Features of the inflammatory process of the nasal mucous membrane and paranasal sinuses in patients with chronic rhinosinusitis with nasal polyps

Objectives to assess the features of the inflammatory process of the nasal mucous membrane and sinuses in patients with сhronic rhinosinusitis with nasal polyps (CRSwNP). Material and methods. We analyzed the results of examination of 44 patients with CRSwNP. The objects of investigation were smears-reprints from the mucous membrane of the middle turbinate (rhinocytograms) and the intensity of the extracellular peroxidase activity of the lavage fluids of the maxillary sinuses. The data obtained were processed using the Statistica 8.0 software. Results. When analyzing rhinocytograms of the mucous membrane of the middle turbinates, the epithelial type of rhinocytogram was most often detected in 65.9% of cases (epithelial cells more than 50%); the eosinophilic type in 22.7% (eosinophils more than 1%) and smears with mast cells in 4.6% of cases; the neutrophilic type was less frequent (neutrophils more than 50%) 6.8% of cases. In 34.1% of patients, the cells of the columnar epithelium had pronounced changes in the cytoplasm (vacuolization and enzymatic activity); and in 38.6% of cases the gross pathology was recorded directly in the nucleus of the cells (nucleoli, granules, destruction of the nucleus). The revealed pathology of the cell nucleus suggests the viral etiology of the development of productive inflammation in the nasal cavity and sinuses In the lavage fluids of the maxillary sinuses, a high intensity of extracellular peroxidase activity was recorded (1777.9132.4 a.u. compared to 1225.0190.9 a.u. in patients with chronic purulent rhinosinusitis and 1245.0362.3 a.u. in patients with purulent-polypous rhinosinusitis). Conclusion. Chronic rhinosinusitis with nasal polyps is accompanied by a pronounced inflammatory process of the nasal mucous membrane and paranasal sinuses in the form of structural and functional changes in the cells of the columnar epithelium and a high intensity of extracellular peroxidase activity. The epithelial nucleus damage (the presence of nucleoli, granules, destruction of the nucleus) suggests a viral nature with the development of productive inflammation in the nasal cavity and sinuses.

Topical glucocorticosteroids in the treatment of patients with allergic rhinitis

Allergic rhinitis (AR) is a common disease that affects people regardless of age, place of residence or social status. As a rule, the allergen enters the body through the upper respiratory tract, the entrance gate is mainly the nasal mucous membrane. According to statistics, in recent years the frequency of perennial AR (PAR) in economically developed countries has been approaching 40-50%. In AR, inflammatory infiltration of the nasal mucous membrane by various cells is observed. Nowadays, AR is characterized by early onset, often with continuous relapsing course and resistance to antiallergic therapy. The study of the mechanisms of disease development creates the basis for rational therapy, which involves the impact on a complex inflammatory response, not only on the symptoms of allergy. Therefore, timely conservative therapy with intranasal topical glucocorticosteroid is advisable. The article shows the importance of the effectiveness of Flixonase intranasal spray in the treatment of AR. This drug may be recommended for the treatment of PAR. Studies of the use of the drug have shown a multi-purpose mechanism of its action. Flixonase significantly reduces the number of inflammatory cells in the nasal mucous membrane and inhibits the action of local inflammatory mediators in both seasonal ARs and PARs. To achieve the best results, the drug should be used at the first signs of nascent AR.

Epigenetic Regulation of Gene Activity in Epithelial Cells of Nasal Mucous Membrane in Patients with Polypous Rhinosinusitis

Nowadays, a wide clinico-laboratory polymorphism of “polypous rhinosinusitis” is observed. It suggests the potential role of heredity in the formation of the disease indicating the necessity of studying the role of genetic factor in the formation of various clinico-pathogenic variants of polyposis in detail.The objective of the research was to study the degree of functional abnormalities in the epithelial cell genome of the nasal mucous membrane in patients with polypous rhinosinusitis using the cytogenetic methods.Materials and methods.The article presents the results of cytogenetic study of 70 patients with various types of polypous rhinosinusitis (aspirin-intolerant and allergic). Hereditary predisposition to the disease was determined applying clinical and genealogical analysis.Results.Significant differences in the quantitative characteristics of the functional state of the nasal epithelial cell genome by the criterion of chromatization indices, the nucleolar index, the indices of the heteropyknotic X chromosome and pathologically altered nuclei were found in patients with aspirin-intolerant polypous rhinosinusitis as compared to those with allergic polypous rhinosinusitis as well as the control group.The identified changes serve as a criterion of the reduction in the activity of the transcriptional-translational processes in aspirin-intolerant polypous rhinosinusitis.Conclusions.The studied changes in the parameters of the functional state of the epithelial cell genome in the nasal mucous membrane provided an objective confirmation of hypothesis about epigenetic nature of pathology formation.