Predicting the development of complications in patients with rhinosinusitis by cytokine profile indicators

Abstract

Aim. To develop a method for predicting the development of complications in rhinosinusitis patients based on the cytokine profile study.

Methods. We examined 110 patients with rhinosinusitis and 30 healthy donors (control group). The patients were divided into the group without a complicated course of rhinosinusitis (first group, n=65) and the group with a complicated course of rhinosinusitis (second group, n=45). The blood serum levels of interleukin (IL)-1β, IL-4, IL-8, IL-10, IL-17, IL-18, interferon (IFN)-γ were determined by enzyme immunoassay. Statistical analysis of the results was performed by using Microsoft Excel 2013 and Statistica 12.0 software. Statistically significant differences between the compared groups were determined by using the Mann–Whitney U-test, and p <0.05 was considered significant. Multivariate analysis included correlation analysis and stepwise regression analysis. The mathematical model consistency was determined by using Fisher's F-test, and p <0.05 was considered significant.

Results. Changes in cytokine profile manifested by a decrease in the level of interleukin-1β (p=0.00001), interleukin-4 (p=0.045) and an increase in the level of interleukin-18 (p=0.00001) were revealed in patients with uncomplicated course of rhinosinusitis. The complicated course of rhinosinusitis was characterized by a decrease in the level of interleukin-1β (p=0.00002), interleukin-4 (p=0.049) and an increase in the level of interleukin-8 (p=0.023), interleukin-17 (p=0.00015) and interleukin-18 (p=0.0002). Comparative analysis of the first and the second groups of patients showed an increased level of interleukin-8 (p=0.00001), interleukin-17 (p=0.0001) and reduced levels of interleukin-18 (p=0.00045) in the group of patients with complicated course of rhinosinusitis. Based on interleukin-17, interleukin-8 and interleukin-18 levels, the mathematical model for predicting the development of complications in patients with rhinosinusitis was developed.

Conclusion. The complicated course of rhinosinusitis was characterized by decreased levels of interleukin-1β, interleukin-4 and increased levels of interleukin-17, interleukin-8 and interleukin-18, indicating a more pronounced inflammatory process; for personalized therapy, an approach based on interleukin-17, interleukin-8 and interleukin-18 levels was developed on which the development of a complicated course in patients with rhinosinusitis can be predicted.

Keywords

rhinosinusitis / cytokines / immune system / prognosis

References

[1] Volkov A.G., Stagnieva I.V., Eroshenko A.Iu. Significance of local pain syndrome in patients with frontitis. Vestnik otorinolaringologii. 2010; (4): 38–40. (In Russ.)

[2] Волков А.Г., Стагниева И.В., Ерошенко А.Ю. Значимость локального болевого синдрома при фронтите. Вестн. оториноларингол. 2010; (4): 38–40.

[3] Lopatin A.S., Gamov V.P. Ostryy i khronicheskiy rinosinusit: etiologiya, patogenez, klinika, diagnostika i printsipy lecheniya. (Acute and chro­nic rhinosinusitis: etiology, pathogenesis, clinical picture, diagnosis and treatment principles.) M.: Pervyy MGMU im. I.M. Sechenova, 2013; 91 р. (In Russ.)

[4] Лопатин А.С., Гамов В.П. Острый и хронический риносинусит: этиология, патогенез, клиника, диагностика и принципы лечения. М.: Первый МГМУ им. И.М. Сеченова, 2013; 91 с.

[5] Svistushkin V.M, Shevchik E.A. Topical antibacterial therapy in the practice of otolaryngologist. Meditsinskiy sovet. 2019; (8): 10–17. (In Russ.) DOI: 10.21518/2079-701X-2019-8-10-17.

[6] Свистушкин В.М., Шевчик Е.А. Топическая антибактериальная терапия в практике отоларинголога. Мед. совет. 2019; (8): 10–17. DOI: 10.21518/2079-701X-2019-8-10-17.

[7] Eremeyeva K.V., Budeikina L.S. Speci­fics of the local treatment of acute otitis media. Meditsinskiy sovet. 2017; (8): 84–86. (In Russ.) DOI: 10.21518/2079-701X-2017-8-84-86.

[8] Еремеева К.В., Будейкина Л.С. Особенности топической терапии острого среднего отита. Мед. совет. 2017; (8): 84–86. DOI: 10.21518/2079-701X-2017-8-84-86.

[9] Kryukov A.I., Kunelskaya N.L., Ivoylov A.Yu., Garov E.V., Garova E.E., Yanovskiy V.V. New trends in the treatment of uncomplicated acute otitis media in adults: evidence-based approach. Meditsinskiy sovet. 2013; (7): 36–40. (In Russ.) DOI: 10.21518/2079-701X-2013-7-36-40.

[10] Крюков А.И., Кунельская Н.Л., Ивойлов А.Ю., Гаров Е.В., Гарова Е.Е., Яновский В.В. Новые тенденции в лечении острого неосложнённого среднего отита у взрослых с позиций доказательной медицины. Мед. совет. 2013; (7): 36–40. DOI: 10.21518/2079-701X-2013-7-36-40.

[11] Bayke E.V., Urazova O.I. The cytokine profile of blood in dependence on polymorphism of cytokine genes in patients with chro­nic purulent otitis media. Bulletin of Siberian Medicine. 2018; 17 (1): 24–35. (In Russ.) DOI: 10.20538/1682-0363-2018-1-24-35.

[12] Байке Е.В., Уразова О.И. Цитокиновый профиль крови в зависимости от полиморфизма генов цитокинов у больных хроническим гнойным средним отитом. Бюлл. сибирской мед. 2018; 17 (1): 24–35. DOI: 10.20538/1682-0363-2018-1-24-35.

[13] Baranova N.I., Shkurova N.A., Fedin A.V. Features of the microbial picture, the activity of the phagocytosis system and the profile of key cytokines in patients with rhinosinusites and otitis media caused by the type 2 diabetes. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. 2020; (2): 5–14. (In Russ.) DOI: 10.21685/2072-3032-2020-2-1.

[14] Баранова Н.И., Шкурова Н.А., Федин А.В. Особенности микробного пейзажа, активности системы фагоцитоза и профиля ключевых цитокинов у больных с риносинуситами и средними отитами на фоне сахарного диабета 2 типа. Известия высших учебных заведений. Поволжский регион. 2020; (2): 5–14. DOI: 10.21685/2072-3032-2020-2-1.

[15] Popov N.N., Gariuk G.I., Filatova I.V., Ognivenko E.V. Clinical immunological characteristics of the course of purulent maxillary sinusitis in patients with diabetes mellitus. Mezhdunarodnyy meditsinskiy zhurnal. 2007; (1): 103–107. (In Russ.)

[16] Попов Н.Н., Гарюк Г.И., Филатова И.В., Огнивенко Е.В. Клинико-иммунологическая характеристика течения хронического гнойного верхнечелюстного синусита у больных сахарным диабетом. Международн. мед. ж. 2007; (1): 103–107.

[17] Gurov A.V. Features of antibacterial therapy of acute purulent sinu­sitis and acute purulent otitis media. Meditsinskiy sovet. 2018; (6): 78–82. (In Russ.) DOI: 10.21518/2079-701X-2018-6-78-82.

[18] Гуров А.В. Особенности антибактериальной терапии острого гнойного синусита и острого гнойного среднего отита. Мед. совет. 2018; (6): 78–82. DOI: 10.21518/2079-701X-2018-6-78-82.

[19] Stagniyeva I.V., Simbirtsev A.S. Role of cytokine profile in manifestation of pain in rhinosinusitis. Tsitokiny i vospaleniye. 2015; 14 (4): 29–34. (In Russ.)

[20] Стагниева И.В., Симбирцев А.С. Значение цитокинового профиля в проявлении болевого симптома при риносинусите. Цитокины и воспаление. 2015; 14 (4): 29–34.

[21] Arefieva N.A., Aznabaeva L.F., Sharipova E.R. The role of interleukin 1-beta in pathogenesis and treatment of recurrent suppurative rhinosinusitis. Vestnik otorinolaringologii. 2012; (6): 51–52. (In Russ.)

[22] Арефьева Н.А., Азнабаева Л.Ф., Шарипова Э.Р. IL-1β в патогенезе и лечении рецидивирующего гнойного риносинусита. Вестн. оториноларингол. 2012; (6): 51–52.

[23] Shkurova N.A., Baranova N.I. Immunological aspects of the pathogenesis of rhinosinusitis and medium otitis with diabetes mellitus type 2. Rossiyskiy immunologicheskiy zhurnal. 2014; 8 (3): 641–644. (In Russ.)

[24] Шкурова Н.А., Баранова Н.И. Иммунологические аспекты патогенеза риносинуситов и средних отитов у больных на фоне сахарного диабета 2 типа. Рос. иммунол. ж. 2014; 8 (3): 641–644.

[25] Simbirtsev A.S. Tsitokiny v patogeneze i lechenii zabolevaniy cheloveka. (Cytokines in the pathogenesis and treatment of human diseases.) SPb.: Foliant. 2018; 512 р. (In Russ.)

[26] Симбирцев А.С. Цитокины в патогенезе и лечении заболеваний человека. СПб.: Фолиант. 2018; 512 с.

[27] Nacharov P.V., Klyachko L.L., Yanov Yu.K. Cytokines in the pathogenesis of otitis media. Tsitokiny i vospaleniye. 2016; 15 (1): 5–11. (In Russ.)

[28] Начаров П.В., Клячко Л.Л., Янов Ю.К. Цитокины в патогенезе средних отитов. Цитокины и воспаление. 2016; 15 (1): 5–11.

[29] Bezrukova E.V., Simbirtsev A.S., Kondratieva E.V., Kalashnikova O.V. The study of the levels of cytokines in nasal secretions of patients with various forms of rhinosinu­sitis. Tsitokiny i vospaleniye. 2012; 11 (2): 63–67. (In Russ.)

[30] Безрукова Е.В., Симбирцев А.С., Кондратьева Е.В., Калашникова О.В. Изучение роли цитокинов в носовом секрете больных различными формами риносинусита. Цитокины и воспаление. 2012; 11 (2): 63–67.

[31] Klimov A.V., Klimov V.V., Shustova V.A., Ta­zin I.D. Soderzhaniye IL-8, IL-17, IL-22 i IFN-γ v nazal′nom sekrete detey s khronicheskim adenoiditom i retsidiviru­yushchim kariyesom. Meditsinskaya immunologiya. 2015; 17 (S): 315. (In Russ.)

[32] Климов А.В., Климов В.В., Шустова В.А., Тазин И.Д. Содержание IL-8, IL-17, IL-22 и IFN-γ в назальном секрете детей с хроническим аденоидитом и рецидивирующим кариесом. Мед. иммунол. 2015; 17 (S): 315.

[33] Khaitov R.M. Immunologiya: struktura i funktsii immunnoy sistemy. Uchebnoe posobie. (Immunology: structure and function of the immune system. Tutorial.) M.: GEOTAR-Media. 2013; 280 р. (In Russ.)

[34] Хаитов Р.М. Иммунология: структура и функции иммунной системы. Учебное пособие. М.: ГЭОТАР-­Медиа. 2013; 280 с.

[35] Fedin A.V., Baranova N.I. Indicators of key cytokines in patients with acute bacterial rhinosinusi­tis. Mezhdunarodnyy nauchno-issledovatel'skiy zhurnal. 2013; (7-5): 78–79. (In Russ.)

[36] Федин А.В., Баранова Н.И. Показатели ключевых цитокинов у больных острым бактериальным риносинуситом. Международн. науч.-исслед. ж. 2013; (­7-5): 78–79.

RIGHTS & PERMISSIONS

Baranova N.I., Aschina L.A., Fedin A.V., Shkurova N.A., Sergeev S.V.