Granulocyte-Macrophage Colony-Stimulating Factor Production and Tissue Eosinophilia in Chronic Rhinitis

Abstract Introduction Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a strong proinflammatory cytokine that takes part in allergic nasal inflammation as an eosinophil colony-stimulating factor. However, the role of GM-CSF in non-allergic rhinitis has not been fully explored. Objectives The aim of this investigation was to assess the concentration of GM-CSF in nasal secretions of patients with non-allergic rhinitis with eosinophilia syndrome (NARES) in comparison to patients with perennial allergic rhinitis (PAR) and healthy subjects, as well as to assess the relationship with the degree of eosinophilic inflammation and clinical characteristics of the patients. Methods Fourteen patients with diagnosis of NARES, 14 PAR patients, and 14 healthy subjects were included in this cross-sectional study. All patients underwent symptom score assessment, nasal endoscopy, allergy testing, and cytological evaluation. The concentration of GM-CSF in nasal secretions of all participants was measured by enzyme-linked immunosorbent assay ( ELISA ). Results We found significantly higher levels of GM-CSF in patients with NARES than in the control group (p= 0.035). The percent of eosinophils in nasal mucosa was higher in NARES patients in comparison to patients with PAR (p< 0.001) and control patients (p< 0.0001). We found positive correlations between GM-CSF levels and eosinophil counts only in NARES patients. Conclusion The concentrations of GM-CSF in nasal secretions correlate well with eosinophil counts in the nasal mucosa of NARES patients. These facts indicate a possible role of GM-CSF as a favorable marker for assessment of nasal disease severity and the degree of chronic eosinophilic inflammation in the nasal mucosa.

Granulocyte-Macrophage Colony-Stimulating Factor Production and Tissue Eosinophilia in Chronic Rhinitis.

Introduction Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a strong proinflammatory cytokine that takes part in allergic nasal inflammation as an eosinophil colony-stimulating factor. However, the role of GM-CSF in non-allergic rhinitis has not been fully explored. Objectives The aim of this investigation was to assess the concentration of GM-CSF in nasal secretions of patients with non-allergic rhinitis with eosinophilia syndrome (NARES) in comparison to patients with perennial allergic rhinitis (PAR) and healthy subjects, as well as to assess the relationship with the degree of eosinophilic inflammation and clinical characteristics of the patients. Methods Fourteen patients with diagnosis of NARES, 14 PAR patients, and 14 healthy subjects were included in this cross-sectional study. All patients underwent symptom score assessment, nasal endoscopy, allergy testing, and cytological evaluation. The concentration of GM-CSF in nasal secretions of all participants was measured by enzyme-linked immunosorbent assay (ELISA). Results We found significantly higher levels of GM-CSF in patients with NARES than in the control group (p = 0.035). The percent of eosinophils in nasal mucosa was higher in NARES patients in comparison to patients with PAR (p < 0.001) and control patients (p < 0.0001). We found positive correlations between GM-CSF levels and eosinophil counts only in NARES patients. Conclusion The concentrations of GM-CSF in nasal secretions correlate well with eosinophil counts in the nasal mucosa of NARES patients. These facts indicate a possible role of GM-CSF as a favorable marker for assessment of nasal disease severity and the degree of chronic eosinophilic inflammation in the nasal mucosa.

Nonselective chemokine levels in nasal secretions of patients with perennial nonallergic and allergic rhinitis.

BACKGROUND: An increased production of several chemoattractants, responsible for guiding the eosinophilic inflammatory process, has been reported in chronic rhinitis. The aim of this study was to evaluate nasal secretion levels of monocyte chemoattractant protein-1 (MCP-1), MCP-3, and regulated on activation normal T cell expressed and secreted (RANTES) and to correlate those levels with nasal symptoms and degree of eosinophilia in patients with nonallergic rhinitis with eosinophilia syndrome (NARES) and perennial allergic rhinitis (PAR). METHODS: Fourteen patients with PAR and 14 NARES patients were recruited for this cross-sectional study. Fourteen healthy subjects were included as controls. The concentrations of MCP-1, MCP-3, and RANTES in nasal secretions were measured using enzyme-linked immunosorbent assay (ELISA). Eosinophil counts were performed by percentage of differential granulocyte counts during cytological examination of scraped nasal mucosa obtained from the inferior turbinate. Therefore, we scored rhinitis patients according to nasal symptom score. RESULTS: We found significantly higher concentrations of MCP-1 (p < 0.0001), MCP-3 (p = 0.018), and RANTES (p < 0.0001) in nasal fluid of NARES patients compared to patients with PAR. In PAR patients, we found positive correlation between RANTES levels and nasal symptom score and eosinophil counts. In patients with NARES, the concentrations of MCP-1 and RANTES were associated with nasal symptom score and percentage of eosinophils. CONCLUSION: NARES is characterized by higher degree of eosinophilic inflammation than PAR. RANTES correlates well with the level of eosinophilic inflammation in both diseases. The measurement of chemokine levels in nasal secretions could be useful in evaluating the degree of chronic nasal inflammation.

Large Doubly Septated Concha Bullosa: An Unusual Anatomic Variation.

Partial or total pneumatization of the middle turbinate is called concha bullosa. It's one of the most common anatomic variations of the lateral nasal wall. The exact reason of such pneumatization is not known. It can originate from the frontal recess, middle meatus, sinus lateralis or, less frequently, from the posterior ethmoid cells. Concha bullosa remains usually asymptomatic. However, an extensively pneumatized middle turbinate may constitute space-occupying mass, and thus, it may cause nasal obstruction. We report an extremely rare case of a patient with a large, doubly septated concha bullosa with four different sources of aeration.