Journal
JOURNAL OF LARYNGOLOGY AND OTOLOGY
Volume 126, Issue 5, Pages 495-502Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0022215112000485
Keywords
Nasal Polyps; Clarithromycin; Eosinophils; Allergy; Rhinitis; Cytokines
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Funding
- Military Medical Academy
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Background: Little is known about the effects of macrolides on the cytokines and chemokines that modulate the function of eosinophils in nasal polyposis. Methods: Twenty-two non-allergic and 18 allergic patients with nasal polyps were administered clarithromycin 500 mg/day (single oral dose) for eight weeks. We measured the nasal secretion levels of the T helper 2 (also known as Th2) cytokines interleukin 4, 5 and 6, the 'regulated on activation, normal T cell expressed and secreted' (also known as RANTES) chemokine, and the eosinophilic cationic protein, before and after treatment. Results: After clarithromycin treatment, we found reduced levels of the 'regulated on activation, normal T cell expressed and secreted' chemokine in samples from both non-allergic and allergic patients (p < 0.05). Clarithromycin treatment decreased the levels of eosinophilic cationic protein only in non-allergic patients (p < 0.05), and decreased the level of interleukin 6 only in allergic patients (p < 0.05). Decreased levels of the 'regulated on activation, normal T cell expressed and secreted' chemokine were associated with a reduction in polyp size both in non-allergic and allergic patients. Conclusion: Clarithromycin has a strong anti-inflammatory effect in nasal polyposis, but has different immunomodulatory effects in allergic and non-allergic nasal polyposis patients.
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