| Prognostic factors of chronic rhinosinusitis under long-term low-dose macrolide therapy. | |
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MedLine Citation:
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PMID: 10810255 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We studied the immunological and histopathological factors that affect the prognosis of chronic rhinosinusitis under long-term low-dose macrolide therapy. Sixteen patients with chronic rhinosinusitis were given 200 mg clarithromycin or 150 mg roxithromycin orally once a day without other concurrent treatments for 2-3 months. Measurement of the serum IgE level, blood cell count and differential leukocyte count of the peripheral blood, cytological assessment of the nasal smear and computed tomographic (CT) scans of the paranasal sinuses were performed before treatment. The opacity of the sinuses was estimated and scored by the CT images. After treatment, anterior ethmoidal mucosa samples were collected, an infiltrated inflammatory cells, interferon (IFN)-gamma-positive cells and interleukin (IL)-4-positive cells were examined histologically and immunohistochemically. The severity of nasal symptoms was scored before and after treatment, and the improvement rate of the score (symptomatic improvement rate) was calculated. Patients with normal levels of serum IgE (</=250 U/ml) showed a significantly higher symptomatic improvement rate than those with high levels of serum IgE (42.1 +/- 11.2 vs. 4.9 +/- 3.1%, p = 0.046). The symptomatic improvement rate was inversely correlated with the eosinophil counts in the peripheral blood (r = -0.51, p = 0.04), in the nasal smear (r = -0.54, p = 0.045) and in the sinus mucosa (r = -0.54, p = 0.02). Meanwhile, the CT score, the number of IFN-gamma-positive cells and IL-4-positive cells in the sinus mucosa and neutrophil counts in the nasal smear and in the sinus mucosa failed to correlate with the symptomatic improvement rate. These results suggest that macrolide therapy is indicated for patients without atopy or smear/tissue/peripheral blood eosinophilia. On the contrary, the severity of the disease, Th1/Th2 dominance in the sinus mucosa and neutrophilia are unlikely to be prognostic factors of chronic rhinosinusitis under long-term low-dose marolide therapy. |
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Authors:
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H Suzuki; K Ikeda; R Honma; S Gotoh; T Oshima; M Furukawa; T Takasaka |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: ORL; journal for oto-rhino-laryngology and its related specialties Volume: 62 ISSN: 0301-1569 ISO Abbreviation: ORL J. Otorhinolaryngol. Relat. Spec. Publication Date: 2000 May-Jun |
Date Detail:
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Created Date: 2000-08-31 Completed Date: 2000-08-31 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0334721 Medline TA: ORL J Otorhinolaryngol Relat Spec Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 121-7 Citation Subset: IM |
Copyright Information:
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Copyright 2000 S. Karger AG, Basel |
Affiliation:
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Department of Otolaryngology, Sendai National Hospital, Sendai, Japan. suzuhyde@mb.infoweb.ne.jp |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Anti-Bacterial Agents / administration & dosage*, therapeutic use Chronic Disease Clarithromycin / administration & dosage*, therapeutic use Drug Administration Schedule Eosinophils / metabolism Ethmoid Sinus* / metabolism, radiography Humans Immunoglobulin E / blood Immunohistochemistry Middle Aged Mucous Membrane / metabolism Prognosis Prospective Studies Roxithromycin / administration & dosage*, therapeutic use Severity of Illness Index Sinusitis / diagnosis, drug therapy*, metabolism Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 37341-29-0/Immunoglobulin E; 80214-83-1/Roxithromycin; 81103-11-9/Clarithromycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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