Immune and cytological features of restoration of the nasal mucosa after combined treatment of chronic rhinosinusitis

Objective. To determine immunological, cytological and microbiome markers of the formation of functional deficit of the nasal mucosa (NM) after combined treatment of chronic rhinosinusitis (CRS). Patients and methods. A study of nasopharyngeal lavage cytokines (interleukin-1, -4, -6 and tumor necrosis factor-α), results of brush microbiopsy of the NM by an original method and analysis of DNA markers of opportunistic microorganisms and resident viruses were carried out in 108 patients with various nosological forms of CRS who underwent surgery or outpatient treatment with medium-dose intranasal glucocorticosteroids. The studies were performed upon admission and discharge from the hospital as well as 1 month after discharge. Results. Regression analysis identified predictors and protectors of functional deficit of the NM after combined treatment of CRS, which developed in 26% of patients. The following indicators were predictors of this functional deficit: high concentrations of interleukin-6 and interferon-α in nasopharyngeal lavage before surgery, as well as increased expression of DNA markers of the Staphylococcaceae family according to polymerase chain reaction data and coccal microflora according to brush microbiopsy of the NM. From anamnestic data, the patient’s smoking and exacerbations of CRS after acute respiratory viral infections were the predictors of this functional deficit. Conclusion. An effective and significant logistic equation that can be used to assess the risk of developing functional deficit of the NM after combined treatment of CRS was obtained.