Secretion of TGF-betal, TGF-beta2, EGF and PDGF into nasal fluid after sinus surgery.

Abstract

Wound healing is a highly coordinated process involving clot formation, inflammatory reaction, immune response and tissue remodeling. The transforming growth factor beta (TGF-beta), epidermal growth factor (EGF) and platelet-derived growth factor (PDGF) are known to be active during different phases of wound repair. The authors postulated that changes in the spontaneous secretion of these growth factors could be detected in nasal fluid after sinus surgery and propose a standardized technique to follow the healing process. The study was designed as a single-center prospective pilot study. Nasal secretions were obtained from eight patients at 1, 2 and 3 weeks after functional endoscopic sinus surgery (FESS) and compared to 13 controls. Nasal fluid was collected by sinus packing and was analyzed by ELISA for TGF-betal, TGF-beta2, EGF and PDGF. Comparing patients at 1 week after surgery with control subjects, a significant increase in the concentrations of TGF-betal, TGF-beta2 and PDGF in nasal secretions could be demonstrated ( P<0.001). At 2 and 3 weeks after surgery, decreasing amounts of these growth factors were found, nearly reaching normal conditions again. This decrease was not significant between visits. In contrast, EGF concentrations in nasal fluids tended to have decreased in patients 1 week after FESS compared to controls, with this level persisting during 3 weeks of mucosal healing. This is the first study proposing a follow-up method for nasal and sinus mucosal healing after surgery in order to determine cytokine secretion profiles.