Cytokine production by sinus lavage, bronchial lavage, and blood mononuclear cells in chronic rhinosinusitis with or without atopy

Background: Chronic sinus inflammation may be determined partly by a balanc e of proinflammatory and counterregulatory cytokines and other mediators in the sinus. However, their mechanistic roles in chronic rhinosinusitis (CRS ) are not well understood. Objective: To evaluate production of proinflammatory (interferon gamma [IFN -gamma] and interleukin [IL] 12) and counterregulatory cytokines (IL-10 and IL-4) by sinus lavage (SL),bronchial lavage CBL), and peripheral blood mon onuclear (PBMN) cells in patients with CRS. Methods: We analyzed SL, BL, and PB samples obtained at surgery from 26 pat ients with CRS. Cytokine production was determined by culturing cells with or without stimuli. The results were evaluated in comparison with other inf lammatory variables (cytologic findings, total protein, IgG, and lactose de hydrogenase), bacterial cultures, and clinical features. Results: Production of IFN-gamma by SL, cells was variable and did not corr elate with other inflammatory variables, microbes grown, IL-10/IL-12p40 pro duction by SL cells, or IFN-gamma production by BL or PBMN cells. Productio n of IL-4 by lavage cells was undetectable. None of 10 patients with elevat ed IFN-gamma production (>800 pg/10(6) SL cells with mitogen stimuli had al lergic rhinitis, whereas 12 of 16 patients with, low IFN-gamma production ( <500 pg/10(6) SL cells) had allergic rhinitis with positive reactivity to c ommon aeoroallergens. There was no significant difference in other variable s measured between low and high IFN-gamma production groups. Conclusions: Elevated IFN-gamma production by SL cells may indicate much le ss possibility of allergic rhinitis in patients with CRS, but other variabl es measured did not differ in patients with high or low IFN-gamma productio n by SL cells.