Nasal interleukin-5, immunoglobulin E, eosinophilic cationic protein, and soluble intercellular adhesion molecule-1 in chronic sinusitis, allergic rhinitis, and nasal polyposis

Objective: To compare concentrations of interleukin-5 (IL-5), immunoglobuli n E (IgE), eosinophilic cationic protein (ECP), and soluble intercellular a dhesion molecule-1 (sICAM-1) in nasal secretion and serum of patients with chronic nonallergic sinusitis, allergic rhinitis, and nonallergic nasal pol yposis to obtain information about the pathogenesis of these diseases. Meth ods: Nasal secretion and serum were analyzed by routine enzyme-linked immun osorbent assay techniques. Nineteen patients with chronic nonallergic sinus itis, 24 patients with seasonal allergic rhinitis, and 18 patients with non allergic nasal polyposis were included in the study. Eight healthy, nonalle rgic probands served as control subjects. Results: Significantly elevated c oncentrations of IL-5 (5-fold, P < .05) and IgE (15-fold, P < .01) were det ected in nasal secretion of patients with allergic rhinitis (IL-5, 51.8 +/- 13.2 pg/mL; IgE, 41.9 +/- 20.9 kU/L) or nonallergic nasal polyposis (IL-5, 57.9 +/- 36.9 pg/mL; IgE, 40.5 +/- 20.2 kU/L) compared with controls (IL-5 , 10.6 +/- 7.8 pg/mL; IgE, 2.8 +/- 0.5 kU/L) or with patients with chronic nonallergic sinusitis (IL-5, 16.5 +/- 13.2 pg/mL; IgE, 5.4 +/- 3.1 kU/L). T here were no significant differences between patients with allergic rhiniti s and those with nonallergic nasal polyposis. Concentrations of ECP were si gnificantly elevated (sixfold, P < .01) in patients with allergic rhinitis (297.8 ng/mL +/- 173.1) compared with controls (52.4 +/- 28.0 ng/mL;) or pa tients with chronic nonallergic sinusitis (44.8 +/- 40.1 ng/mL), whereas tw ofold higher concentrations (not significant) of ECP were observed in patie nts with nonallergic nasal polyposis (107.1 +/- 26.6 ng/mL). Significantly elevated concentrations of sICAM-1 in nasal secretion (threefold, P < .05) were detected only in patients with chronic nonallergic sinusitis (79.4 +/- 45.6 ng/mL). The elevated sICAM-1 nasal secretion values in this group cor related significantly (P < .05) to the serum values. Conclusions: Equally e levated concentrations of IL-5 and IgE in patients with allergic rhinitis a nd nonallergic nasal polyposis implicated similar pathogenic processes in b oth diseases. Whereas the pathogenesis of allergic rhinitis is IgE-specific , the pathogenesis of nasal polyps is not as clear. IL-5 was suggested to p lay a pivotal role in tissue eosinophilia, which was confirmed by data in t he present study. Elevated concentrations of ECP were suggested to result f rom tissue eosinophilia-a characteristic of both diseases. Elevated concent rations of sICAM-1 in patients with chronic nonallergic sinusitis pointed t o its key role in the recruitment of neutrophils into the inflamed tissue, whereas an important role in eosinophil recruitment was ruled out.