The Clinical Significance Of Eosinophil Cationic Protein In Nasal Secretion Of Chronic Rhinosinusitis

Objective: To explore the role of eosinophilic cationic protein in nasal secretion for monitoring the degree of nasal inflammation and guiding clinical therapy in patients with chronic rhinosinusitis.Methods: Study was prospective, with 36 chronic rhinosinusitis aged 14 to 65 years; 20 deviation of nasal septum or orbital decompression patients aged 16 to 48 years served as controls. Patients with chronic rhinosinusitis were divided into allergic group (13 cases) and no-allergic group (23 cases) according to special IgE and symptoms scores. Collection of nasal secretion in middle meatus by suction was performed before treatment and treated 3 months later, eosinophilic cationic protein were measured by fluoroimmunoassay. Ethmoid mucosa specimens obtained during function endoscopic sinus surgery were stained by hematoxylin and eosin. The totalnumber of inflammation cells and the number of eosinophill in the tissue were counted at 400×magnification. At the same time symptom - oriented scores obtained, and the preoperative CT scans were scored by the staging system of Gliklich Meston.Results: The grade of the eosinophill infiltration in the ethmoid mucosa correlated with the total number of inflammation cells in chronic rhinosinusitis patients (r=0.48, P=0.003 ) . Allergy had effect on the proportion of the eosinophilic infiltration(P=0.019). Increased nasal level of eosinophilic cationic protein in patients were detected when compared with control subjects(P<0.05 ). And eosinophilic cationic protein concentrations were strongly related to the quantity of the eosinophill in the ethmoid mucosa (r=0.924, P < 0.05 ) . Checked at 3 months after treatment, eosinophilic cationic protein levels rose.Conclusions: According to this study, there is eosinophill infiltration in the ethmoid mucosa in most chronic rhinosinusitis patients, and allergy is one cause of the eosinophilic infiltration. The level of eosinophilic cationic protein is higher in nasal secretion in chronic rhinosinusitis patients than in controls. So the measurement of eosinophilic cationic protein in nasal secretion could be useful in monitoring nasal inflammation and guiding prescription in chronic rhinosinusitis patients.