The Efficacy Of Clarithromycin And Dexamethasone On Different Types Of CRS

Objective:Chronic rhinosinusitis (CRS) is a common disease which is characterized by persistent inflammation of the sinonasal mucosa in otorhinolarynology head and neck. Currently, both macrolide antibiotics and nasal glucocorticoids have been used for control the symptom of CRS, but the mechanism of its anti-inflammatory effect and what the difference between the effect of macrolide and glucocorticoids remains unclear. Our study mainly focused on the difference efficacy of clarithromycin and dexamethasone on broad panel of cytokines of sinonasal mucosa prior to and late the stimulus. To further insight into the probable mechanisms behind the beneficial effects of clarithromycin and dexamethasone。Methods:1Hematoxylin-eosin (HE) stain was used for histology characteristics of surgical samples and count total inflammatory cells and eosinophils.2Use of nasal mucosal Tissue explant culture measure, administrate clarithromycin or dexamethasone, then culture supernatant and nasal mucosal Tissue were collected after treatment. ELISA and real-time RT-PCR analysis were applied to detect the levels of related factors.Results:1According to the percentage of eosinophils out of total inflammatory cells, we divided the CRSwNP patients’tissue samples into eosinophilic CRSwNP and non-eosinophilic CRSwNP.2RANTES、IL-5、IL-13and ECP display higher expression levels only in eosinophilic CRSwNP.3IFN-g, TNF-α and IL-lb expression levels increased significantly in CRSsNP4There was basically no difference between the groups undergo clarithromycin and dexamethasone treatment on expression level of chronic rhinosinusitis related innate pattern recognition receptors, tissue remodeling and reconstruction factors, DCs phenotype critical epithelium-derived DCs regulated molecules and chemokine and cytokines of the Thl, Th2, Thl7and Treg cells.Conclusion:It should be emphasized that Th2responses enhanced obviously in eosinophilic chronic rhinosinusitis with nasal polyps (Eos CRSwNP), chronic rhinosinusitis without nasal polyps (CRSsNP) is confirmed to be a predominant Thl skewed inflammation, we found no significant difference in therapeutic efficacy between clarithromycin and dexamethasone treatment。...