Backgrounds and Objectives: We studied the effect of long-term low-dose macrolide therapy on the level of IL-8, IL-1 beta, and TNF-alpha in the nasal secretions get from children with chronic rhinosinusitis before and after medication, and investigated the association between the changes in the chemical mediator levels and the clinical outcome before and after macrolide treatment.
Materials and Methods: The nasal lavage was obtained from 10 patients with nonallergic chronic rhinosinusitis and also from 10 healthy children. Nasal lavage was obtained before and 1 month after full dose (8 mg/kg ) macrolide administration, and then second lavage was obtained after half dose (4 mg/kg ) administration for 2 month. The level of IL-8, IL-1 beta and TNF-alpha in nasal lavage were measured by using ELISA kit. The symptoms were also scored by visual analogue scale before and after treatment.
Results: The IL-8 concentration was decreased from 317.4 pg/ml to 227.1 pg/ml at 12 weeks after this treatment (p<0.05). The level of IL-1beta was decreased from 412.5 pg/ml to 41.5 pg/ml (p<0.05), and TNF-alpha was also decreased from 49.8 pg/ml to 3.9 pg/ml (p<0.05). The symptoms of most patients with macrolide treatment were improved at 3 months after treatment.
Conclusion: Macrolide decreased the concentration of inflammatory mediators in nasal discharge, such as IL-8, IL-1beta and TNF-alpha and this anti-inflammatory effect of macrolide could explain the way of improvement with subclinical dosage of drug.
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