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Journal 'Cytokines & inflammation', 2015, No. 4

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Original Articles

Number 4'2015

Role of cytokine profile in manifestation of pain in rhinosinusitis

I.V. Stagnieva, A.S. Simbirtsev

Clinical forms of rhinosinusitis are changing, and pain symptom not always corresponds to severity of inflammatory process. The aim of the study was to determine the role of cytokines in pathogenesis of pain symptoms in rhinosinusitis. We have observed 380 patients with rhinosinusitis. Estimation of pain symptoms was performed using the "Multidimensional verbal and color pain test." All patients underwent investigation of the level of substance P (SP) and IL-1β, IL-4, IL-6, IL-8, IL-10, TNFα, INFγ in blood plasma, complete clinical and laboratory examination. Changes in the level of SP in the serum of patients were considered as a marker of violated immune interactions. In patients without pain symptoms with the level of SP less than 100 pg/ml. cytokine balance shifted towards anti-inflammatory cytokines, whereas the concentration of proinflammatory cytokines drastically reduced, resulting in immunodeficiency. An adequate immune response in rhinosinusitis was associated with typical pain symptoms, and the levels of SP in serum 100 to 2000 pg/ml. Very strong pain symptom was characterized by SP levels above 2000 pg/ml and suggested neurogenic inflammation. This resulted in dysregulated mechanisms of cytokine-mediated cooperation between T lymphocytes, humoral response failure, and prolongation of pain symptoms. Conclusions: 1) an adequate response of the immune system when the cytokine profile corresponds to the severity of the inflammatory process in rhinosinusitis is manifested with moderate pain symptoms; 2) a violation of immune reactivity as a dysregulation of cytokine-mediated mechanisms leads to atypical pain symptoms: lack of it or significant pain, not characteristic of rhinosinusitis; 3) shift of cytokine balance towards anti-inflammatory predominance reduces pain symptom, whereas prevalence of pro-inflammatory cytokines enhances and prolongs facial pain. (Cytokines and Infammation. 2015. Vol. 14. № 4. P. 29–34.)

Keywords: cytokines, rhinosinusitis, facial pain.

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