Interleukin-1 beta, interleukin-5, interleukin-6, interleukin-8, and tumornecrosis factor-alpha in chronic sinusitis: Response to systemic corticosteroids

Recently the role of various cytokines in the pathogenesis of chronic rhino sinusitis has come under investigation. Various studies have reported incre ased levels of interleukin-3, interleukin-4, interleukin-5, interleukin-13, and granulocyte macrophage-colony stimulating factor in the sinonasal muco sa of patients with chronic rhinosinusitis. The present study investigated the levels of pro-inflammatory cytokines, including interleukin-1 beta (IL- 1 beta), interleukin-5 (IL-5), interleukin-6 (IL-6), interleukin-8 (IL-8), and turner necrosis factor-alpha (TNF-alpha), in the sinonasal mucosa of pa tients with chronic rhinosinusitis, and evaluated the response of these cyt okines to oral corticosteroids. Chronic rhinosinusitis subjects (n = 15) an d control subjects (n = 9) underwent ent nasal endoscopy and biopsy of the sinonasal mucosa. Chronic rhinosinusitis subjects were subsequently tr trea ted with a 10-day tapering dose of prednisone followed by a second sinonasa l endoscopic exam and biopsy. Mucosal biopsy specimens were immunostained f or IL-I beta, IL-5, IL-6, IL-8, and TNF-a. In chronic rhinosinusitis subjec ts, mucosal levels of IL-1 beta IL,-6 IL-8, and TNF-alpha were significantl y elevated when compared with control subjects, and levels of IL-5 demonstr ated a strong trend toward elevation. In posttreatment chronic rhinosinusit is subjects, levels of IL-6 were significantly decreased when compared with pretreatment levels, and TNF-alpha levels demonstrated a significant trend coward reduction. These findings support the hypothesis that the inflammat ory response in chronic rhinosinusitis is associated with elevated levels o f pro-inflammatory cytokines, and suggest that oral corticosteroids may eve rt a benefic beneficial effect by significantly reducing the levels of IL-6 and TNF-alpha.