Evaluation of substance P and bradykinin levels in nasal secretions of patients with nasal polyposis with and without sensitivity to non-steroidal anti-inflammatory drugs.

Objective: The role of neurogenic inflammation in pathogenesis of chronic rhinitis is well known. However, very little is known about its importance in pathogenesis of nasal polyposis (NP), especially in form of NP which appears as a part of aspirin-exacerbated respiratory disease (AERD). The aim of this study was to examine the concentrations of neuropeptides substance P (SP) and bradykinin (BK) in nasal secretions of patients with NP. Methods: Fourteen patients with NP as a part of AERD with mild persistent asthma, 14 patients with NP without aspirin sensitivity, and 14 control subjects without nasal inflammation (C) entered this cross-sectional study. Clinical parameters (symptoms, endoscopic, and radiological findings) were assessed. The concentrations of SP and BK were measured in the nasal secretion samples using commercial human enzyme immunoassay kits. Results: The concentration of SP in nasal secretions was significantly higher in NP patients without aspirin sensitivity and AERD patients compared to controls (p = .022; p < .0001, respectively), but higher in AERD than in non-AERD patients (p = .018). The level of BK in nasal fluid was higher in non-AERD and AERD NP patients than in controls (p < .0001; p < .0001, respectively), but also higher in AERD than in non-AERD patients (p < .0001). We found high positive correlations between BK in nasal fluid and Lund-Mackay computed tomography (CT) score in both non-AERD and AERD groups of NP patients. Conclusion: Our results suggest more intense release of SP and BK from the nasal mucosa in patients with AERD than in patients with NP who do not have aspirin sensitivity. The strong correlation between concentration of BK in nasal secretions and CT score suggests that BK in nasal fluid could be used as a marker for disease severity as measured by the Lund-Mackay score.

Comparison of cytokine levels in bilateral ear effusions in patients with otitis media secretoria.

OBJECTIVE: The aim of this study was to clarify the site of primary pathology in otitis media with effusion. STUDY DESIGN AND SETTING: The levels of the inflammatory mediators TNF-alpha, TNF-beta, IL-1beta, IL-8, IL-6, IL-4, IL-2, IL-5, IL-10, and IFN-gamma were measured in 54 pairs (108 samples) using specific enzyme-linked immunosorbent assays (ELISAs). RESULTS: The levels of pro-inflammatory cytokines TNF-alpha, TNF-beta, IL-1beta, IL-8, anti-inflammatory cytokines IL-5, IL-4, IL-10, IL-6, and cytokines with immunoregulatory potential IFN-gamma, IL-2 were different between both ears of the same patient. CONCLUSION: The results suggest that in one individual both ears have different immunological processes or rates and this has implications on using the opposite ear as a control in clinical trials. SIGNIFICANCE: Profiles of interlink of examined cytokines within the samples of both ear effusions were significantly different. A significant bilateral difference was found in the levels of IFN-gamma.

Cytokine levels in groups of patients with different duration of chronic secretory otitis.

Chronic secretory otitis relates to the permanent presence of secretion in the middle ear for more than 3 months. The reason why applied therapy is often ineffective is that, for now, etiopathogenic molecular mechanisms responsible for the cause and the course of the secretory process in the mucus of the middle ear have not been precisely defined. Cytokines are the key mediators in middle ear inflammation with secretory otitis and regulating different inflammation states can add to the cause of the molecular processes that lead to hystopathological changes in mucus and submucus characteristically for the chronic state of secretory otitis. The aim of our work was to define the pro-inflammatory, immunoregulatory and allergy-associated cytokine levels in middle ear secretion samples of diseased children and to compare the defined values with the secretory process continuance in groups of patients who were diseased for more or less than 3 months. According to the results that have showed higher concentration of all ten examined cytokines in the secretion samples of the children who had secretory otitis for a longer time, it can be concluded that the disturbance expression regulation of the pro-inflammatory TNFalpha, TNFbeta, IL1beta, IFNgamma, IL-6 and IL-8, as well as immunoregulatory IL-2 and IL-10, and allergy associated cytokines IL-4 and IL-5 relating to the hyper production can add to the conversion of the inflammatory process to the chronic state, which has been maintained for longer than 3 months.

Advantages of CO2 laser use in surgical management of otosclerosis.

BACKGROUND: Otosclerosis is a progressive osteo-destructive disorder of the bony labyrinth in which the fixation of the stapes causes the hearing loss. The aim of this study was the postoperative determination of parameters of the effect of surgical intervention on hearing and the incidence of complications and, on the basis of the differences in the examined parameters of the study, the estimation of the efficacy of the two mentioned surgical techniques in the treatment of otosclerosis. METHODS: In our research 40 patients with conductive hearing loss caused by otosclerosis underwent surgery with CO2 laser. Functional results were compared postoperatively with the results of 40 patients operated by the classical technique without the use of CO2 laser. The research was accomplished as a prospective comparative study. RESULTS: The air-bone interval (gap) as the difference between the rim of air and bone conductivity for separate frequencies did not significantly differ between the control and the experimental group. Both methods were effective in closing the air-bone gap with the rates of closure to within 10 dB in 82.6% and 75.3% for the laser and drill, respectively. The incidence of tinnitus was significantly lower in patients who underwent surgery with CO2 laser. The frequency of intraoperative and postoperative complications was significantly lower in the laser group. Differences were statistically significant for all parameters (p < 0.05). CONCLUSION: On the basis of the degree of postoperative hearing improvement, tinnitus and the incidence of complications it can be concluded that the use of CO2 laser during inverse stapedoplasty represents an effective and safe method, justifying the promotion of its use in the surgical management of otosclerosis.