Abstract
Background: The asthmatic triad (AT) is a well described condition manifesting as chronic rhinosinusitis with nasal polyposis (RP), asthma and intolerance to non-narcotic analgesics and non-steroidal anti-inflammatory drugs. Aim: The study was conducted to identify markers for the formation of unfolded AT in patients with nasal polyposis based on local and serum cytokine concentration. Methods: The subjects of the study were patients with RP (n = 68) and AT (n = 37). As a control was healthy (n = 209). Determination of the concentration of IL-2, IL-4, IL-6, IL-10, IFN-γ and TNFα in the serum and nasal washes was done using an enzyme-linked immunosorbent assay. Results: It was shown that the concentration of IL-2 in the serum and nasal washes was increased at RP and AT with respect to control. The concentration of IL-6 in the serum was higher with RP compared with the AT and control. The concentration of IL-10 in serum was increased with RP and AT with respect to control. Concentration of IFN-γ and TNFα in serum are higher at AT relative to RP and control. Conclusions: Cytokine imbalance is characterized by a deviation of the immune response to the Th1 type. Given the progression of the pathology from RP to AT, the increase of TNFα is likely to reflect the spread of the inflammatory process. Probably, the development of unfolded AT is accompanied by an increase in the concentration of IL-4, which activates the humoral mechanisms of the immune response. The revealed features of local and systemic concentration of cytokines at RP and AT can be used as markers of the prognosis for the formation of the unfolded AT.
Published Version
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