Neutrophil extracellular traps as an important part of the pathogenesis of chronic rhinosinusitis without polyps

Background. Chronic sinusitis occurs in the Russian Federation in 16.4±10.89% of the population and has a great impact on the quality of life of patients. The inflammatory process underlying this pathology is often resistant to conservative treatment and causes surgical intervention. The study of the role of neutrophil extracellular traps as an important part of the immune response, as well as the capabilities of drugs capable of influencing the processes of netosis, is an important and relevant area of modern research. Aim. Studying the role of NETs in the pathogenesis of CRS without polyps, assessing the effect of azoximer bromide on the metabolism of NETs in patients with CRS. Materials and methods. The study included 82 patients diagnosed with chronic rhinosinusitis (average age 37±12 years), and 40 healthy volunteers (average age 34±10 years). Patients with CRS were treated with surgery and a course of azoximer bromide, the severity of the disease did not differ in patients. Nasal secretions and venous blood were analyzed in all study participants with the determination of surrogate markers of neutrophil extracellular traps – myeloperoxidase complexes with DNA and the detection of double-stranded DNA (Quant Pico Green dsDNA kit). In patients who received azoximer bromide, the material was taken twice – before the start of treatment and 10 days after the course of treatment. Results. In patients with CRS, the amount of NETs in nasal secretions and venous blood is higher compared to the control group (p0.05). The use of azoximer bromide in CRS outside of exacerbation reduces the activity of NETosis processes with intranasal use of the drug not only in the area of inflammation (reduction of NET in nasal secretions); p0.05, but also at the general level (decrease NETs in venous blood); p0.05. Conclusion. An increase in the amount of NETs in nasal flushes and venous blood in patients with CRS without exacerbation compared with the control group may indicate a likely pathological role of NETosis processes, and an increase in the amount of NETs in the blood of patients with CRS without exacerbation compared with the control group indicates the systemic effect of a local inflammatory process in the mucous membrane of the nasal cavity and paranasal sinuses.