ASSESSMENT OF INFLAMMATION IN NONINFECTIOUS CHRONIC MAXILLARY SINUSITIS

Background and aim: Pathologic examination of the sinus mucosa and tit ration of inflammatory mediators in the sinus fluid were carried out t o characterize inflammation in chronic sinusitis and determine whether patients with chronic allergic rhinitis (CAR) and sinusitis differ fr om patients with chronic nonallergic rhinitis (CNAR) and sinusitis. Me thods: Nine central subjects (patients requiring ear; nose, and throat surgery not related to sinusitis), 12 patients with CAR and sinusitis , and 13 patients with CNAR and sinusitis were investigated. Eosinophi l cationic protein, tryptase, myeloperoxidase, histamine, and prostagl andin D-2 were measured in the sinus lavage fluids, and cells were enu merated. The cellular infiltrate was studied by immunohistochemistry w ith monoclonal antibodies against eosinophil cationic protein (eosinop hils), tryptase (mast cells), neutrophil elastase (neutrophils), CD3 ( lymphocytes), CD68 (macrophages), and proliferating cell nuclear antig ens. Results: Neutrophils were not increased in sinusitis. In comparis on with control subjects, patients with CAR and CNAR with sinusitis sh owed significant increases in eosinophils and macrophages in biopsy sp ecimens and in eosinophil cationic protein in sinus lavage fluids. In comparison with patients with CNAR, patients with CAR had an increased number of intraepithelial mast cells and lymphocytes. Conclusions: Th ese findings suggest chat patients with CNAR and sinusitis can be dist inguished from patients with CAR and sinusitis, which resembles nonall ergic rhinitis with eosinophilia syndrome.