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Relation between cellular infiltration and markers in patients with chronic rhinosinusitis and asthma

The aim of the study was to show the difference in the pattern of inflammation (and Th1/Th2 polarization) between asthmatic and non-asthmatic patients with CRS. Specifically eosinophil activation, local IgE levels in the sinus fluid and tissue, and severity of inflammation were measured. The maxillary sinus lavages, mucosal biopsies and bacteriological swabs were taken in 23 asthmatic and 36 non-asthmatic adult patients with CRS. The concentrations of IgE, eosinophil cationic protein (ECP), myeloperoxidase (MPO), and tryptase were analyzed and IgE+ cells, eosinophils, lymphocytes and plasma cells counted. The granulocyte activation markers and IgE in sinus lavages, and the inflammatory and IgE + cells counts were significantly higher in the asthmatics with the greatest difference in ECP and IgE concentrations. The tryptase concentrations did not differ, but only in the asthmatics they correlated significantly with IgE concentrations and IgE+ cells count. Subjective scores were decreased after therapy in both groups of patients and without correlation with objective parameters of inflammation. Asthmatic patients present a distinct subgroup among the patients with chronic rhinosinusitis (CRS). The levels of cellular markers and IgE in the sinus fluid differ from those of non-asthmatic patients with CRS. The activation of granulocytes (especially eosinophils), local IgE concentrations and the inflammatory cells infiltration are significantly higher in the asthmatics.

Chronic rhinosinusitis; asthma; cellular infiltration

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