Role of Vitamin D and Its Receptors in the Pathophysiology of Chronic Rhinosinusitis.

OBJECTIVES: Chronic rhinosinusitis (CRS) is a disease that represents a challenging therapeutic problem. Vitamin D and its receptors (VDR) are involved in the regulation of the immune system and may play role in CRS. Objectives of this study were to assess the relationships between the total concentration of vitamin D (25VD3) in sera, vitamin D receptor (VDR) expression, 1α-hydroxylase expression, and clinical data, including age, gender, Sino-Nasal Outcome Test (SNOT-22), computerized tomography (CT) scan, allergy status, and vitamin D supplementation in CRS patients with (CRSwNP) and without nasal polyps (CRSsNP), and in a control group. METHODS: The studied group comprised 52 patients with CRS without nasal polyps (sNP), 55 with CRS with nasal polyps (wNP), and 59 in the control group. The endpoints were determined by appropriate methods. We conducted immunohistochemical staining of gathered tissue from the ostiomeatal complex for determination of VDR and 1α-hydroxylase. Analytical results were compared with clinical data as already noted. RESULTS: A decrease in VDR nuclear staining occurred in CRS patients as compared to controls. Insignificant differences were observed in 1α-hydroxylase, expression in all studied groups, while VDR and cytochrome CYP27B1 protein expression (1α-hydroxylase) correlated with clinical data. CONCLUSIONS: The data provide evidence that indicates that vitamin D and its receptor and enzymes may play a role in CRS.

[Efficacy of noninvasive hemolaserotherapy in patients with bronchial asthma and concomitant rhinosinusitis]. / Effektivnost' neinvazivnoi gemolazeroterapii u bol'nykh bronkhial'noi astmoi s soputstvuiushchim rinosinusitom.

AIM: To study efficacy of low-intensive infrared laser radiation impact on the tympanic membrane in patients with bronchial asthma (BA) and concomitant rhinosinusitis (RS). MATERIAL AND METHODS: 78 patients with moderate BA of a mixed type and concomitant chronic RS were divided into 3 groups: group 1 patients received medication plus infrared laser radiation of the tympanic membrane and paranasal sinuses; group 2 patients were exposed to supravenous laser radiation (0.63 mcm); group 3 received pharmacotherapy alone. The effect of the treatment was assessed by spirometry, peakflowmetry and paranasal sinuses findings. RESULTS: The highest response was achieved in group 1 which manifested with positive changes in clinical, device and spirometric data on BA and x-ray data on RS courses. The least effective treatment was observed in group 3. CONCLUSION: Use of infrared laser radiation of the tympanic membrane and paranasal sinuses projection in the treatment of BA patients with RS is effective, nontoxic and easy to use both in hospitals and outpatient departments.

The role of interleukin-12, and tissue antioxidants in chronic sinusitis.

BACKGROUND: The role of cytokines and reactive oxygen species formation in the pathogenesis of chronic sinusitis is still not fully understood. This work was designed to determine if patients with chronic sinusitis demonstrate altered levels of serum IL-12 and/or tissue antioxidants. SUBJECTS AND METHODS: Mucosal biopsy specimens from the uncinate process of patients with chronic sinusitis were obtained from 52 patients using functional endoscopic sinus surgery. Normal mucosa samples were collected from 20 healthy controls. Patients' group was further classified according to computerized tomography findings into mild and severe subgroups. Serum IL-12 was estimated using enzyme immunoassay (EIA). The levels of tissue uric acid, and reduced glutathione were determined biochemically, alpha-tocopherol was measured by HPLC. Superoxide dismutase (SOD) activity was determined by spectrophotometry. RESULTS: A significant decrease in serum IL-12, tissue alpha-tocopherol and SOD in patient group was demonstrated (p < 0.05). Tissue uric acid and reduced glutathione showed primary increase in mild subgroup followed by significant drop in severe subgroup (p < 0.05). Negative significant correlation was observed between glutathione, uric acid, and SOD, and the severity of the disease (p < 0.05) independent of the cellularity of the biopsy. CONCLUSION: The presented data suggests a possible role of IL-12, and tissue antioxidants in development and progression of chronic sinusitis. Adjuvant antioxidant treatment may have role in achieving better prognosis of the disease.