Abstract

Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) share some similar pathological mechanisms. In current study, we intend to investigate the impact of AR on CRS. In addition, we explored the efficacy of erythromycin (EM) treatment on CRS mice with or without AR (CRSwoAR, CRSwAR). Study subjects were divided into control, CRSwoAR, and CRSwAR groups. Experimental mice were divided similarly into control, CRSwoAR, and CRSwAR groups. In addition, CRS mice were treated with EM at 0.75, 7.5, or 75 mg/kg or with dexamethasone (Dex) at 1 mg/kg. In our results, allergy exacerbates inflammation that was evident in nasal histology and cytokine expression both in patients and in mice with CRS. Dex 1 mg/kg, EM 7.5 or 75 mg/kg treatments significantly inhibited serum IgE and IgG2a in CRS mice. EM-treated CRS mice had significantly elevated IL-10 levels and had a reversal of Th-1/Th-2 cytokine expression in nasal-associated lymphoid tissue. MUC5AC expressions were significantly reduced in the 7.5 or 75 mg/kg EM-treated mice compared with untreated mice. EM showed inhibitions on immunoglobulin production and mucus secretion stronger than Dex. We concluded that comorbid AR enhanced inflammation of CRS. EM and Dex treatments showed similar anti-inflammatory effects on CRS but through partly different mechanisms.

Highlights

  • Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) share some similar pathological mechanisms

  • Patients were diagnosed with AR according to specific immunoglobulin E (IgE) tests and clinical history for at least 2 years on having allergic symptoms when contacted with allergens and irritants

  • Enrolled subjects were divided into three groups: control, CRS without allergic rhinitis (CRSwoAR), and CRS with allergic rhinitis (CRSwAR) groups

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Summary

Introduction

Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) share some similar pathological mechanisms. Allergy exacerbates inflammation that was evident in nasal histology and cytokine expression both in patients and in mice with CRS. EM-treated CRS mice had significantly elevated IL-10 levels and had a reversal of Th-1/Th-2 cytokine expression in nasal-associated lymphoid tissue. Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are the two most prevalent upper airway diseases. Epithelial barrier is formed by epithelium, intercellular tight and adherens junctions Together they maintain barrier integrity by controlling the paracellular permeability. Defects in the sinonasal epithelial barrier, increased exposures to pathogens, dysregulation of the host immune system and mucociliary clearance all of which are considered important in the pathophysiology of chronic r­ hinosinusitis[12,13]. Patients of CRS comorbid with allergy display immune responses comparable to those underlied by Th-2 inflammation

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