Immunotherapy Efficiency in Rhinosinusitis Patients

Abstract

Latent rhinosinusitis proceeds without facial pain symptoms. Immune deficiency plays a leading role in pathogenesis of the disease latency. Substance P seems to be a universal mediator of painful irritation and inflammation. The objective of our study was to determine effectiveness of therapies in patients with latent rhinosinusitis, in terms of substance P levels. We treated 148 patients with rhinosinusitis, being free of local pains. All the patients underwent clinical and laboratory examination, including immune profile assessment, measurements of serum cytokines IL-1β, IL-4, IL-6, IL-8, IL-10, TNFα, IFNγ, and substance P. To correct a secondary immunodeficiency, the standard treatment of rhinosinusitis in a subgroup of the patients was accomplished by immunomodulatory drugs from the first day of therapy. The latter drugs were avoided for the rest of study group. Efficacy of treatment was evaluated by clinical signs and laboratory parameters on day 7 of the medication. Pre-treatment levels of substance P were determined in all the patients with latent clinical course and lack of pain symptoms. Low substance P levels (< 100 pg /ml) were considered as indications for immunomodulatory therapy, due to immune deficiency confirmed by the cytokine imbalance. Choice of a specific drug was dependent on immunopathogenesis, i.e., for catarrhal rhinosinusitis and deficiency of cellular immunity, we administered IFN-ES-lipint; in cases of purulent rhinosinusitis, Likopid was applied. The patients treated with immunomodulatory drugs showed improvement of immune indexes by the 7th day of treatment, along with return of substance P levels to control values typical to healthy persons. Among patients with low substance P levels and immune deficiency (without immunomodulatory treatment), the immune parameters and substance P levels did not exhibit any sufficient changes over time. Low contents of substance P (SP ≤ 100 pg /ml) in blood serum in pain-free patients with latent rhinosinusitis are indicative of immune deficiency and may serve as an indication for immune modulation therapy. Individual selection of the pathogenetically proven schedule therapy, when treating patients with latent (painless) rhinosinusitis may result into effective prevention of severe inflammation, normalization of immune response, prevention of a protracted disease course, and appropriate complications, as well as shortening of treatment terms to 8-10 days.

Glucosaminyl muramy ldipeptide in treatment and prevention of infectious diseases

“…Исследование влияния ГМДП в составе комплексной терапии 148 пациентов (возраста от 16 до 78 лет) с риносинуситом без болевого симптома выявило достоверное улучшение по клиническим признакам и лабораторным показателям. Назначение амоксициллина+клавуланата внутрь, Ликопида по 2 мг 3 раза/сут в течение 10 дней сублингвально, мометазона фуроата, ксилометазолина местно (в полость носа) привела к увеличению функциональной активности фагоцитов, повышению синтеза специфических антител, усилению пролиферации Т-и В-лимфоцитов, нормализации цитокинового баланса и уровня субстанции Р [19].…”

The condition of the vegetative nervous system and methods of correction of its changes in patients with seasonal allergic rhinitis

“…Allergic rhinitis (AR) is a fairly common pathology of the body, in which the target organ is the nasal cavity, characterized by a symptom complex that includes swelling of the mucous membrane and nasal congestion, itching in the nasal cavity and sneezing, rhinorrhea and difficulty in nasal breathing [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] . Although AR is not life-threatening, it sharply reduces the quality of life, physical and social activity of the patient, it can turn into bronchial asthma, which affects from 20 to 60% of the population [9,13,14].…”

“…Severe disturbances in the functional activity of the ANS -autonomic hyperreactivity, are observed in most patients with polypous rhinosinusitis [7,10].…”

Methodological Issues of Determining Concentrations of Some Cytokines in Peripheral Mblood From Healthy Individuals

“…В основе этих видов анализа лежит связывание с моноклональными антителами, фиксированными на поверхности микрочастиц или микрошариков. Проведенный нами анализ отечественной научной литературы иммунологического профиля на примере двух российских журналов «Медицинская иммунология» и «Инфекция и иммунитет» показал, что наибольшее распространение при проведении клинико-иммунологических исследований с определением содержания цитокинов в сыворотке/плазме крови получил твердофазный ИФА [4,6,7,13,14,15,16,17,23,25,26,27,28,29,31, 32] и мультиплексный иммуноанализ в формате хМАР- [2,9,19,20,21,22,30] и СВА-технологий [3,18].…”