficiency. 240 patients with rhinosinusitis without pain symptom were divided into 3 groups: group 1 - patients with acute viral rhinosinusitis (AVRS), group 2 - patients with acute bacterial sinusitis (ABRS), group 3 (n = 32) - control. All patients underwent a complete otorhinolaryngological examination, assessment of the pain symptom, an immunogram, the level of SP in the blood serum. At SP > 100 pg/ml in group 1, the change in indicators was typical for viral infection, in group 2, for bacterial infection. With an SP < 100 pg/ml, the cytokine balance is predominantly biased towards anti-inflammatory cytokines, and the direction of differentiation of Th-1/Th-2 lymphocytes towards the Th-2 pathway, which is manifested by immune deficiency, which leads to severe or prolonged course of the disease, which may indicate impaired neuro-immune interactions.
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