Original scientific paper

Effects of long-term low-dose treatment by clarithromycin on Th1 cytokine levels in nasal discharge of patients with nasal polyposis

Aleksandar Perić ; Department of Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
Danilo Vojvodić ; Institute of Medical Research, Division of Clinical and Experimental Immunology, Military Medical Academy, Belgrade, Serbia
Vladimir Jakovljević ; Institute of Physiology, Medical Faculty Kragujevac, Serbia
Nenad Baletić ; Department of Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
Ivan Stanojević ; Institute of Medical Research, Division of Clinical and Experimental Immunology, Military Medical Academy, Belgrade, Serbia

Abstract

Aim: Inflammatory processes in nasal mucosa are reflected in various local mediators, found both in mucosal tissue and nasal discharge. In this prospective study, we assessed the effects of long-term low-dose oral administration of clarithromycin (CAM) on Th1 cytokines in nasal secretions and on clinical parameters of severity of nasal polyposis. Methods: A total of forty nasal polyp patients (22 nonallergic and 18 allergic) received 500 mg/day single oral dose of CAM for eight weeks. We measured the levels of proinflammatory Th1 cytokines TNF-α, TNF-β, IL-1β, IL-2, IL-12, and IFN-γ in the nasal fluid samples, before and after treatment by CAM, using flow cytometric method. Before and after therapy, we scored each of the 40 patients according to nasal symptom score and endoscopic score. Results: Following treatment, we found significantly reduced levels of TNF-α (p=0.006) in nasal secretions of nonallergic patients, and of IL-1β (p=0.008) in nasal fluid of allergic patients. Our results suggest an association between the reduction of nasal polyp size and reduction of TNF-α levels in nasal fluid of nonatopic patients and an association between the reduction of nasal polyp size and reduction of IL-12 levels in nasal discharge of atopic patients. Macrolide therapy decreased the size of polyps in 10/22 nonatopic and in 9/18 atopic patients. After macrolide therapy, we found 67.83% nonallergic subjects and 55.55% allergic subjects with improved nasal symptomatology. Conclusion: Long-term low-dose treatment with CAM is effective in the management of nasal polyposis, because of its antiinflammatory and immunomodulatory actions.

Keywords

chronic inflammation; clarithromycin; nasal polyposis; nasal secretions; Th1 cytokines

Hrčak ID:

80232

URI

https://hrcak.srce.hr/80232

Publication date:

1.3.2012.

Article data in other languages: croatian

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