396). When we compared differences between endoscopic scores at the time points of 12 months and six months postoperatively (ESt12 minus ESt6), we found statistically lower differences in the clarithromycin-surgery group than in the surgery group (p = 0.006). Conclusion: Preoperative clarithromycin administration postponed nasal polyp relapse after FESS. Allergies have no influence on the clinical efficacy of clarithromycin therapy and on the efficacy of FESS.Keywords: Clarithromycin, long term, low dose, nasal polyposis, surgical procedures Efectos de la Administración de Claritromicina Preoperatoria en Pacientes con Poliposis Nasal

On histopathological examination, nasal polyps and nasal mucosa in allergic rhinitis show different forms of pseudostratifi ed respiratory epithelium, whereas the dominant characteristic of lamina propria is an eosinophilic infi ltration. The aim of this study was to compare interleukin (IL)-5 and eosinophilic cationic protein (ECP) levels in the nasal fl uid of 42 patients: 12 with allergic rhinitis and nasal septal deviation, 17 non-atopic patients with nasal polyposis, and 13 atopic nasal polyp patients were enrolled in this crosssectional study. Nasal secretion samples were collected a few days before surgery. The levels of IL-5 were measured using fl ow cytometry and the ECP using a commercial ELISA kit. In addition, we counted eosinophils in hematoxylin-and-eosin-stained sections of all nasal polyp and all nasal mucosa samples taken from the inferior nasal turbinates during septoplasty. A signifi cantly higher concentration of IL-5 was found in the nasal fl uid of atopic patients with nasal polyposis than in non-atopic nasal polyp patients (p=0.025) and patients with allergic rhinitis (p=0.05). ECP was higher in atopic nasal polyp patients than in patients with allergic rhinitis (p<0.0001) and than in non-atopic nasal polyp patients (p<0.0001). Polyp eosinophils were higher in atopic' than in non-atopic patients (p<0.0001) and higher than in the mucosa of patients with allergic rhinitis (p<0.0001). These however had signifi cantly more mucosal eosinophils than was found in the polyps of non-atopic patients' (p=0.025). ECP levels in nasal fl uid and eosinophil counts in tissue specimens correlated well in all three groups of patients. Our study has shown that atopic nasal polyp patients have a higher level of eosinophilic infl ammation than non-atopic patients with nasal polyps and patients with allergic rhinitis. Arh Hig Rada Tokiskol 2011;62:341-348 Allergic rhinitis is the most common atopic disease in the human population as it affects one in four people worldwide (1, 2). Its prevalence in the European countries ranges between 15 % and 25 %, with a tendency to rise by about 3.5 % with every decade (3). It is a type I allergic reaction mediated by mast cellbound immunoglobulin E (IgE) with a typical helper T-cell type 2 (Th2) profi le (3). KEY WORDS: eosinophilic cationic protein, eosinophils, epithelium, interleukin-5, nasal fl uid Perić A, et al. INFLAMMATORY MEDIATORS IN ALLERGIC RHINITIS AND NASAL POLYPOSISNasal polyposis is characterised by the proliferation of pseudostratifi ed respiratory epithelium, thickening of the basement membrane, oedema, proliferation of fi broblasts, focal fi brosis, and infl ammatory infi ltration of the lamina propria (4). The stromal layer of the polyp tissue includes mixed infl ammatory cells. The predominant histological form of nasal polyposis is the eosinophilic type, with an incidence of about 90 % (5). The non-eosinophilic form of nasal polyps is much less common and the dominant cells in the stroma are lymphocytes and plasmocytes (5). Polyps usually originate ...

Aims. Cytokine levels in nasal secretions reflect the inflammatory status of the nasal and paranasal sinus mucosa and the development of mucosal disease. The results of previous investigations suggest that macrolide antibiotics can be effective in treatment of chronic rhinosinusitis and nasal polyposis. The aim of this prospective study was to compare the immunomodulatory and clinical effects of long-term low-dose macrolide treatment of nonatopic and atopic patients with nasal polyposis.Methods. Forty (n = 40) patients with nasal polyposis, 22 allergic and 18 nonallergic were administered clarithromycin (CAM) 500 mg/day single oral dose for eight weeks. We measured the levels of proinflammatory Th1 cytokines TNF-α and IL-1β, Th2 cytokines IL-4, IL-5 and IL-6, and chemokine IL-8 in the nasal fluid samples, before and after treatment, using flow cytometric method. We also scored each of the 40 patients before and after therapy according to nasal symptom score and endoscopic score.Results. Following treatment, we found significantly reduced levels of IL-8 (p<0.01) and TNF-α (p<0.01) in nasal secretions in nonallergic patients. In subjects with nasal polyposis and allergy, we found decreased levels of IL-8 (p<0.01), IL-6 (p<0.05) and IL-1β (p<0.01). Macrolide therapy decreased the size of polyps in 45.45% of nonatopic and in 50% of atopic patients. After macrolide treatment, we found 67.83% patients in nonallergic group and 55.55% patients in allergic group with improved nasal symptoms.Conclusions. Long-term low-dose treatment with CAM was effective in the management of nasal polyposis. Our results showed that macrolide treatment of nasal polyposis have different immunomodulatory and similar clinical effects in allergic and nonallergic patients.

Extranasopharyngeal angiofibromas arising from the nasal cavity are extremely rare tumors. Immunohistochemical analysis is very important in all doubtful cases, especially in those with atypical location.

MIP-1α may play a role in eosinophil recruitment in NP. Our results suggest that the measurement of MIP-1α in nasal secretions could be useful in evaluating the degree of eosinophil inflammation and severity of disease in nonallergic patients.